The world is currently engaged in a fierce battle to contain the spread of the deadly coronavirus pandemic, which has so far resulted in thousands of deaths and millions of infections worldwide. While the coronavirus pandemic has caused great panic and worry, and has brought into focus the capacity of health systems in various countries, the tuberculosis (TB) epidemic is also a serious health concern which cannot be taken lightly.
The reality is that, even though the disease is curable and preventable, TB is one of the top 10 causes of death, and is the leading cause from a single infectious agent. For this reason, governments and health partners must not allow the coronavirus pandemic to overshadow the threat of TB, and therefore every opportunity must be used to increase public awareness about the devastating medical, social and economic consequences of the disease.
The World Health Organisation (WHO) has reported that, prior to the onset of COVID-19, many countries were making steady progress in tackling TB, with a 9% reduction in incidents seen between 2015 and 2019, and a 14% drop in deaths in that same period. High-level political commitments at global and national levels were delivering results, the WHO stated.
However, a new report from WHO shows that access to TB services remains a challenge, and global targets for prevention and treatment would likely be missed without urgent action and investments. According to WHO, approximately 1.4 million people died from TB-related illnesses in 2019. Of the estimated 10 million people who developed TB that year, some 3 million were not diagnosed with the disease, or were not officially reported to national authorities.
About 14 million people were treated for TB in the period 2018-2019, just over one-third of the way towards the 5-year target (2018-2022) of 40 million, according to the report. Some 6.3 million people started TB-preventive treatment in 2018-2019, about one-fifth of the way towards the 5-year target of 30 million.
The report highlights that disruptions in services caused by the COVID-19 pandemic have led to further setbacks. In many countries, human, financial and other resources have been reallocated from TB to the COVID-19 response, and data collection and reporting systems have also been negatively impacted.
According to the new report, data collated from over 200 countries has shown significant reductions in TB case notifications, with 25-30% drops reported in 3 high burden countries – India, Indonesia, the Philippines – between January and June 2020, compared to the same 6-month period in 2019. These reductions in case notifications could lead to a dramatic increase in additional TB deaths, according to WHO modelling.
However, in line with WHO guidance, countries have taken measures to mitigate the impact of COVID-19 on essential TB services, including by strengthening infection control. A total of 108 countries – including 21 countries with a high TB burden – have expanded the use of digital technologies to provide remote advice and support. To reduce the need for visits to health facilities, many countries are encouraging home-based treatment, all-oral treatments for people with drug-resistant TB, provision of TB-preventive treatment, and ensuring people with TB maintain an adequate supply of drugs.
The WHO End TB Strategy aims for a 90 per cent reduction in TB deaths and an 80 per cent reduction in TB incidence rate by 2030, compared to the 2015 baseline.
Even though Guyana still has a far way to go, this country can boast of tremendous progress made in its fight against TB; and all efforts must be made to ensure these gains are not reversed. It could be recalled that the actual number of new TB cases diagnosed by the National TB Programme (NTBP) rose steadily throughout the 90s. However, with some key interventions by health authorities, annual cases declined from 2008, and stabilised for four years thereafter due to further Directly Observed Treatment Short-course (DOTS) expansion.
Funding remains a crucial factor in fighting TB. All partners can help take forward innovative approaches to ensure that everyone suffering from the disease has access to TB diagnosis, treatment and cure. Governments and NGOs may have the best ideas to tackle TB, but it makes very little sense if there are inadequate financial resources to ensure their effective implementation.
Further, ending TB would be achieved only with greater collaboration within and across governments, and with partners from civil society, communities, researchers, the private sector and development agencies. This means taking a whole-of-society and multidisciplinary approach in the context of universal health coverage.
