Urgent Action Needed To End Tuberculosis By 2030, Concludes WHO’s Global Tuberculosis Report
TB screening activities in rural Cambodia.

The world must take urgent action to end the global tuberculosis epidemic by 2030, especially as the pandemic threatens to unwind hard-won progress made in past decades, concluded the WHO’s 2020 Global Tuberculosis Report on Wednesday. 

While the WHO European region is on track to achieve key 2020 targets, the rest of the world has fallen short of the milestones set for this year. Those targets included a 20% reduction in tuberculosis incidence and a 35% reduction in deaths between 2015 and 2020. 

As of 2019, global TB incidence had only dropped by 9% and TB deaths only dropped by 14%, warned the report. And progress is likely to lag even further due to the severe interruptions seen this year in TB diagnosis and treatment activities. 

“The report is sobering [and shows] that we were not on track, even before COVID hit,” warned Peter Sands, Executive Director of the Global Fund at Wednesday’s launch of the report. “Far too many people die of TB [1.4 million]…and the gap between those that fall ill and those that are diagnosed and treated is far too great.”

The report comes just two years after the world gathered at the United Nations high-level meeting on Tuberculosis (TB) to set bold targets to bring the world’s most deadly infectious disease to a halt. 

Although TB is largely preventable and treatable, it kills 4,000 people a day. That is as compared to just over 5,000 deaths from the coronavirus in past weeks. Since 2000, scientific and health systems innovations leading to much more effective and rapid TB diagnosis and treatment have averted 60 million deaths, according to the WHO.

The world is off track to reach TB targets for 2020.

TB Funding “Major Issue”; TB Testing “Critical”

Funding, however, remains a “major issue” for TB prevention, diagnosis, treatment and care, added Sands. In 2020, funding for TB prevention, diagnosis, treatment and care was only half of the US$ 13 billion target agreed by world leaders in 2018 – a “tiny fraction” compared to the world’s spending on COVID. 

Similarly to previous years, 85% of TB funding is domestic, which is problematic given recent reallocations in funding towards COVID by member states, said panelists on Wednesday.

TB testing in high-burden countries since January 2020

Although TB testing is critical to save lives, countries have struggled to maintain pre-pandemic levels of testing, especially in high burden countries like India, Indonesia, the Philippines and South Africa, according to data collated from over 200 countries. In these countries, testing has dropped by up to a third between January and June 2020, in comparison to the same 6-month period in 2019, said WHO’s Global TB Programme Director Tereza Kasaeva on Wednesday.

“A clear focus [is needed] on identifying missing cases and getting these people treatment. If you don’t find them, you can’t treat them, you can’t save their lives,” warned Sands.

In light of limited COVID-19 testing infrastructure, existing TB diagnosis platforms have been repurposed to test for COVID-19, such as the molecular GeneXpert platform, said Sands. And while these machines are “very effective” to detect COVID-19, countries should explore how to screen for both diseases, potentially by running GeneXpert machines for longer periods, buying more machines, and most importantly, investing in low-cost rapid diagnostic tests for TB.

“One of the biggest things that could transform the effectiveness of the fight against TB would be access at scale to cheap high quality rapid diagnostic tests, because that would make finding missing people with TB significantly more effective.” 

According to the WHO’s predictions, a 50% drop in TB case detection could result in up to 400,000 additional TB deaths this year alone – although other estimates suggest an additional 1.4 million TB deaths in the next five years.

Peter Sands, Executive Director of Global Fund

Image Credits: Yoshi Shimizu/WHO, WHO , WHO, The Global Fund.

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