Impact of COVID-19 on the fight against tuberculosis

Therefore, the damage of the coronavirus pandemic does not only refer to the fact that the mandatory quarantine prevented access to medical services for patients with tuberculosis. By infecting patients who already suffered (knowingly or not) from tuberculosis, it also contributed to raising the death rate among those people.

The World Health Organization (WHO) estimates that by 2020 this rate was 1.3 million deaths from tuberculosis among HIV-negative patients and 214,000 more among HIV-positive people.

But havoc doesn't stop there. The WHO also estimates that between 2019 and 2020 there was a 15% reduction in the number of drug-resistant people receiving treatment. And the figure rose to -21% in the case of those receiving preventive treatment against tuberculosis. As if that were not enough, the drop in investment globally in diagnosis, treatment and prevention fell to around 5,3 million dollars, which is less than half of what is needed to adequately combat this health problem.

Clearly, it is imperative to carry out actions that mitigate the impact that the urgent attention of the fight against COVID-19 has generated, and to restore access to tuberculosis detection and treatment services as soon as possible.

That is one of the central messages of the "Global Tuberculosis Report 2021" that the WHO published last year. Below we share some of the figures contained in this document, so that they can provide an overview of the combat against this problem that affects approximately one third of the world's population.

• In 2020, the global number of deaths caused by tuberculosis was 1.3 million people, almost double the deaths from AIDS (0.60 million). This means that the presence of COVID-19 has impacted people with tuberculosis more severely than those with AIDS.
• In 2019, according to WHO estimates, tuberculosis ranked 13th as the leading cause of death globally and the first as a cause of death by a single infectious agent. By 2020 they anticipated that it would be the second leading cause of death caused by a single infectious agent, just one place behind COVID-19 deaths.
  
• The incidence of tuberculosis in the regions served by WHO is as follows: Southeast Asia 43%, Africa 25%, Pacific West 18%, America 3%, Europe 2.3%.
• The most affected countries are: India (26%), China (8.5%), Indonesia (8.4%), the Philippines (6.0%), Pakistan (5.8%), Nigeria (4.6%), Bangladesh (3.6%) and South Africa (3.3%).
  
• Although tuberculosis affects people without distinguishing sex or age, in 2020 56% of patients were adult males. In contrast, 33% were adult women and 11% were children. This information is consistent with WHO data showing that the disease affects men more than women, and that the lack of timely detection is greater in men.
  
• While WHO's global goal for 2020 was to reduce the rate of TB deaths by 35% and the incidence by 20% (compared to 2015 levels), COVID-19 prevented them from being achieved. Globally, the reduction in the death rate between 2019-2020 was only 9.2%.  The good news is that, at the regional level, Europe reached 26% of the proposed goal.
  

Although the "Global Tuberculosis Report 2021" figures are far from what was expected, this document is a valuable map that indicates the steps needed to resume the fight against tuberculosis with new vitality.

We are confident that despite the stumbles, the efforts of the entire medical and scientific community, and WHO will bring this epidemic to an end to the date proposed by WHO in its End TB Strategy: 2035.

REFERENCE: WHO “Global Tuberculosis Report 2021”.