Dalvin Modore walked as if there was broken glass beneath his feet, stepping gingerly, his frail shoulders hunched against the anticipation of pain. His trousers had become so loose that he had to hold them up as he inched around his small farm in western Kenya.
Mr. Modore has tuberculosis. He is 40, a tall man whose weight has dropped to 110 pounds. He has a wracking cough and sometimes vomits blood. He fears the disease will kill him and has been desperate to be on medication to treat it.
Mr. Modore is one of thousands of Kenyans, and hundreds of thousands of people worldwide, with TB who have lost access to treatments and testing in the weeks since the Trump administration slashed foreign aid and withdrawn funding for health programs around the globe.
Many, like Mr. Modore, have grown significantly sicker. As they go about their lives, waiting and hoping, they are spreading the disease to others in their own families, communities, and beyond.
The whole system of finding, diagnosing and treating tuberculosis — which kills more people worldwide than any other infectious disease — has collapsed in dozens of countries across Africa and Asia since President Trump ordered the aid freeze on Jan. 20, Inauguration Day.
The United States contributed about half of international donor funding to TB last year and here in Kenya paid for an array of essentials. Trump administration officials have said that other countries should contribute a greater share to global health programs. They say the administration is evaluating foreign aid contracts to determine whether they are in the national interest of the United States.
While some of the TB programs may ultimately survive, none have received any money for months.
Family members of infected people are not being put on preventive therapy. Infected adults are sharing rooms in crowded Nairobi tenements, and infected children are sleeping four to a bed with their siblings. Parents who took their sick children to get tested the day before Mr. Trump was inaugurated are still waiting to hear if their children have tuberculosis. And people who have the near-totally drug-resistant form of tuberculosis are not being treated.
Mr. Modore shares a bed with his cousin and his home with four other relatives. All of them have watched him get sicker and thinner, fearing also for their own health.
Despite being fully treatable, tuberculosis claimed 1.25 million lives in 2023, the last year for which data is available. If TB begins to spread unchecked, people throughout the world could become at risk.
The main TB research effort, testing new diagnostics and therapies, has been terminated. The global procurement agency for TB medications lost its funds, then was told it might regain them, but still has not. Stop TB, the global consortium of government and patient groups that coordinates tuberculosis tracking and treatment, was terminated, had the termination rescinded, but still has received no funds.
The United States did not pay for all the TB care in Kenya, but it funded critical pieces. And when those were frozen, it was enough to bring the entire system to a halt.
The United States paid for motorbike drivers, who earned about $1 for transporting a sample taken from a person with a presumptive infection to a lab to test it for TB. The drivers were fired on the first day of the funding cut — so the transportation of samples stopped.
The United States paid for some laboratory equipment used to process tests. In many places, processing stopped.
The United States paid for the internet connectivity that allowed many testing sites to send results back to far-off patients via local community advocates known as TB Champions. So even when patients found a way to send samples to a working lab, notification of results stopped.
Without testing that confirms whether a person is infected and what type of TB they have, family members cannot start on preventive therapy.
The United States paid for the half-dozen tests that patients need before beginning treatment for multi-drug-resistant TB, to make sure their bodies will be able to tolerate the harsh drugs. These tests can cost $80 or more, beyond the reach of many patients. Without the tests, clinicians don’t know what drugs to prescribe very sick patients. Prescriptions stopped.
The United States paid for the ships and trucks that moved drugs to ports and on to warehouses and clinics. Shipments …
Source link
