Which came first, the chicken or the egg? Much as Aristotle reasoned that both the chicken and the egg must have always existed, we come to a similar conclusion when debating which came first, poverty or tuberculosis (TB)? Both must have always existed. Poor people around the world are much more susceptible to TB and TB is also a leading cause of poverty around the world.
ACTION was created in 2004 to combat the global incidence of TB infection. At that time, many of ACTION’s partners were already advocating around TB since TB infection was the number one reason that women were not able to repay their microfinance loans throwing them and their families further into poverty.
The financial and time costs of TB treatment too often exceed the ability of a patient in an endemic country to pay for it. There is the direct cost of the drugs themselves, which can top more than $5,000 for some types of TB. There is also the "opportunity cost" from having to travel long distances multiple times per week to take these drugs in front of health workers. Too frequently, patients will stop going for treatment once they begin to feel better because they are eager to get back to work in order to provide for their families. Failing to adhere to an entire drug regimen can breed drug-resistant TB, which can be more difficult to diagnose, take longer to treat and incorporate more expensive drugs. This treatment time could be used running a small business or working to earn even a modest income. Furthermore, in low income regions, those infected with TB are frequently stigmatized and are unable to interact with others. This environment pushes people even deeper into a situation of poverty and social immobility.
Along with its allies, ACTION has mobilized billions of dollars for TB prevention and treatment through both direct U.S. foreign aid and U.S. contributions to multilateral funding institutions such as The Global Fund To Fight AIDS, Tuberculosis and Malaria. Since ACTION’s establishment, the incidence of TB has been falling, complementing the fall in global poverty rates. However, much still needs to be done.
Only HIV is more prevalent than TB. Globally, one in three people is infected with TB. Drug resistance is growing at a frightening rate across the globe, and TB/HIV coinfection remains one of the most alarming issues in global health. Every year millions of people still fall into poverty due to TB.
Moving forward, until we have a safe and viable vaccine, we need faster, cheaper, and more accurate diagnostics that can reduce the amount of time people have to spend away from work. We need simpler and more effective drug therapies that enable patients to return to work more quickly and that address the threat of drug resistance. Finally, we need to advocate in high burden countries to decrease the financial and social costs of TB infection.
Through these efforts, we can continue to further reduce the incidence of TB around the world and foster the amelioration of global poverty.
By Jordan Emont, a senior at George Washington University studying International Affairs with a double concentration in Global Public Health and Latin America and a double minor in History and Public Health. He is currently interning at RESULTS Educational Fund working with its global health advocacy partnership ACTION.
This blog is part of a series in recognition of the UN's International Day for the Eradication of Poverty, Oct. 17.