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Urgent measures are needed to improve access to tuberculosis care, health experts have warned after a global report found that COVID-19 has wiped out years of progress in tackling the curable disease.
Deaths from TB have increased globally for the first time in more than a decade according to the World Health Organization’s Global Tuberculosis Report 2021, rising to 1.5 million in 2020 from 1.4 million in 2019.
Mel Spigelman, president and chief executive officer of the TB Alliance, said it was time for countries to honour their pledges on TB.
“We have seen a number of highly promising breakthroughs in tuberculosis drug development over the past few years, but the promise of new treatments must be accompanied by equitable and universal access,” he said.
UN targets are to reduce deaths from TB by 90 per cent and TB incidence by 80 per cent by 2030 compared with 2015 levels.
Although TB incidence fell by 11 per cent globally between 2015 and 2020, TB programmes in many countries remain “off target” due to disruptions to services during the COVID-19 pandemic, according to the report, which includes data from 200 countries.
“Reduced access to TB diagnosis and treatment has resulted in an increase in TB deaths,” it explains, forecasting the impact to be “much worse in 2021 and 2022”.
As COVID-19 has swept across the world, health systems have come under strain, while lockdowns and stigma have also reduced people’s ability to seek TB care, it notes.
“We have seen a number of highly promising breakthroughs in tuberculosis drug development over the past few years, but the promise of new treatments must be accompanied by equitable and universal access.”
Mel Spigelman, president and chief executive officer, TB Alliance
WHO director-general Tedros Adhanom Ghebreyesus said: “This report confirms our fears that the disruption of essential health services due to the pandemic could start to unravel years of progress against tuberculosis.”
The WHO estimates that 9.9 million people were infected by tuberculosis in 2020 but 4.1 million of them were neither diagnosed nor reported to authorities. The number of undiagnosed or unreported was only 2.9 million in 2019.
“Countries need to put in place urgent measures to restore access to essential TB services,” said the WHO’s global TB programme director, Tereza Kasaeva during a virtual press briefing in Geneva on 14 October.
TB is a curable and preventable disease caused by bacteria that usually affects the lungs.
In 2020, the largest number of new TB cases (43 per cent) occurred in the WHO South-East Asia region, followed by the WHO Africa region (25 per cent) and the WHO Western Pacific region (18 per cent).
Responding to the report, advocacy organisations highlighted concerns over unfair access to TB care in affected communities and funding shortfalls for TB programmes.
The WHO report revealed that global spending on TB diagnostic, treatment and prevention services fell from US$ 5.8 billion to US$ 5.3 billion between 2019 and 2020.
Lucica Ditiu, executive director of the Stop TB Partnership, said: “People are dying because we are failing to empower and support them and failing to ensure they have access to the preventive therapy, diagnostic tools, and treatments they need.”
She added: “I am afraid we are running out of time, and we need speed, money, and commitment today if we want to make a dent in the TB epidemic.”
Osamu Kunii, head of strategy, investment and impact at the Global Fund, said that nearly 70 per cent of TB financing came from domestic resources, highlighting the need to mobilise more domestic resources and increase the efficiency of TB programmes.
“Increasing domestic resources is a must. We need a more strategic approach in innovative financing, to mobilise more resources for TB,’ said Kunii.
Tuberculosis is second only to COVID-19 as the leading cause of death worldwide from a single infectious agent, according to the WHO.
The rise in TB deaths during the pandemic should serve as a lesson and inform public health decisions during future health crises, said Elisha Osati, a respiratory physician from the department of internal medicine at Muhimbili National Hospital in Tanzania.
“We need to explore opportunities presented by COVID-19 in advancing the prevention of TB in such unprecedented scenarios like pandemics,” Osati told SciDev.Net.
“When the pandemic hit, it was necessary that people with or at risk of infectious diseases such TB, malaria and HIV, be given special attention in terms of extending access to essential medical services.”