New York is lucky, in a sense. The newly appointed Commissioner for Health, Dr. Thomas Frieden, was the senior public health physician in charge of fighting the Tuberculosis (TB) epidemic that gripped New York in 1991 and 1992 during the days of the administration of Bush the First. At that time the city’s Department of Health required a federal grant to pay for his services

Now Frieden will be tested again and, again, he will have a Bush in the White House. The New York Times has focused on the new immigrants who live in Queens as the reason for the upsurge in TB – an argument that, at least in part, has some merit. Immigrants from Pakistan, Bangladesh, Mexico, India, Haiti and Ecuador are bringing TB with them.

But, blaming immigration for the increase in TB is not the whole story. Immigration is not a disease. It cannot be cured. There is no antibiotic or drug to stem its spread. Immigration just describes the movement of people between two areas of the world. The question should be, why are people migrating?

To answer that question is to find the reason why New York had the TB outbreak of the early ’90s and why it is experiencing the outbreak today: poverty, unemployment, low wages and inaccessible health services. These are the reasons that millions of people migrate to places where they hope to find work and better living conditions.

The mad dash for profit by transnational corporations, combined with the anti-people policies of the International Monetary Fund, are behind the rise of poverty throughout the world. The International Poverty and Health Network (www.iphn.org) has documented the international health crisis that brings thousands of protesters to annual meetings of the World Economic Forum.

Just as coal miners used to have a canary in a cage to detect deadly methane gas, TB is an early warning socio-economic signal for public health professionals. For example, in 2001, in one part of Queens, there were 36.1 cases per 100,000 residents, more than double the citywide rate.

You can get a free booklet of]n TB off of the website of the Centers for Disease Control (www.cdc.gov). As the booklet states, “People who are infected with latent TB do not feel sick, do not have any symptoms, and cannot spread TB. But, they may develop TB disease at some time in the future. People with TB disease can be treated and cured if they seek medical help. Even better, people who have latent TB infection but are not yet sick can take medicine so that they will never develop TB disease.” So sayeth the CDC.

But, what is the situation in New York today? Over 25 percent of New Yorkers do not have health insurance. The rate among immigrant workers and families is surely far higher. But, the goal here is not to wait for health insurance legislation; it is direct access to health services, now.

And, at the same time, newly elected Mayor Bloomberg’s draconian budget, which includes a massive reduction in funding Department of Health services, has to be fought against.

Massive people’s pressure on the mayor, governor and the White House is required to reverse this crisis.

The author can be reached at pww@pww.org

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