Twelve months of Covid-19 reversed 12 years of global progress against tuberculosis, worse than previously estimated.
The pandemic has resulted in a nearly 25% reduction in diagnosis and treatment worldwide, according to research published on Thursday by a coalition working to end tuberculosis.
Due to the impact of the Covid pandemic on services, the number of people diagnosed and treated for tuberculosis in the most affected countries has dropped to 2008 levels, said the executive director of the Stop TB Partnership, Lucica Ditiu. A modeling study published last year estimated a five to eight year setback.
“Twelve years of impressive gains in the fight against tuberculosis – including the reduction in the number of people missing from tuberculosis treatment – have been tragically reversed by another virulent respiratory infection,” said Ditiu.
“I hope that in 2021 we will be able to put on the seat belt and, at the same time, intelligently treat TB and Covid-19 as two airborne diseases with similar symptoms.”
The effect on countries depends on their existing disease burden. Data from India and South Africa showed that people infected with TB and Covid-19 are three times more likely to die than those infected with TB alone, meaning that preventive measures such as contact tracking and testing are essential to maintaining low rates.
“After less than a year, a vaccine has been developed and is now being deployed to help contain and, hopefully, end the Covid-19 pandemic,” said Thokozile Phiri Nkhoma, board member of Stop TB Partnership.
“But although tuberculosis has been around since the time of the pharaohs, the only approved vaccine is 100 years old and does not work fully, especially in adults. First-line treatment for TB has been around for several decades and drug resistance is increasing, while the millions of people with TB who are not found and treated remain at risk of spreading the disease. “
Each year, tuberculosis infects 10 million people and kills 1.5 million, more than any other infectious disease. Although Covid-19 overcame tuberculosis in 2020 as the most common cause of death from infectious disease, tuberculosis still kills more people than Covid in low- and middle-income countries.
Some countries struggled hard to reverse the setbacks. The Indian Ministry of Health, after seeing a 70% drop in TB notifications in the first four months of 2020, integrated TB reach into Covid-19 programming.
“Tuberculosis didn’t go anywhere when the Covid-19 pandemic happened,” said India’s health minister, Harsh Vardhan. “People were distracted, health professionals were redirected and health systems were overwhelmed.
“Recovery efforts are successful with political leadership and substantial resources, along with the insistence that Covid-19’s outreach and prevention efforts include working with tuberculosis rather than replacing it.”
Last week, the US administration approved $ 3.5 billion (£ 2.5 billion) in emergency financing for low- and middle-income countries to combat Covid-19 and help mitigate the impact of the pandemic on efforts to combat tuberculosis, malaria and HIV, all of which have been severely affected by resources being redirected.
Peter Sands, executive director of the Global Fund, said that while it looks like there may be light at the end of the tunnel to Covid, “for the communities we’re talking about here, those at higher risk for tuberculosis, we’re in the darkest spot” .