TB prevention, treatment targets ‘likely to be missed’

PRIOR to the Covid-19 pandemic, many countries were making steady progress in tackling tuberculosis (TB), with a 9% reduction in its incidence seen between 2015 and 2019 and a 14% drop in deaths over the same period.

However, a new report by the World Health Organization ( WHO) shows that access to TB services remains a challenge, and global targets for prevention and treatment will likely be missed without urgent action and investments.

About 1.4 million people died from TB-related illnesses last year.

Of the estimated 10 million people who contracted TB that year, some three million were not diagnosed with the disease, or were not officially reported to national authorities.

About 465 000 people were newly diagnosed with drug-resistant TB last year and, of these, less than 40% were able to access treatment.

There was limited progress in scaling up access to treatment to prevent TB, the WHO said.

“Equitable access to quality and timely diagnosis, prevention, treatment and care remains a challenge,” said WHO director-general Dr Tedros Adhanom Ghebreyesus.

“Accelerated action is urgently needed worldwide if we are to meet our targets by 2022.”

About 14 million people were treated for TB in 2018-2019, just over one-third of the way towards the fiveyear target of 40 million, according to the report.

Some 6.3 million people started TB preventive treatment in 2018-2019, about one-fifth of the way towards the five-year target of 30 million.

This year funding for TB prevention, diagnosis, treatment and care reached $6.5 billion (R108bn), representing only half of the $13billion target agreed by world leaders in the UN Political Declaration on TB.

Disruptions in services caused by the Covid-19 pandemic have led to further setbacks. In many countries, human, financial and other resources have been reallocated from TB to the Covid-19 response. Data collection and reporting systems have also been negatively impacted.

According to the report, data collated from over 200 countries has shown significant reductions in TB case notifications, with 25%-30% drops reported in high-burden countries India, Indonesia and the Philippines between January and June compared to the same six-month period last year.

These reductions in case notifications could lead to a dramatic increase in additional TB deaths, according to WHO modelling.

However, in line with WHO guidance, countries have taken measures to mitigate the impact of Covid-19 on essential TB services, including by strengthening infection control.

A total of 108 countries – including 21 countries with a high TB burden – have expanded the use of digital technologies to provide remote advice and support. To reduce the need for visits to health facilities, many countries are encouraging home-based treatment, all-oral treatments for people with drug-resistant TB, provision of TB preventive treatment, and ensuring people with TB maintain an adequate supply of drugs.

“In the face of the pandemic, countries, civil society and other partners have joined forces to ensure that essential services for both TB and Covid-19 are maintained for those in need,” the WHO’s Global TB Programme director Dr Tereza Kaseva said.

“These efforts are vital to strengthen health systems, ensure health for all, and save lives.”