Focus on Covid-19 undermines fight against other lethal diseases

The coronavirus pandemic threatens to derail years of effort and investment that has gone into the fight against tuberculosis (TB), one of the world’s deadliest diseases, if governments don’t take immediate countermeasures, experts say. 

No other disease has killed as many people as TB, which is caused by the airborne pathogen Mycobacterium tuberculosis, even as treatments and drugs have been around for decades.

TB kills 1.4 million people every year, mostly in developing countries like India and Indonesia. But in 2020, Covid-19 related deaths surpassed TB’s casualty count. 

Governments around the world have diverted health resources into tracing Covid-19 patients and containing the pandemic, which has battered the global economy and killed more than 2.5 million since it emerged last year. 

The number of TB patients registered in nine high-burden countries, which account for 60 percent of all cases, saw a drop of between 16 percent and 41 percent, according to the Stop TB Partnership and US Agency for International Development. 

“A 20 percent global drop in TB treatment enrollment pushes the TB response to 2008 levels in terms of people diagnosed and treated,” wrote Dr Harsh Vardhan, India’s Health Minister, and Dr Lucica Ditiu of Stop TB Partnership, in an article they co-authored and published last month. 

“Twelve years of hard work and investments are simply lost, and we see ourselves on a difficult path to recovery.” 

Besides TB, experts say, efforts to contain other deadly diseases such as malaria and measles face a setback if governments don’t come up with an effective strategy to tackle the challenge. 

Still strong after a billion deaths

TB has killed over a billion people in the past 200 years. But scientific progress and the development of antibiotics has helped slow its spread and made treatment possible. 

The mortality rate of TB fell 47 percent between 1990 and 2014 due to better international coordination, say the Bill and Melinda Gates Foundation, which backs anti-TB efforts. 

A poor man’s disease, it mostly infects those who suffer from malnutrition and live in confined places, which lack proper ventilation and hygienic sewage disposal systems. 

TB’s spread in low-income communities often means that patients are unable to afford the expensive treatments as they have to continue work to earn their daily wages. 

This has led to mutations such as drug-resistant TB, in which the first line of antibiotics don’t work, and which has become a serious health concern. 

The Covid-19 pandemic, which has overwhelmed hospitals around the world, has added to the challenge of tracing TB cases as a lesser number of patients are showing up at clinics for treatment. 

Much like Covid-19, TB spreads when an infected person coughs or sneezes.

While it's treatable, people living with HIV/Aids and a weakened immune system due to any other illness are particularly vulnerable. 

Does Covid-19 response offer hope?

TB continues to spread as labs still rely on a century-old method to detect it. Examining a sputum sample under a microscope remains the most widely used and effective means to check if someone has TB. 

Experts have long called for investments in modern diagnostic tools, which can help doctors speed up detection, and drugs that can treat the disease faster. The BCG vaccine, used to treat TB, was first used in the 1920s. 

Over the years, WHO and NGOs have stressed on the importance of screening and tracing to curtail TB’s spread. But with social distancing becoming a norm during the Covid-19 pandemic, health staff is reaching out to fewer TB patients - something which is essential to ensure that a drug course is completed. 

This also led to decrease in TB enrollment programmes, which authorities use to keep track of patients. 

But countries such as the Philippines, Pakistan, Nigeria, Bangladesh and South Africa, can follow India’s example in this regard as New Delhi has successively integrated its Covid-19 strategy with the TB tracing programme, Vardhan and Ditiu wrote. 

India, which accounted for 31 percent of the global TB cases in 2019, saw a drop in its TB enrollment programme in wake of the lockdowns but was able to significantly narrow the gap by the end of 2020.