‘A worse reality than we expected’: COVID-19 fuels TB epidemic
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Experts said during a media briefing Thursday that the impact of COVID-19 on the tuberculosis epidemic is even worse than they predicted a year ago.
“A year ago, we did a very similar briefing,” said Lucica Ditiu, MD, executive director of the Stop TB Partnership. “In that briefing, we assessed 3 months of lockdown and 10 months of recovery — we thought that by the end of 2020 we would be back to normal — and the modeling done at the time and estimates we shared became a reality, and a worse reality than we expected.”
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On Thursday, the Stop TB Partnership shared updated data showing that nine of the countries with the most TB cases — which represent 60% of the global TB burden — saw a drastic decline in diagnosis and treatment of TB infections in 2020, ranging from 16% to 41%. Looking at the 23 countries included in Stop TB Partnership surveillance, 1 million fewer people were tested and diagnosed for TB, equaling a 23% overall decrease. According to the data, this drop in diagnosis and treatment brought the overall number of people diagnosed and treated for TB in those countries to 2008 levels.
“Not only do we have a lot of lives of people suffering, but this is also taking us back to 2008-2009 data,” Ditiu said. “This is a dramatic situation.”
In addition to the worldwide drop in TB diagnosis and treatment, data shared from India and South Africa show that individuals with TB and COVID-19 coinfections have three times higher mortality than people infected with only TB, making contact tracing, case finding and TB and COVID-19 testing more important than ever, according to the Stop TB Partnership.
“We may not reach the 2030 goals to end TB with the current pace,” Thokozile Phiri Nkhoma, a Stop TB Partnership board member, said during Thursday’s briefing. “My request is that we are all reminded of the efforts that we had set aside in 2018. We need more and more comprehensive, collaborative service for TB and COVID-19 to ensure that the achievements made continue.”
Previously, in May 2020, the Stop TB Partnership shared data from a modeling study showing that a 3-month lockdown, followed by 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 during this time, at a global level.
“Did it matter? Not too much, I have to say,” Ditiu said. “There were a few countries that paid attention and tried to find a way to address TB and COVID-19 at the same time. However, globally, there was not a lot of attention paid.”
Despite this, Ditiu says that there is hope moving forward.
“There are ways forward. It is possible to recover from this. We just need the vision, power, and the ambition to push the TB agenda and not allow COVID-19 mitigation measures and COVID-19 disease and pandemic to impact TB,” Ditiu said. “We need to buckle up and recover from this.”
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