By Travis Decaminada
Key Takeaway: The World Health Organization recently released their 2021 Global Tuberculosis (TB) Report, wherein the organization notes that for the first time in a decade TB infections are increasing. Some experts suggest that Covid-19 is largely responsible for this surge, noting that healthcare resources are stretched thin by the pandemic and more, fear of Covid-19 may cause some TB patients to forgo visiting medical centers for both diagnoses and treatments.
Globally, tuberculosis (TB) infections have been decreasing for over a decade, now, however, infections are on the rise again, reports the World Health Organization (WHO). The problem is multi-faceted and interlinked with the Covid-19 pandemic – limited or diverted healthcare resources mean that fewer cases of TB are being diagnosed and that infected patients are going without treatment. Consequently, more people died of TB in 2020 than in any year since 2010.
To be more specific, according to the WHO’s 2021 Global TB Report, approximately 1.3 million people died of TB last year, up from 1.2 million in 2019. However, only 5.8 million people were diagnosed with TB in 2020, down from 7.1 million in 2019. The WHO estimate that there are currently 4.1 million people infected with TB worldwide, but whom have not been formally diagnosed and their cases not reported to the proper authorities. Preventative TB treatments are also being administered less frequently, reportedly down 21% over the past year. Modeling from the WHO suggest that 2021 and 2022 may also see excessive TB deaths. From the WHO:
“This report confirms our fears that the disruption of essential health services due to the pandemic could start to unravel years of progress against tuberculosis,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This is alarming news that must serve as a global wake-up call to the urgent need for investments and innovation to close the gaps in diagnosis, treatment and care for the millions of people affected by this ancient but preventable and treatable disease.”
TB is especially dangerous for the immunocompromised and those suffering from HIV; In addition to the 1.3 million deaths in 2020, the WHO also report that ~200,000 HIV positive people also lost their lives while battling TB. The relationship between HIV and TB is extremely severe, in some countries, such as South Africa, where upwards of 65% of patients diagnosed with TB are also HIV positive.
A related article from NPR posits that fear of Covid-19 may be preventing some people infected with TB from visiting a doctor or clinic to receive treatment. One doctor from South Africa is quoted in the article as saying “The reason that people didn't come for (TB) treatment is principally because they were afraid that they would get COVID at a health care facility. And let's face it, that's not impossible." Curing TB can reportedly often take months, if not years, and oftentimes requires many visits to a doctor’s office. This also means that some people infected with TB wait until symptoms are overly severe before they seek treatment, not only putting themselves in danger but also contributing to overloaded hospital systems.
Finally, funding to fight TB is yet another pain point, especially when resources are being diverted to fight Covid-19. Per the WHO, in 2020 global spending to combat TB fell from $5.8 billion to $5.3 billion, falling short of the WHO’s $13 billion-dollar annual target. Investments to develop new TB diagnostics, drugs, and vaccines are also significantly lower than expected.
Information on TB from the Centers for Disease Control and Prevention.
More information on TB from the World Health Organization.