It's hard to believe that a disease so deadly and so widespread around the globe gets so little attention. I'll bet if I asked 100 people in the US what single infectious disease agent kills more people than any other, not one person would come up with the right answer. And I also bet that when I give them the answer, I will be met by a puzzled look and the question, "Really? I thought that disease was long gone."
Do you think you know?
It's tuberculosis. TB.
TB made 9.6 million people sick in 2014 and killed 1.5 million. It killed more people than HIV/AIDS, more people than malaria and about a hundred times more people than Ebola.
I mention these other diseases to help bring perspective. People in the public health field don't like to compare diseases like that. We believe that all diseases causing human suffering should have appropriate investments to control and prevent them. But today is World TB Day - and it's important to understand the impact of this global epidemic to encourage the political will and world interest to bring it to an end.
Current investments in TB vaccine research and development (R&D) are consistently quite low compared to other diseases. In fact, in 2014 HIV vaccine R&D received six times the amount of funding that was invested in TB vaccine R&D ($652 million compared to $112 million).
It's particularly important to support R&D for a new, effective, and affordable TB vaccine. Here's why:
1. The human cost of this disease is enormous. Someone dies from TB every 21 seconds. That's over 4,000 people every day.
2. It is spread through the air. People with active TB spread the disease by coughing, sneezing and talking. TB is most easily spread to family members and work colleagues who are in close contact. But it can be spread on a bus, train, plane or other close quarters.
3. The economic impact of TB is staggering for individuals, families, communities and governments. Adults with TB are often unable to work for at least four months and may have difficulty caring for their children. While TB can affect anyone, most people who contract the disease are living in poverty. The lost wages and costs of care are especially burdensome to these people, who already face numerous financial challenges. This is only amplified when the disease spreads among family members.
4. Superbugs are a serious threat and have been reported in 105 countries, including the U.S. Multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) increase treatment time and costs, and cause potentially debilitating side effects for patients. Treatments last for at least 18 months, with 6 months of painful injections, and can cause substantial side effects that make it difficult for some patients to complete treatment. Only about half of people with MDR-TB survive, and even fewer survive XDR-TB1. And it can cost 5 to 15 times more to treat MDR- and XDR-TB than drug-sensitive TB. In the U.S., treating a single case of XDR-TB can cost more than $400,000 - enough to wipe out some cities' total public health budget for a year. While diseases consistently develop resistance to drugs, vaccines are typically effective against even those strains that become resistant to treatment.
5. A new effective and affordable TB vaccine would be the ultimate game changer that could help end this epidemic. History is clear. Vaccines have been crucial in combatting other deadly infectious diseases, such as polio, smallpox, measles, and tetanus. The World Health Organization (WHO) and other key stakeholders agree that treatment alone will not end the TB epidemic. Investments in R&D for new tools, including improved drugs, diagnostics, and vaccines, are essential to eliminate TB and end the tremendous human suffering it causes. The only current vaccine is not the answer. Developed nearly 100 years ago, the BCG vaccine is only moderately effective in preventing severe TB in infants and young children - and it doesn't adequately protect teens and adults, who are most at risk for developing and spreading TB.
6. Investing in TB vaccine R&D makes economic sense. The WHO estimates that TB costs the world $8 billion every year1. Looking at the next five years, experts estimate that $1.25 billion is needed for TB vaccine development. Since vaccine development is likely to take at least ten years, let's double that amount to $2.5 billion over the next ten years for the sake of this conversation. That would average $250 million each year. $250 million per year to develop a new TB vaccine. Versus the $8 billion the world spends every year responding to TB. In September of last year, the United Nations endorsed its new Sustainable Development Goals, which include a target to end the TB epidemic by 2030. This goal simply cannot be met without a new, effective vaccine. And NOT making these investments only increases the human and economic costs of TB, resulting in millions more unnecessary illnesses and deaths, and millions of dollars in cost of care, and lost productivity.
There is great hope that the TB vaccine the world needs so desperately is achievable. We have so many promising scientific avenues worthy of exploration, but they remain untouched without sufficient resources. And with these tools left undiscovered, the disease continues to take a tremendous personal and economic toll around the world.
This post is part of the 'The Isolation of Airborne Cancer' series produced by The Huffington Post for World TB Day. This series will look at the devastating issues surrounding tuberculosis, the number one infectious killer. To follow the conversation on Twitter, view #WorldTBDay.
139 days of isolation: What it's like living with Tuberculosis
'Make it stop': The tender casualties of drug-resistant Tuberculosis
UN special envoy on Tuberculosis: Giving voice to the voiceless