GAO to review funding for additional TB control
June 1, 2000 2 minutes read
GAO to review funding for additional TB control
Commerce committee chair requests investigation
The General Accounting Office (GAO) has begun looking at operations and funding levels for tuberculosis control in the United States, especially as those issues relate to multidrug-resistant TB. The report, which should be finished in about a year, was requested by U.S. Rep. Tom Bliley (R-VA), the three-time chairman of the House Commerce Committee.
"A GAO report is a significant event," says Eric Wohlschlegel, an aide to Bliley. "It usually signals the start of a policy change."
Bliley’s concern about the rise in rates of drug resistance at home and abroad spurred him to ask for the investigation. "We are concerned about tuberculosis control, particularly the growing public health threat of multidrug-resistant tuberculosis," he wrote in a letter addressed to David Walker, head of the GAO. "Lethal strains of MDR-TB in just three years have spread from 38 mostly undeveloped nations to more than 100 countries, including the United States."
The study, which began in early March, will focus on three areas of inquiry:
1. How have federal dollars strengthened surveillance and helped labs do cultures and "real-time" susceptibility testing?
2. How well are state and federal programs doing at targeting and treating disease and infection in high-risk and hard-to-reach groups?
3. How much has the administration sought for TB control in the years since 1989? How much has Congress granted?
GAO could issue recommendations
Though the GAO is not a policy-making body, it frequently issues recommendations as part of its reports. Most of the time, that advice is heeded, says public affairs specialist Laura Koppelson. "We follow our reports for four years, and we’ve found that about 70% of the recommendations are adopted," she says. Bliley hasn’t specifically asked for recommendations, but that doesn’t mean the GAO won’t provide them, she adds.
Bliley is an active partisan in the field of health care. Before entering politics, he presided over his family’s funeral-home business, an experience that helped shape his interest in health care and TB, notes Wolschlegel. (For more information on TB in funeral homes, see TB Monitor, March 2000, pp. 26-28.) As an ex officio member of the subcommittee on Health and the Environment, Bliley pushed for the Food and Drug Administration and Modernization Act, the Mammography Quality Standards Act, and the Food Safety and Safe Water Drinking Act.
The GAO, the oversight arm of Congress, is charged with investigating the use of federal funds. Although it’s best known as a watchdog agency that ferrets out waste and incompetence, the agency sometimes advises spending more money, not less, notes Koppelson. "Sometimes to do the job right, that’s what it takes," she says.
The GAO has issued recent reports on how funds for the Ryan White Care Act are spent, on adverse drug events, and on how research data on women are collected at the National Institutes of Health.
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