Since 2001, the government has spent almost $50 billion for national biodefense at sites such as Fort Detrick and other specialty laboratories and universities, and this amount is likely to increase further with ambitious plans to build high-containment laboratories across the country. To be sure, there is an excellent rationale for improving our defense against biological threats. But the diseases that we are preparing against do not currently exist in our country. There is no inhalational anthrax, smallpox or bird flu, and it is unclear whether we are likely to face such biological threats any time soon.
However, there is a largely unaddressed biological threat that does exist in America today - especially in places where poverty is concentrated, such as Baltimore. It is a hidden underbelly of poverty-related diseases that are ordinarily thought of as health problems in less-developed countries. The mainly Hispanic and African-American populations living in inner cities and rural areas are suffering from high rates of these ailments, known as the "neglected infections of poverty."
That these diseases exist in large numbers in the world's most prosperous nation is reason for shame and alarm - and action.
Neglected infections of poverty are so named because they affect the voiceless poor and because they actually cause poverty by impairing child development and memory, causing bad pregnancy outcomes and harming worker productivity. For instance, cysticercosis - a brain infection caused by a tapeworm parasite - occurs in an estimated 169,000 Hispanics in whom it is now a leading cause of epilepsy and seizures. Hundreds of thousands of Hispanics living in poverty in the U.S. are also at risk from acquiring Chagas disease, a cause of heart failure that results from infection with a protozoan parasite transmitted by the bite of assassin bugs resembling large cockroaches.
But these are not immigrant diseases. Baltimore, for example, is far from immune to these debilitating conditions. Since the 1990s, it has been known that leptospirosis is transmitted among residents of Baltimore who are exposed to rat urine. (A study published in 1992 found that 16 percent of black males at an STD clinic tested positive for leptospirosis, which can cause a debilitating illness called Weil's disease.)
