Support TB interventions now to protect against future threats 

For Fetene, the conflict in Ethiopia not only cost her family their home—it also endangered her health. After fighting broke out in Amhara, Fetene and her two daughters were forced to flee the region, traveling for days on foot. But while seeking refuge at a shelter for internally displaced people (IDPs), Fetene realized that she had not taken her TB medication for six weeks. “I asked if there was a nearby health center so I could get my medication, but then the conflict reached us and we had to run again,” Fetene explains.  

Eventually, a medical team supported by the USAID Eliminate TB Project at another IDP center began screening people for TB to help identify those whose treatment was disrupted by the conflict. “Thanks to the medical team, I managed to restart my drugs,” Fetene said. Through the coordinated search for patients among the displaced population, the project helped identify 119 people like Fetene across 20 IDP centers, allowing those patients to restart their treatment course and get back on the road to recovery.  

Fetene may live thousands of miles from Washington, D.C., but her fate, and those of millions of others in similar situations, is inextricably tied to two things happening in the U.S. in the coming months: the United Nations High Level Meeting (HLM) on TB is being held in New York and Congress is set to consider the bipartisan End Tuberculosis Now Act (ETNA) of 2023, which calls for a strengthened commitment to the global fight against TB. By passing the ETNA and making robust commitments at the HLM, the U.S. can both demonstrate leadership against a scourge we know how to defeat and help prepare the world for unknown threats to come.  

Before the COVID-19 pandemic, TB was the largest infectious killer in the world, causing more deaths annually than HIV/AIDS and malaria combined—even though the global health community has the knowledge to treat, cure, and even prevent it. Now that the danger of COVID-19 has started to recede, the threat from TB still looms. In 2021, an estimated 10.6 million people contracted TB and 1.6 million died. TB is the leading killer of people living with HIV, and it is responsible for one in three deaths stemming from antimicrobial resistance. Unless the global community renews its efforts for 2023-2030, the Stop TB Partnership estimates that this largely preventable disease will result in $1 trillion in global economic loss. 

At the UN’s first HLM on TB in 2018, world leaders set bold goals, allocated new funds, and changed policy to kickstart a new era of TB response. In many countries, the resulting programs (which the U.S. supported) were instrumental in addressing COVID-19; the PCR testing machines, infection prevention protocols, contact tracing systems, and other established components of TB response became key weapons in the fight against the novel coronavirus. 

But as a result, TB response suffered, and cases have surged.  

Passing the ETNA, authored by Sens. Robert Menendez (D-N.J.) and Todd Young (R-Ind.) in the Senate and Reps. Ami Bera (D-Calif.) and Maria Elvira Salazar (R-Fla.) in the House, is a critical step to reestablishing bold goals, strengthening bilateral coordination to adapt and improve the global TB response, and revitalizing research and development efforts to address the growing worldwide threat of drug-resistant strains.  

A strong response to TB means we will be better prepared for the next respiratory pandemic. It is crucial for the U.S. to lead the way in reinvigorating these programs and integrating them into primary health care—for the sake of people like Fetene, who suffer from TB today, and for all of us who are at risk from potential disease outbreaks in the future. 

Ben Weingrod is director of policy and advocacy at Management Sciences for Health, a global nonprofit health advisory organization. Dr. Daniel Gemechu Datiko is the Chief of Party of the USAID Eliminate TB Project and country representative of Management Sciences for Health in Ethiopia.