The headline on the Aug. 10 front-page article on tuberculosis, "Science Races to Stem TB's Threat," seemed particularly inappropriate, because the war against TB has been marked much more by inadequate attention and complacency in recent years than by any kind of "race" to stem it. The headline also may perpetuate the false impression that much is being done to fight tuberculosis, when evidence of insufficient efforts and political commitment abounds. NIH funding for TB research is surprisingly incommensurate with its disease burden: compare approximately $35 spent per TB death with $810 spent per AIDS death.

As stated in the article, true control and eventual eradication of tuberculosis will likely occur only through a vaccine, rather than the highly touted "directly observed treatment, short-course," or DOTS, treatment, which is available to only 16 percent of TB patients. The development of a vaccine, however, will require the United States to invest $40 million per year over the next 20 years. While this amount may seem daunting, it represents considerable savings compared with the estimated $700 million per year the United States spends treating and controlling the disease.

Finally, the article implied that continuing technological advances in decoding the human genome will translate into gains for TB vaccine research; however, these gains will be realized only if there is a renewed and long-term commitment to fighting TB among scientists, the health community and policymakers.

DANA M. DEATON

Project Manager

Princeton Project 55 Tuberculosis Initiative

Washington