Federal inaction blamed for TB rise Report cites lack of preventive funds


WASHINGTON -- Tuberculosis has increased 20 percent since 1985, creating an urban epidemic out of a manageable disease, a congressional report said yesterday. The report said that the federal government had failed in every year over that period to supply the money needed to curtail the epidemic.

"All three of the last administrations, on a bipartisan basis, have ignored the warnings of public health experts," Rep. Henry A. Waxman, D-Cal., said at a bipartisan news conference yesterday. His criticism of the Clinton administration was no less severe than of the Bush and Reagan administrations.

"If there were such a thing as public health malpractice, all three administrations would be guilty," said Mr. Waxman, the chairman of the House Subcommittee on Health and the Environment.

He was joined by Sen. Orrin G. Hatch, R-Utah, Sen. Edward M. Kennedy, D-Mass., and Rep. Edolphus Towns, D-N.Y., who is the chairman of the House Subcommittee on Human Resources and Intergovernmental Relations.

Until 1985, the incidence of tuberculosis had been steadily declining for 30 years because an effective treatment was available. But since 1985, when 22,000 cases were reported, the number has risen every year, to about 27,000 in 1992, according to the report by the Office of Technology Assessment, a bipartisan congressional research agency.

Dr. Michael Gluck, who led the team that wrote the report, said that the number is still increasing.

Nationally, over the past seven years, about 52,000 cases have occurred above what the historical trend would have predicted up to 1985. These additional cases as well as others might have been prevented if money proposed by the U.S. Centers for Disease Control to combat the disease had been appropriated, the report said.

The report's chief recommendation is for the government to come up with the money proposed by CDC for a tuberculosis control program. That would be about $484 million beginning in 1994. At the same time, the report recommends building up the ability of state and city health departments to seek out and treat people with the disease.

In 1989, the centers proposed a National Action Plan to Combat Multidrug-Resistant Tuberculosis, a plan that it said would halt the epidemic.

The Department of Health and Human Services backed the plan beginning in 1989, but each year the White House cut the money out of the budget. The cost of similar program in the coming year would be about $484 million, because of the spread of the disease since that time, the centers said.

The Clinton administration cut the amount requested to $124 million before sending the proposal to Congress.This week a conference committee authorized $111 million for the program. The bill now goes back to the separate chambers.

The report, "The Continuing Challenge of Tuberculosis," is available from the Government Printing Office or the Office of Technology Assessment in Congress.

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