The world is currently engaged in a fierce battle to contain the spread of the deadly coronavirus, which has so far resulted in thousands of deaths and infections worldwide. Many countries have shut off their borders and have been calling on their citizens to heed the health warnings and practise social distancing, etc, to bring a halt to the disease. At the moment, fighting the virus is the number one priority for Governments and health authorities, and resources are mostly channelled in this direction. It is no wonder why World TB Day, which was observed yesterday (March 24), passed with little or no attention being paid to its significance.
March 24 marks the day in 1882 when Dr Robert Koch announced that he had discovered the bacterium that causes tuberculosis (TB), which opened the way towards diagnosing and curing this disease. While the coronavirus pandemic has caused great panic and worry and brought into focus the capacity of health systems in various countries, the TB epidemic is also a serious health concern which cannot be taken lightly.
The reality is that TB is one of the top 10 causes of death and the leading cause from a single infectious agent, even though the disease is curable and preventable. For this reason, every opportunity must be used to increase public awareness about the devastating health, social, and economic consequences of TB.
The stats in relation to TB are staggering. According to the World Health Organisation (WHO), worldwide, a total of 1.5 million people died from TB in 2018 (including 251,000 people with HIV). In 2018, an estimated 10 million people fell ill with TB worldwide – 5.7 million men, 3.2 million women and 1.1 million children. There were cases in all countries and age groups.
However, globally, TB incidence is falling at about two per cent per year. International health partners say this needs to accelerate to a four to five per cent annual decline to reach the 2020 milestones of the End TB Strategy. An estimated 58 million lives were saved through TB diagnosis and treatment between 2000 and 2018.
At a United Nations gathering recently, global leaders had agreed to: scale up access to prevention and treatment; build accountability; ensure sufficient and sustainable financing including for research; promote an end to stigma and discrimination, and promote an equitable, rights-based and people-centred TB response.
The WHO has launched a joint initiative “Find. Treat. All. #EndTB” with the Global Fund and Stop TB Partnership, with the aim of accelerating the TB response and ensuring access to care, in line with WHO’s overall drive towards Universal Health Coverage.
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.
Based on official statistics, the case notification rate over the past five years decreased from 92 per 100,000 in 2012 to 70 per 100,000 in 2017. This is quite an achievement and kudos must be given to all the stakeholders that are working to further reduce TB cases in Guyana.
Some years ago, the DOTS system was successfully implemented in all the regions of the country and has been essential to ensuring case detection, standardised treatment, with supervision and patient support.
Funding also remains a crucial component. 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 Non-Governmental Organisations (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.
Ending TB will only be achieved 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. While fighting the spread of coronavirus is crucial at this time, the battle against TB must also be maintained.