The COVID-19 pandemic has reversed years of global progress in tackling tuberculosis and for the first time in over a decade, TB deaths have increased, according to the 2021 Global TB report released recently by the World Health Organization (WHO).
Worse, India (41%) was on the list of countries which topped those that contributed most to the global reduction in TB notifications between 2019 and 2020. India along with Indonesia (14%), the Philippines (12%), China (8%) and 12 other countries accounted for 93% of the total global drop in notifications.
The WHO estimated that some 4.1 million people currently suffer from TB but had not been diagnosed with the disease or had not officially reported to national authorities. This figure is up from 2.9 million in 2019.
The organisation added that there was also a reduction in provision of TB preventive treatment.
“Some 2.8 million people accessed this in 2020, a 21% reduction since 2019. In addition, the number of people treated for drug-resistant TB fell by 15%, from 1,77,000 in 2019 to 1,50,000 in 2020, equivalent to only about 1 in 3 of those in need,’’ it said.
In 2020, more people died from TB, with far fewer people being diagnosed and treated or provided with TB preventive treatment compared with 2019, and overall spending on essential TB services falling, it added.
It explained that the first challenge was disruption in access to TB services and a reduction in resources. In many countries, human, financial and other resources had been reallocated from tackling TB to the COVID-19 response, limiting the availability of essential services. The second was that people had struggled to seek care in the context of lockdowns.
“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,” said WHO director-general Tedros Adhanom Ghebreyesus. “This is alarming news that must serve as a global wake-up call to the urgent need for investments and innovation to close the gaps in diagnosis, treatment and care for the millions of people affected by this ancient but preventable and treatable disease,” he added in the release.
TB services are among many others disrupted by the COVID-19 pandemic in 2020, but the impact on TB has been particularly severe.
For example, approximately, 1.5 million people died from TB in 2020 (including 2,14,000 among HIV positive people).
The increase in the number of TB deaths occurred mainly in the 30 countries with the highest burden of TB. Now WHO modelling projections suggest the number of people developing TB and dying from the disease could be much higher in 2021 and 2022.
“Challenges with providing and accessing essential TB services have meant that many people with TB were not diagnosed in 2020. 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,’’ noted the WHO.
Giving details of the global investment for TB falls, the WHO said that the funding in the low- and middle-income countries that account for 98% of reported TB cases remained a challenge. Of the total funding available in 2020, 81% came from domestic sources, with the BRICS countries (Brazil, Russian Federation, India, China and South Africa) accounting for 65% of total domestic funding.
Earlier globally, the number of people falling ill with TB each year (relative to population) dropped 11% from 2015 to 2020, just over half-way to the 2020 milestone of 20%.