What immediately comes to mind when you see the word “epidemic”? Most likely, the outbreak of the Ebola virus in West Africa. As I write this, the Centers for Disease Control and Prevention estimates that one million patients could be infected by January, if nothing is done.
But something is being done. The outbreak has been simmering for months, but the issue did not grab national attention until two Americans contracted the disease. (And, just before this went to press, a Liberian national is critically ill in a Dallas hospital with the Ebola virus.) The United States and other nations have begun sending resources, troops, and healthcare workers.
If pressed to give a second answer on your “epidemic list,” you might mention HIV/AIDS. For years, celebrities have spotlighted attention on research for prevention and treatment. Cary Grant’s death motivated his friend Elizabeth Taylor to take up the cause. More recently, Bono has concentrated his considerable influence to help eliminate AIDS in Africa. Malaria, too, has gained celebrity attention.
Celebrities—or deaths of Americans—are often the fuse that lights the fires of charitable engagement. There is no harm, and much good, that can be generated through celebrity engagement. But what about epidemics that lack a big name champion?
I am thinking about the epidemic of multidrug-resistant tuberculosis (MDR-TB) burning through Vietnam, India, and elsewhere. Nearly two decades ago, the World Health Organization declared TB as a global public health emergency.[1] The rate of decline is lethargic (2% per year). Meanwhile, a new form of MDR-TB has emerged. MDR-TB patients who misuse or are prey to mismanagement of drugs may succumb to the even more tenacious extensively drug-resistant tuberculosis (XDR-TB). Estimates are admittedly imprecise, but WHO suggests that 170,000 died from MDR-TB in 2012, and 450,000 new cases of MDR-TB had emerged by 2013.[2] India’s Union Health Minister recently declared MDR-TB a “national emergency.”[3]
Who is the celebrity face of tuberculosis? Is that what is needed to mobilize prevention and treatment resources?
Cornelia Hennig, WHO medical officer in Vietnam, laments that, “TB is still a neglected disease.” Also in Vietnam, CDC director Michelle McConnell agrees, “It doesn’t get quite as much attention as some newer and more publicized diseases.”[4]
Granted, the United States cannot supply resources to prevent, treat, and cure every serious disease. But tuberculosis is one of the five deadliest infectious diseases worldwide, and is the primary cause of death for people with HIV infection.[5]
Recently, attention has been focused on tuberculosis in the United States. This is not because of an epidemic—only one person exhibited the disease—but because of the population that was exposed. In a Texas hospital, more than 700 infants may have been exposed over the course of one year to a nurse who tested positive for TB in August 2014.[6]
Don’t chastise the U.S. for not taking care of every crisis. The point is, we do respond. Even if it takes “one of our own” or a celebrity to bring the attention to the forefront, we generally do not ignore the crisis. In Texas, the response was swift and comprehensive. The hospital made multiple attempts to contact all parents, urging them to bring in their child for free TB screening. Currently, over 500 are scheduled for testing.[7]
The point here is not to cast aspersions on those who are focused on the currently popular issues such as HIV/AIDS, malaria, and human trafficking. Rather, we must not forget the less popular, and perhaps overly familiar, diseases that are major causes of deaths worldwide. In low income countries, the number one cause of death is lower respiratory infections, followed by HIV/AIDS. Also on the list are stroke, diarrhoeal disease, ischaemic heart disease, and, yes, tuberculosis. You might respond that stroke awareness is high in the United States. Naturally so, because it is also the second leading cause of death.
There will always be epidemics and pandemics, generating national and worldwide attention and responses. I applaud those who are selflessly working and giving to prevent and cure “celebrity diseases.” And I am just as grateful for those who concentrate on diseases affecting the poor that may be less prevalent in the U.S. For example, the Bill & Melinda Gates Foundation is funding innovative strategies for rapid diagnosis and treatment of tuberculosis, even as their top priority is innovative, accelerated approaches to TB vaccine development.[8] And the connection between HIV/AIDS and tuberculosis helps draw attention to both.
The next time you meet a researcher working on a neglected disease, a missionary doctor caring for the overlooked, or an organization dedicated to disease prevention, thank them. I suggest that we go even farther, and pay attention to what is not in the headlines or trending on Twitter. Look beyond chic causes. Passion for healthcare as a matter of social justice should not be dictated by what is trendy. As Christians, we should be alert to extend compassion and practical help to those who are often disenfranchised or marginalized. You may not be a celebrity, but you can be a champion.
[1] World Health Organization, Global Tuberculosis Report 2013, http://apps.who.int/iris/bitstream/10665/91355/1/9789241564656_eng.pdf?ua=1.
[2] World Health Organization, “Multidrug-resistant Tuberculosis (MDR -TB ), October 2013 Update,” http://www.who.int/tb/challenges/mdr/mdr_tb_factsheet.pdf?ua=1.
[3] “Tuberculosis a National Emergency: Harsh Vadhan,” DNAIndia, September 6, 2014. http://www.dnaindia.com/india/report-tuberculosis-a-national-emergency-harsh-vardhan-2016671.
[4] Jens Erik Gould, “TB Battle is Global,” Chicago Tribune, August 15, 2014. Sec. 5, p. 1.
[5] The National Academies of Sciences, “What You Need to Know about Infectious Disease: Disease Threats: Global Killers,” http://needtoknow.nas.edu/id/threats/global-killers/.
[6] Andrew Soergel, “Nurse Exposes More Than 700 Infants to Tuberculosis,” U.S. News & World Report, September 24, 2014, http://www.usnews.com/news/newsgram/articles/2014/09/24/el-paso-nurse-exposes-more-than-700-infants-to-tuberculosis. Another 45 infants were added to the number exposed. Jacque Wilson, “45 Infants Added to TB Exposure List,” CNN, September 24, 2014, http://www.cnn.com/2014/09/24/health/infants-tb-texas/.
[7] Diana Washington Valdez, “Providence CEO Apologizes Over Massive TB Exposure to Babies,” El Paso Times, September 24, 2014, http://www.elpasotimes.com/news/ci_26590269/45-more-babies-may-have-been-exposed-tuberculosis.
[8] Bill & Melinda Gates Foundation, “Tuberculosis Strategy Overview,” http://www.gatesfoundation.org/What-We-Do/Global-Health/Tuberculosis.
Paige Comstock Cunningham, "From the Director's Desk: Celebrity Epidemics,” Dignitas 21, no. 3 (2014): 2–3.