USAid cuts could create untreatable TB bug 'resistant to everything we have'

Totally-drug-resistant tuberculosis (TDR-TB) breaking out widely is among the more terrifying nightmare scenarios of which I'm aware, and has been high on my list of concerns for well over a decade.[1].

Unlike more virulant diseases (think, say, Ebola), TDR-TB transmits slowly, but steadily, especially under conditions of poverty (overcrowding, poor ventilation, poor hygiene), many carriers are asymptomatic (we've seen what this does with Covid-19), and there is no cure.

The only treatment is to give patients free and isolated housing, plus food, clothing and entertainment. As a friend noted, "If you execute them or put them in prison cells and feed them slop nobody goes to the doctor if they have a cough." (See: <https://web.archive.org/web/20230531181139/https://old.reddi...>).

TDR-TB already exists in places such as India.

If an uncontrolled outbreak were to emerge in one of the world's poor megacities, places such as Dhaka, Bangladesh; Cairo, Egypt; Kinshasa, Democratic Republic of the Congo; Lagos, Nigeria; Karachi, Pakistan; Delhi, or Mumbai, or Kolkata, India; Jakarta, Indonesia; Metro Manila, Philippines; Mexico City, Mexico; Ho Chi Minh City, Vietnam; Luanda, Angola; or in other places with public health systems which are already dysfunctional and are now under further direct attack, such as the United States of America, it's going to be a very, very, very troubling future.

Cutting USAID is already beyond idiotic and short-sighted. This is simply suicidal.

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Notes:

1. See e.g., <https://web.archive.org/web/20230531181139/https://old.reddi...> <https://news.ycombinator.com/item?id=6640362>.

This hospital in Uganda will stop receiving UsAid funds https://fondazionecorti.it/usaid-lascia-luganda/

they are pretty much desperate!

__________________ google translation ___________

Dear all, I am writing to you from Lacor, where I arrived a few days ago.

In addition to the challenges that we have been facing for many years together with the hospital staff, there is another challenge that was unimaginable until a few weeks ago: the blocking of funds from the US agency USAID. For over twenty years, USAID has financed the life-saving program for HIV-positive people, that is, prevention, diagnosis and above all the expensive treatment of HIV patients.

Yesterday, March 6, we received the letter that puts an end to the hopes of continuing to receive at least the precious drugs.

For Lacor, this means a loss of approximately 600 thousand dollars a year. The antiretroviral drugs alone that were guaranteed to the 7 thousand HIV-positive people being treated at Lacor had a value of 400 thousand dollars. A sum equal to the cost of all the other drugs needed to treat the rest of the 190 thousand patients that the hospital receives every year.

In addition, Lacor received approximately 200 thousand dollars to cover the salaries of approximately 40 employees involved in the care of HIV patients.

Costs that Lacor, already in crisis due to the exceptional increases caused by the pandemic and the geopolitical situation, cannot afford. The Foundation, which meets the needs in times of crisis, cannot even cope with further figures of this magnitude.

Since yesterday, Dr Emmanuel Ochola, scientific director and head of the HIV program at Lacor, has stopped outreach, missions for check-ups and the distribution of drugs to those who live in distant villages.

In a few days we will run out of antiretroviral reserves in the hospital.

For me, for all my Ugandan and Italian colleagues, health workers and otherwise, who share with me the happiness and responsibility of this work, these are not faceless people who live on the other side of the world. They are women who have worked in the hospital for decades, who support their families. Women who I remember reduced like my mother to a skeleton, sick every other week until, in 2004, this program was started.

With antiretrovirals they started living again, they had children... now the thoughts and worries are crazy.

But it is just another of those diseases that here in Uganda lead to death, while in Italy they are quickly and simply resolved.

Without antiretrovirals, HIV is a death sentence and again a great danger of spreading the virus.

We are looking for solutions to stem the emergency, but the blanket is short, the resources increasingly stretched.

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> The US has historically provided between $200m (£155m) and $250m a year in bilateral funding to poorer countries for their work on TB, the World Health Organization said last week, warning that “abrupt funding cuts” would “cripple TB prevention and treatment efforts, reverse decades of progress, and endanger millions of lives”.

> The WHO and UN have set targets of eradicating the disease by 2030, but even before the US aid decision, there was an $11bn shortfall in the global response.

So even without the usaid money, we're still at an $11bn shortfall due to rounding! Nice try, Guardian!

The whole world is shocked and awed that we stopped paying while holding out empty wallets themselves.

The US isn't an empire in decline...it was given away!

Sometimes people say something I agree with in a way which is so annoying it makes me want to disagree with them.

It's bad USAid stopped funding this but can you tell me that in a less infuriating way please?

I mean here obviously the bug creates itself through an evolutionary process. USAid had been doing great work to make this less likely, and now they've stopped. That doesn't mean the cuts create the bug!