Disruption to testing and treatment services has reversed years of progress in tackling TB, one of the deadliest infectious killers on the planet
Years of progress in tackling TB – the second deadliest infectious killer on the planet, after Covid – have been reversed as a result of the pandemic, according to a new WHO report.
Some 1.5 million people died from the disease in 2020, up from 1.4 million in the previous year. New diagnoses fell from 7.1 million to 5.8 million over the same period – though estimates for undiagnosed patients living with TB rose. And the number of people accessing preventative treatment decreased by 21 per cent, to 2.8 million.
“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,” said Dr Tedros Adhanom Ghebreyesus, director-general of the WHO.
Caused by a bacterium called Mycobacterium tuberculosis, the infection is spread through inhaling tiny droplets from the coughs or sneezes of an infected person. TB typically affects the lungs, but can attack other parts of the body, such as the kidney or brain.
Prior to the emergence of Covid-19, it was the deadliest infectious disease in circulation among humans. Approximately 90 percent of those who fall sick with TB each year live in just 30 countries, including India, Nigeria, South Africa and Vietnam.
As a result of disruption from Covid-19, the global targets for tackling TB “appear increasingly out of reach,” the WHO said. The organisation’s ‘End TB Strategy,’ set in 2015, aims for a 90 per cent reduction in TB deaths and 80 per cent reduction in infections by 2030.
Even before Covid, these targets were off track. Globally, the number of annual TB deaths reported between 2015 and 2020 fell by just 9.2 per cent, while cases dropped by 11 per cent.
The WHO said the impact of the pandemic on TB services in 2020 had been “particularly severe”, with far fewer people being diagnosed and treated. Global investment into tackling the disease also dropped off last year.
As part of its report, the WHO outlined two main challenges that had emerged throughout the 2020 in tackling the infection: the movement of human and financial resources away from TB services to the Covid response; and the inability of people to seek and regularly access care in during lockdowns.
The increase in deaths occurred mainly in the 30 countries with the highest burden of TB, the WHO said. Of the 1.5 million fatalities reported last year, 214,000 were among HIV patients, who are particularly vulnerable to TB.
Modelling projections suggest the number of people who develop and die from the disease could further rise in 2021 and 2022.
Currently, an estimated 4.1 million people suffer from TB but have not been diagnosed with the disease or officially reported to national authorities, the WHO’s report added. This figure is up from 2.9 million in 2019.
Along with a reduction in the provision of preventive treatment, the number of people treated for drug-resistant TB fell by 15 per cent, from 170, 000 to 150, 000 – equivalent to only about 1 in 3 of those in need.
Global spending on testing, treatment and prevention services fell, too, from £4.2 billion to £3.8 billion, according to the WHO’s research.
Having plagued humanity for thousands of years, TB was first shown to be curable in the late 1950s. About 85 per cent of people who develop the disease can be successfully treated with a six-month drug programme. This also curtails onward transmission of the infection.
The international charity Medecins Sans Frontieres (MSF) said it was unacceptable that millions of people are continuing to die each year from a curable disease “because they do not have access to the diagnostics and drugs that can save their lives”.
Stijn Deborggraeve, a diagnostics advisor at MSF, added: “With the alarming increase in TB deaths in 2020 due to the Covid-19 pandemic, much more needs to be done to close the deadly testing gap and ensure that many more people with TB are diagnosed and treated.”