US senator on global health: ‘Achievable stuff’

WASHINGTON — For those in the global health world — and there are many in the nation’s capital — one common question is why in tight budgetary times should Congress support spending on research and development to fight diseases around the world.

At a congressional briefing today put on by the Global Health Technologies Coalition (GHTC), a group that represents 40 global health research and advocacy organizations, several experts gave a variety of answers to that question.

Katherine “Kemy” Monahan, deputy executive director of the Obama administration’s Global Health Initiative, said, “These global health programs are literally saving lives, and not just a few lives, lots of lives … We are (also) protecting Americans at home and traveling abroad from infectious diseases.”

Col. Peter J. Weina, deputy commander of Walter Reed Army Institute of Research, said, “We protect soldiers’ lives … Infectious diseases have ravaged military forces operating worldwide. … It also ravages populations we’ve worked with.”

From 2003 to 2008, for instance, US troops in Iraq and Afghanistan had roughly 2,000 confirmed cases of leishmaniasis, a disease transmitted by the bite of a tiny sandfly. The disease causes a broad range of outcomes, some of them fatal.

Then US Sen. John Boozman, a Republican from Arkansas, took the microphone from the back of the Kennedy Caucus Room at the Russell Senate Office Building, and gave his case for ongoing global health research.

“It’s achievable stuff,” he said. “It represents real calamity. These are difficult problems, but they are very, very solvable. … You have a lot of support on Capitol Hill.
We can be very, very proud of what has been accomplished so far.”

A GHTC analysis of the Obama administration’s global health budget found a large number of decreases in funding compared to the previous year’s budget.

Funding cuts were most glaring in the President’s Emergency Plan for AIDS Relief (PEPFAR), neglected tropical disease programs, and several other programs at the US Agency for International Development (USAID).

But the budget also included increases to The Global Fund to Fight AIDS, Tuberculosis and Malaria and the GAVI Alliance. The National Institutes of Health and the Centers for Disease Control and Prevention (CDC) were funded at the same level.

“It’s a time of fiscal austerity,” Kevin De Cock, the director of CDC’s Center for Global Health, said in an interview after the briefing. “The cuts for global health programs might have been less than many people feared. There’s a need now for everyone in government to strive for greater efficiency and to find savings wherever they can in their budgets.”

Karen A. Goraleski, the executive director of the American Society of Tropical Medicine and Hygiene who was the moderator at the event, said global health R&D also has economic benefits at home, including the creation of thousands of jobs. “It’s fueling our economy,” she said.

For F. Marc LaForce, director of the Meningitis Vaccine Project, the importance of research could be seen in the story of the fight against meningitis. He said last year’s results were enough to show how US research can have a major impact in saving lives.

In West Africa, the often-fatal disease has been so prevalent that the area is referred to by the name of the disease. It’s the Meningitis Belt.

His project, a partnership between the World Health Organization and PATH, which included earlier research done by the Walter Reed Army Institute of Research, produced a vaccine that cost less than 50 cents a dose. It was administered to 19 million people last fall in three West African countries. Usually, the countries report thousands of cases of meningitis. Last year, the countries reported fewer than a dozen — all from children who were not vaccinated.

“The coverage rates with the vaccine have been extremely good,” LaForce said. “We are probably at the beginning of the end. With sufficient funding, this epidemic is likely to be pretty much over in the next 10 years.”