By Tabitha Oeri

Pandemic response in the past one year has pushed aside tuberculosis (TB) outreach and services resulting in a tremendous decrease in diagnosis and treatment worldwide. The drop has eliminated 12 years of progress in the fight against TB, a recent data by Stop TB Partnership reveals.

According to the data, nine of the countries with the most TB cases—representing 60% of the global TB burden—saw a drastic decline in diagnosis and treatment of TB infections in 2020, ranging from 16% -41% (an average of 23%).

These countries are namely Bangladesh, India, Indonesia, Myanmar, Pakistan, Philippines, South Africa, Tajikistan, and Ukraine. The drop brought the overall number of people diagnosed and treated for TB in these countries to 2008 levels implying a setback of 12 years thus calling upon an immediate recovery effort to be initiated.

“Twelve years of impressive gains in the fight against TB, including in reducing the number of people who were missing from TB care have been tragically reversed by another virulent respiratory infection,” Dr Lucica Ditiu, Executive Director of the Stop TB Partnership said.

“In the process, we put the lives and livelihoods of millions of people in jeopardy. I hope that in 2021 we buckle up and we smartly address, at the same time, TB and COVID-19 as two airborne diseases with similar symptoms.”

In a May 2020 Modelling Study research to predict the impact of COVID-19-related measures on TB conducted by Stop TB Partnership in collaboration with Imperial College and others, authors concluded that while stringent COVID-19 responses may only last months, they would have a lasting effect on TB in high-burden settings as they would limit outreach that focuses on TB diagnosis and treatment.

It was projected that a three-month lockdown and a protracted 10-month restoration period could lead to an additional 6.3 million cases of TB between 2020 and 2025 and an additional 1.4 million TB deaths.

Global TB incidence and deaths in 2021 would increase to levels last seen in between 2013 and 2016 respectively, implying an estimated setback of at least 5 to 8 years in the fight against TB due to focus on COVID-19 global pandemic that has turned the world on its head.

Currently TB programs of several high TB burden countries have made efforts to recover, some more successful than others. India was one of the first countries where the dramatic decline in TB notifications was seen and the national government’s TB notification system, “Nikshay,” reported a 70% drop between the 10th and 15th weeks of 2020.

By August 2020 a high-level committee under the chairmanship of the Indian Minister of Health developed a rapid response plan, with a primary goal of integrating TB outreach into all COVID-19 programming, taking advantage of how both infections attack people’s respiratory systems.

Dr Harsh Vardhan, Minister of Health and Family Welfare, India acknowledges that, “TB didn’t go anywhere when the COVID-19 pandemic hit. People just got distracted, health workers were redirected, and health systems became overwhelmed.”

Dr Vardhan adds that recovery efforts succeed with political leadership and substantial resources, along with an insistence that COVID-19 outreach and prevention efforts include TB work, instead of replacing it.

Stop TB calls for global investment in TB outreach and treatment in response to the COVID-19 pandemic. It urges the world to strategically prepare for future airborne pandemics building on the investments and strategies in TB response.

These include: infection control; bi-directional testing and contact tracing; communities, civil society networks and primary health care as diagnosis entry points; and expanding the laboratory networks to support integrated approaches to tackling TB and COVID-19.