The threat of an emerging crisis of a multi-drug resistant tuberculosis around the world was the topic of a hearing Tuesday by Congressman Chris Smith (NJ-04), head of the House Foreign Affairs Global Health Subcommittee, who convened a hearing on “Drug Resistant Tuberculosis: The Next Global Health Crisis.”

Smith’s subcommittee heard testimony from three witnesses who are among the world’s leading experts on combatting TB: United Nations Special Envoy Dr. Eric Goosby; Centers for Disease Control and Prevention (CDC) Director Dr. Tom Frieden, and; USAID’s top medical expert, Dr. Ariel Pablos-Mendez. Smith warned that not enough attention is being paid to eradicating tuberculosis (TB)—a contagious airborne disease which killed 1.5 million people last year—twice the number of deaths of Ebola in West Africa.

“Our next great global public health crisis may very well be multi-drug resistant tuberculosis,” Smith said. “Just as Ebola surprised many at the ferocity with which it spread, I am concerned that the world is not prepared to meet the threat from this highly contagious airborne disease which killed 1.5 million people last year alone.”  Click here to read Smith opening remarks.

            The United States, the CDC reports there were 555 deaths from TB in 2013, the most recent year for which these data are available. This is an 8 percent increase from the 510 TB deaths in 2012. Overall, the number of TB deaths reported annually has decreased by 67 percent since 1992, its recent historical peak. Occasional outbreaks such as those at a Kansas high school this year, and in Jacksonville, Fla. in 2012 have occurred.

“These experts have spoken on the need for proactive vigilance. A sustained focus on tuberculosis prevention today will save lives and money tomorrow, helping people the world over as well protecting the homeland from what otherwise could become a global pandemic,” said Smith.

Dr. Eric Goosby briefed congressional members that “TB is the number one infectious disease killer in the world, surpassing HIV/AIDS…. In this case, being number one is not an achievement – there is no trophy for taking more lives than any other disease.” Click here to read Dr. Goosby’s opening remarks.

Goosby, who was the US Global AIDS Coordinator before assuming his UN post, pointed to a new World Health Organization report on global TB, released on October 28, which estimated that last year some 480,000 people developed multi-drug resistant TB (MDR TB), which is far harder to treat.  Some 10 percent of multidrug-resistant cases are extremely drug resistant, according to the WHO report.

CDC’s Frieden remarked that the spread of MDR TB “is a global health security concern worldwide, threatening decades of progress in TB prevention and control.” He added that even in countries with low TB rates, such drug resistant cases can strain the public health system. The problem is even greater in vulnerable nations, where CDC is helping such nations build core public health competencies. Click here to read Dr. Frieden’s opening remarks.

“New data released this fall by the WHO shows that tuberculosis is now the leading infectious killer in the world,” Dr. Pablos-Mendez said. “Each day, more than 4,100 individuals die, each week, more than 28,000—more than twice the total number of deaths from Ebola in West Africa since the outbreak began—and each year, 1.5 million succumb to this preventable disease. In 2014, approximately 9.6 million people developed TB, including 3.2 million women and 1 million children.” Pablos-Mendez testified that TB affects individuals in the most economically productive age groups and is one of the top five causes of death among women of reproductive age. TB predominantly affects the poorest and most vulnerable, and approximately 95 percent of TB deaths occur in low- and middle-income countries, he said. Click here to read Dr. Pablos-Mendez opening remarks.

The hearing attracted bipartisan support, with the co-Chair of the House Tuberculosis Elimination Caucus, Rep. Eliot Engel of New York, joining the members of the subcommittee. 

Smith finished by stressing a positive note, saying “We can eliminate TB, just as we have successfully fought polio. It takes political will, however, and an investment of resources that will pay dividends in the long run.”

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