Ahead of World Tuberculosis (TB) Day on March 24, doctors are warning that progress in the global fight against the disease has been set back more than a decade by the coronavirus pandemic.
In nine countries with a high prevalence of TB — including Bangladesh, India, Indonesia, Myanmar, Pakistan, Philippines, South Africa, Tajikistan and Ukraine — diagnosis and treatment fell by an average of 23%, according to analysis by the Stop TB Partnership, a non-profit hosted by the United Nations in Geneva.
The group’s Executive Director, Dr. Lucica Ditiu, says the fight against TB has been set back 12 years. “It’s an impact on all the work that we tried to do, but also the finances that we spent, all the efforts of everyone, we are basically back to kind of square one of that time,” Ditiu told VOA.
World TB Day on March 24 marks the day in 1882 when German scientist Robert Koch announced the discovery of the bacteria that causes tuberculosis. It remains the leading cause of death worldwide from a single infectious disease. There is a single vaccine against TB, but it’s effectiveness in adults is limited.
Tuberculosis killed 1.4 million people worldwide in 2019. The report from the Stop TB Partnership says that in 2020, "COVID-19 overtook TB globally as the most common cause of death from an infectious disease, but in low- and middle-income countries, TB deaths remain far higher than those from COVID-19. As the number of people vaccinated against COVID-19 grows, the number of COVID-19 deaths decrease while TB will continue to kill roughly 4,000 people every day."
Like COVID-19, tuberculosis is a disease of the lungs, though it is caused by bacteria rather than a virus. “A lot of the people that are dealing with TB — doctors, nurses, health-care workers, providers — were shifted from TB to COVID,” explains Ditiu.
Hospital wards used for TB patients were rapidly converted into emergency COVID-19 units. As countries imposed lockdowns to fight the pandemic, TB diagnosis and treatment were again hit hard.
“Usually, people with TB are the ones that are most vulnerable and are the ones that have a lot of difficulties in reaching health care. And one of the reasons can be distance, can be money, poverty — and other barriers. These things were actually exacerbated by COVID,” Ditiu said.
Many patients are badly infected by the time they reach any clinic or hospital. “A lot of the clinicians are saying that they are observing ... very, very bad forms of tuberculosis that they didn’t see in many years. These bad forms of TB mean that mortality will be higher. It also means that transmission within the household will be bigger,” Ditiu told VOA in an interview Monday.
Doctors say there is an opportunity to claw back lost progress. The coronavirus pandemic has forced healthcare providers and communities closer together. By combining testing, contact tracing and treatment for COVID and TB, both diseases can be tackled at the same time.
The report from the Stop TB Partnership praises India’s efforts to identify and tackle the decline in diagnosis and treatment at an early stage.
“Bi-directional screening of TB and COVID-19 took place in people displaying influenza-like illness and severe acute respiratory infections. Contact tracing systems and testing for TB linked to COVID-19 contact tracing were quickly set up. Private sector TB care facilities were reopened, and digital tools were rolled out to help people with TB stick to treatment regimens, among other measures,” the report notes.
Scientists say urgent investment also is needed in new TB vaccines and treatments.