Covid pandemic caused slump in TB care

Tuberculosis (TB) care saw a global nosedive during the 2020 Covid-19 pandemic, according to preliminary data from the World Health Organization.

In a press release issued this week, WHO reported that roughly 1.4 million fewer patients received care for TB in 2020 compared to 2019, an overall reduction of 21% — and many nations saw even larger drops, with the highest gaps in India (25%), the Philippines (37%), South Africa (41%), and Indonesia (42%).

“The effects of Covid-19 go far beyond the death and disease caused by the virus itself. The disruption to essential services for people with TB is just one tragic example of the ways the pandemic is disproportionately affecting some of the world’s poorest people, who were already at higher risk for TB,” said Tedros Adhanom Ghebreyesus, PhD, WHO Director-General, in the statement. “These sobering data point to the need for countries to make universal health coverage a key priority as they respond to and recover from the pandemic, to ensure access to essential services for TB and all diseases.”

WHO estimated that over half a million people may have died from undiagnosed TB in 2020 due to barriers to care caused by the pandemic — however, the organization stressed, this problem is far from new: “before Covid-19 struck, the gap between the estimated number of people developing TB each year and the annual number of people officially reported as diagnosed with TB was about 3 million,” WHO explained. “The pandemic has greatly exacerbated the situation.”

To help make sure everyone who has TB gets a proper diagnosis, WHO noted that a more systemic use of screening approaches employing novel tools will be key. “These include the use of molecular rapid diagnostic tests, the use of computer-aided detection to interpret chest radiography and the use of a wider range of approaches for screening people living with HIV for TB,” WHO wrote.

However, the organization added, testing alone will not solve the problem — countries around the globe will need to take steps to help fight TB, including “activating high-level leadership and action across multiple sectors to urgently reduce TB deaths; increasing funding; advancing universal health coverage for TB prevention and care; addressing drug resistance, promoting human rights, and intensifying TB research.”

And, WHO noted, it will be vital to push back against health disparities.

“For centuries, people with TB have been among the most marginalized and vulnerable. Covid-19 has intensified the disparities in living conditions and ability to access services both within and between countries,” said Tereza Kasaeva, MD, PhD, Director of WHO’s Global TB Program. “We must now make a renewed effort to work together to ensure that TB programs are strong enough to deliver during any future emergency – and look for innovative ways to do this.”

WHO’s End TB Strategy, first passed in May 2014, is meant to reduce TB deaths by 95% and cut new cases by 90% from 2015 through 2035, with interim milestones set for 2020, 2025, and 2030. To drive this point home, WHO observed World TB Day on March 24, choosing to commemorate the day with a dire theme — ’The Clock is Ticking.’

In a press release for the campaign, WHO called on the world to accelerate its TB response, setting a goal to diagnose and treat 40 million people with TB — including 3.5 million children and 1.5 million people with drug-resistant disease — and reach 30 million people with preventive treatment, both by the end of 2022. The organization also asked on nations to contribute $13 billion a year to support efforts to end TB, noting that “for every USD 1 invested to end TB, USD 43 is returned as the benefits of a healthy functioning society.” WHO also called for at least $2 billion a year to improve the science, tools, and care delivery necessary to fight the disease.

“THE CLOCK IS TICKING,” WHO wrote. “IT’S TIME TO KEEP OUR PROMISES. IT’S TIME TO #END TB.”

John McKenna, Associate Editor, BreakingMED™

Cat ID: 310

Topic ID: 79,310,730,310,192,151,925

Author