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Deaths from TB increase for the first time in 10 years, says WHO

PT Jyothi Datta Mumbai | Updated on October 16, 2021

Challenges in access to diagnostics, drugs, and funding falls short

For the first time in over a decade, deaths from tuberculosis have increased, said the World Health Organization, pointing to Covid-19 as the cause of this reversal of years of global progress in tackling TB.

“In 2020, more people died from TB, with far fewer people being diagnosed and treated or provided with TB preventive treatment compared to 2019, and overall spending on essential TB services falling,” the WHO said in its Global TB report (2021).

Covid disruption

Disruptions in access to TB services and a reduction in resources were outlined as reasons, as many countries reallocated human and financial resources from TB to Covid-19. The lock-down further exacerbated the situation, as people struggled to access care, the report 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,” Dr Tedros Adhanom Ghebreyesus, WHO Director-General, said on the findings.

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Approximately 1.5 million people died from TB in 2020, the report said, and the increase in the number of deaths was largely in the 30 countries with the highest burden of TB. WHO modelling projections suggest that the number of people developing TB and dying from the disease could be much higher in 2021 and 2022.

Worrying dip in TB notifications

Access challenges to TB services meant that many people with TB were not diagnosed in 2020, the report said. The number of people newly diagnosed with TB and those reported to national governments fell from 7.1 million in 2019 to 5.8 million in 2020.

“WHO estimates that some 4.1 million people currently suffer from TB but have not been diagnosed with the disease or have not officially reported to national authorities. This figure is up from 2.9 million in 2019,” it added.

India was a key contributor to this global dip in TB notifications between 2019 and 2020, at 41 per cent, followed by Indonesia (14 per cent), the Philippines (12 per cent) and China (8 per cent).

“These and 12 other countries accounted for 93 percent of the total global drop in notifications,” it said.

Low funding

Funding was the other challenge in the low- and middle-income countries (LMICs) that account for 98 percent of reported TB cases. Of the total funding available in 2020, 81 percent came from domestic sources, with the BRICS countries (Brazil, Russian Federation, India, China and South Africa) accounting for 65 percent of total domestic funding, the report said.

The report also noted a fall in global spending on TB diagnostic, treatment and prevention services, from $5.8 billion to $5.3 billion, less than half the global target for fully funding the TB response of $13 billion annually by 2022.

Testing and treatment gaps

Pointing out that it was unacceptable that people died from a curable disease because they could not access diagnostics and treatment, Stijn Deborggraeve, Diagnostics Advisor with humanitarian organisation MSF’s Access Campaign, said access to diagnostic tests was still limited in many high TB burden countries because they depended on GeneXpert tests supplied by Cepheid “which remain too expensive”.

Also see: A real shot at ending TB

“Covid-19 vaccine inequity and the failure to come up with a vaccine for tuberculosis are two sides of the same coin — a devaluation of human life in poor countries,” said Guy Marks, President of the International Union Against Tuberculosis and Lung Disease (The Union).

“Until Covid-19 came along, TB was killing more people than any other infectious disease but you´d never know it. If we had spent a fraction of the energy and money that governments and pharma have spent developing Covid-19 vaccines and then getting them to wealthy countries, we’d have stopped TB in its tracks long ago,” he said.

Published on October 16, 2021

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