White House unveils plan for battling MDR-TB

The White House yesterday released a federal action plan for fighting multidrug-resistant tuberculosis (MDR-TB) that will involve a host of federal agencies, especially the US Centers for Disease Control and Prevention (CDC).

The plan was put together by an interagency work group in response to an executive order from President Barack Obama in September 2014, part of a multipronged attack on antibiotic resistance. It includes a set of steps to guide domestic policy and to respond to global threats from both MDR-TB and extensively drug-resistant tuberculosis (XDR-TB).

Tuberculosis causes more deaths than any other infectious disease, killing 1.5 million people throughout the world annually, according to a White House fact sheet on the new plan. It added that nearly a third of the TB-infected population has the multidrug-resistant form but that less than 20% of those affected get the drugs they need. Patients who aren't successfully treated can pass the disease to others.

Plan details

The 38-page National Action Plan sets out critical steps the US government can take, if adequately funded, over the next 3 to 5 years to help with the global battle against the disease. The roadmap is designed to dovetail with broader efforts that have already been set out by the World Health Organization (WHO) and the US government.

The White House said another goal of the plan is to galvanize support from donors, the private sector, and other countries.

The plan has three main goals: to beef up domestic capacity to battle MDR-TB, to improve international capacity and collaboration, and to stimulate research and development on the disease and its detection and treatment.

For example, one of the thrusts of the first goal is to ensure that all patients with TB are promptly identified and treated, with their close contacts carefully monitored as well. The White House said 100 Americans are diagnosed with MDR-TB each year.

Also, the plan sets dates for global targets, from ensuring that 25% of MDR-TB patients in the 10 worst-affected countries are appropriately treated by 2016, with that number rising to 50% by 2020.

Game plan draws praise

In a press release yesterday, the CDC said MDR-TB is now found in every country in the world, and the disease strains public health systems even in countries such as the United States where disease burden is low.

CDC Director Tom Frieden, MD, MPH, said in a statement yesterday, "The White House's National Action Plan is a critical step to combat multidrug-resistant TB. CDC sends our doctors, nurses and scientists to the front lines to find, cure and prevent TB before it develops resistance to last-line antibiotics—so we can eliminate deaths from this curable disease."

The American Thoracic Society (ATS) yesterday said it welcomed release of the plan, which some of its members helped draft. It noted that TB deaths recently eclipsed HIV/AIDS deaths and that the spread of drug-resistant TB, which is complicated and costly to treat, is a global health issue that requires urgent action.

Atul Malhotra, MD, ATS president, said in the statement that all are vulnerable to drug-resistant TB because it is an airborne disease. The battle requires strong commitments from countries around the globe, he added.

"The ATS urges the Administration and Congress to allocate the funding needed to implement this important global health plan beginning in fiscal year 2017, and we pledge to work with them to accomplish this," he said.

See also:

Dec 22 White House plan for battling MDR-TB

Dec 22 White House fact sheet

Sep 19, 2014, CIDRAP News story "White House launches major effort against resistant bacteria"

Dec 22 CDC press release

Dec 22 ATS statement

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