A Military Cutback We Can’t Afford: Fighting Tropical Diseases

Leishmaniasis at The Iraq Infections

“In the coming years leishmaniasis may become the most important condition you have never heard of among veterans”

Barbara Herwaldt CDC on Leishmaniasis

 Contractors will be even less likely to be diagnosed and/or treated timely or effectively.   Diagnoses normally occurs long after they’ve had contact with their families.

Peter Hotez & James Kazura at The Atlantic

In recent months, many politicians and presidential hopefuls have called for budget reductions, and many have specifically targeted military spending for cutbacks. Unfortunately, even programs proven to be cost effective are vulnerable to cuts. Medical research for our troops is no exception to this rule — programs such as the Walter Reed Army Institute of Research (WRAIR) often find themselves low on the priority list despite their crucial role in saving the lives of our troops on the battlefield and here at home.

One important area of research is tropical medicine. During World War II and the Vietnam War, more than one million service members acquired tropical infections such as malaria, dengue fever, hookworm, and typhus, and many of these diseases continued to plague our veterans after they returned home. Today, American troops in Iraq and Afghanistan still face formidable tropical disease threats, especially from a disease transmitted by the bite of sand flies known as leishmaniasis, which can cause a disfiguring ulcer in one form, and a serious systemic condition that clinically resembles leukemia in another. In the coming years leishmaniasis may become the most important condition you have never heard of among veterans.

WRAIR’s leishmaniasis diagnostic laboratory is the only one of its kind in the world, so each time funding is slashed our military loses considerable expertise and capabilities in the diagnosis, treatment, and prevention of this devastating disease. For example, in the years prior to the Gulf War, the WRAIR leishmaniasis program was officially decommissioned and all research was halted. Only after cases of leishmaniasis among U.S. forces exposed to sand-fly bites in the Iraqi desert were the remaining leishmaniasis experts at WRAIR quickly assembled and tasked with making up for lost time. In 2002, the WRAIR leishmaniasis program was again dissolved only to be urgently activated once more with the start of Operation Iraqi Freedom in 2003. The interruptions to the WRAIR leishmaniasis program are part of much larger budget cuts across all of WRAIR’s tropical infectious disease research programs. There is no end to the irony of such cutbacks given that they coincide with the activation in 2008 of the U.S. Africa Command (AFRICOM), charged with fighting the war on terror across the African continent. Today, sub-Saharan Africa has the largest number of cases of tropical diseases anywhere in the world. Many of these tropical infections, such as river blindness and African sleeping sickness, have been shown to destabilize communities and may actually promote conflict in the region.

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