Feature

Millions could die in the coming years as governments take their eye off the biggest infectious disease

Choosing to ignore TB again would erase at least half a decade of hard-earned progress against the world ’ s most deadly infection and make millions more sick

The research , released by the Stop TB Partnership , estimates that at least five years of progress on TB prevention will be lost due to the coronavirus pandemic this year .

Its findings have outraged Dr Lucica Ditiu , executive director of the partnership of 1,500 global organisations with an interest in the disease . She says that governments have got their priorities wrong and should view TB as a comparable threat to public health and our economies , even as COVID-19 continues to spread globally .

“ We never learn from mistakes ,” she said . “ For the past five years , TB has remained the biggest infectious disease killer because the TB agenda has consistently become less visible in front of other priorities .”

She argues that governments today face a torturous path , having to navigate between the “ imminent disaster ” of COVID-19 and the longer-term needs of TB . Choosing to ignore TB again would erase at least half a decade of hard-earned progress against the world ’ s most deadly infection and make millions more sick .

Speaking to Global Health Asia-Pacific from the partnership ’ s offices in Geneva , Dr Ditiu described TB as a “ forgotten disease ”, but one that still kills 1.5 million people each year . Deaths from TB , however , have been declining steadily in recent years due to intensified activities by high burden countries to find and treat people with TB early . To change what has been working , though , would cause the death toll to spike again .

According to the study published in May in collaboration with the Imperial College London , Avenir Health , and Johns Hopkins University , a three-month lockdown and a protracted 10-month restoration of services would lead to global TB incidences and deaths rising next year to levels last seen in 2013 and 2016 . In 2013 an estimated nine million people fell ill with TB and in 2016 1.6 million died from the disease . In comparison , around seven million cases and 1.4 million deaths were recorded last year .

National governments , therefore , will need to take immediate measures if they want to save millions of lives . These should be focused on minimising the impact of the current pandemic on TB and getting TB diagnostics , treatments , and prevention back on track in line with targets set by the United Nations , even during COVID-19 lockdowns in some countries . Governments will also need to undertake a massive catch-up effort to actively diagnose , trace , treat , and prevent TB .

In 2018 , the UN and its members committed to significantly scale up their TB response and identified an additional 600,000 people who could access TB care . Progress was also made in 2019 , but the onset of the pandemic and the mitigation measures put in place to counter it set back efforts to reach the targets .

As a result of these measures , TB case detection has dramatically fallen and treatments have often been delayed . The risk of interruptions in treatment and a potential rise in people with drug-resistant TB has also increased .

To claw back lost ground , Dr Ditiu has called on the leadership in all countries , particularly those with a high TB burden , to continue their TB response programmes and protect the most vulnerable . “ We urge governments to secure the human and financial resources needed for seamless continuation of TB services amid the COVID-19 response ,” she said .

Another frustration faced by the TB community is that research efforts to develop a cure have been put on ice while the world focuses on a vaccine for COVID-19 .

This year , enrolment in a new TB vaccine trial and treatment regimen stalled . At the same time , financing for research , not easy to secure in the best of times , has not been flowing this year as had been hoped .

“ This is really very frustrating for us because the funding hasn ’ t come and the enrolments haven ’ t happened . The vaccine pipeline for COVID-19 and the funding that it ’ s getting have been so impressive , but none of this ever applies for TB . It ’ s a disease that ’ s been around for thousands of years , and there ’ s still no vaccine for it .

52 NOVEMBER 2020 GlobalHealthAsiaPacific . com