WeeklySA_AdminALERT: It is estimated that one-third of people undiagnosed and untreated in 2022…
By WSAM Reporters
More than 27 million lives could be lost globally resulting in more than R247 trillion (or $13 trillion) in economic losses between now and 2050 if the current inaction against the souring tuberculosis (TB) deaths is not curtailed or stopped.
This is according to a new report from the Lancet Commission, which is co-authored by the University of Cape Town’s (UCT) researcher Helen Cox. According to the report, for the first time in 20 years, there has been a significant increase in TB deaths globally — rising from 1.4 million in 2019 to 1.6 million in 2021.
According to Cox, who is an associate professor at UCT’s Institute of Infectious Diseases and Molecular Medicine, one-third of people world-wide were undiagnosed and untreated in 2022 due to a the fact that a significant attention was shifted to Covid- 19 pandemic.
The new study described TB epidemic as a global emergency. This was as a result of Cvid-19 which is said to have erased years of reduction in TB mortality rates. This resulted in a troubling decline in the number of people diagnosed with TB. The study estimates one-third of people to have been undiagnosed and untreated in 2022 globally.
“The COVID-19 pandemic significantly impacted global health systems’ ability to prevent, screen and treat TB. Covid-19 quickly and substantially disrupted TB response efforts as diagnostic infrastructure was diverted away from TB programmes and lockdowns led to reduced access to TB treatment services,” the report said.
It argued that in almost all high TB burden countries, Covid-19 resulted in health worker shortages and burnout, further diminishing health systems’ capacity to provide essential TB services. Covid-19 also had a negative effect on many countries’ abilities to invest in health, with precious resources for health programmes being diverted to respond to Covid-19 and economic disruptions impacting governments’ abilities to prioritise health moving forward.
“As the global community, we have failed dismally in our response – what is now needed is a much greater global commitment that comes with dramatically increased funding on all levels. The response to the Covid-19 pandemic shows us what can be done; we need the same urgency for TB. The global response also needs to be guided by the affected individuals and communities if we are to truly make a difference,” Cox said.
According to her, new treatment regimens and several late-stage vaccine candidates present an incredible opportunity to make major inroads in preventing TB deaths. As the United Nations High-Level Meeting (UNHLM) on tuberculosis (TB) is expected on September 22, the report released recommendations which provide a path forward to turn the tide on this preventable, treatable and curable disease. They include:
- Immediate scale-up in access to molecular diagnostics and AI-assisted chest x-ray technology.
- Sustained investments in research and development to accelerate progress on new tools including non-sputum-based tests such as tongue swabs, urine-based antigen tests and improved screening tools, all of which are faster and more accurate than sputum tests, which can take one to eight weeks to provide results.
- Addressing malnutrition as a major risk factor for TB with more than a third of annual TB incidence attributable to under nutrition — especially in Southeast Asia.
- According to Cox, recent research illustrates the positive impact of giving food baskets to patients with TB and their closest contacts. In a large study in India, better nutrition in patients with TB reduced incidence of infection by nearly 50% while reducing mortality among those treated for TB by nearly 60%.
- Endorsement of the 1/4/6×24 campaign, an effort to bring new, shorter, safe and effective TB regimens to as many countries as possible by 2024. Specifically, the report outlines recommendations for ensuring access to one-month regimen or once-weekly for TB prevention, four months for drug-sensitive TB, and six months treatment regimen for drug-resistant TB.
“The cost of inaction on TB is massive. More than 27 million lives and over R247 trillion or $13 trillion in economic losses will result if there is a business-as-usual trajectory between now and 2050,” said Cox.
A recent estimate commissioned by the STOP TB Partnership proposes a near-term target of R285 billion (US$15 billion) a year, rising to R380 billion (US$20 billion) in 2025, to end TB by 2030. This estimate takes into account lost ground due to Covid-19 and acceleration in the development of new tools.
According to Cox, donor financing plays a significant role in funding TB resources in many low- and middle-income countries as TB receives less funding from the Global Fund compared to HIV and malaria, even though TB accounts for 61% of global deaths caused by the three diseases.
The report recommends that the Global Fund allocate more money to TB based on disease burden and cost-effectiveness. It also suggests prioritising the increase in TB support for low-income countries with higher TB mortality.
This new report is a follow-up to the 2019 Lancet Commission on tuberculosis. The first report outlined a blueprint for reaching the goals set by the first UNHLM in 2018. While progress has been made in some areas, the targets of the UNHLM have not yet been achieved, according to the report.
“More than seven million people have died from TB in the past five years, emphasising the urgency to accelerate efforts,” said Cox.
FACTS ABOUT TB
- Tuberculosis (TB) is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent;
- In 2012, 8.6 million people fell ill with TB and 1.3 million died from TB across the world;
- More than 95 percent of TB deaths occur in low- and middle-income countries, and it is among the top three causes of death for women aged 15 to 44;
- In 2012, an estimated 530 000 children became ill with TB and 74 000 HIV-negative children died of TB;
- TB is a leading killer of people living with HIV causing one-fifth of all deaths;
- Multi-drug resistant TB (MDR-TB) is present in virtually all countries surveyed;
- The TB death rate dropped 45 percent between 1990 and 2012.
- An estimated 22 million lives saved through the use of DOTS and the Stop TB Strategy recommended by WHO.
SOURCE: Dept of Health 2023
