The editorial of Oct. 29th, “Defense bill ignores domestic uncertainties,” oversimplifies our ability to divorce domestic concerns from international ones. Many threats to U.S. citizens may only be addressed adequately at a global level. Public health is one example.

The $200 million the editorial cites as the U.S. contribution to an international fund to fight HIV/AIDS, tuberculosis and malaria is misspent only in that it does not go far enough. No safe barrier exists today between Americans and diseases like tuberculosis that are ravaging populations abroad. In an internationally mobile world population sickness will not stay constrained to one geographical location; HIV/AIDS, tuberculosis, and malaria are global epidemics in which no neat us-them dichotomy exists.

Medicaid may be important, but eradicating the world’s worst infectious killers remains an American concern as well.

S. Helen Labun

The Tuberculosis Initiative

Princeton, NJ