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A new report says that the global response to the COVID-19 pandemic is having unintended yet drastic consequences on tuberculosis (TB) services, with lockdowns and limitations on diagnosis, treatment and prevention services expected to increase the annual number of TB cases and deaths over the next five years; at least five years of progress on TB response will be lost.

Dr Lucica Ditiu, Executive Director, Stop TB Partnership

The modeling analysis released by the Stop TB Partnership on Wednesday, May 6, 2020 shows that, under a three-month lockdown and a protracted 10-month restoration of services, the world could see an additional 6.3 million cases of TB between 2020 and 2025 and an additional 1.4 million TB deaths during that same period.

“We never learn from mistakes. For the past five years, TB, a respiratory disease, has remained the biggest infectious disease killer because the ‘TB agenda’ consistently became less visible in front of other priorities,” said Dr Lucica Ditiu, Executive Director of the Stop TB Partnership.

“Today, governments face a torturous path, navigating between the imminent disaster of COVID-19 and the long-running plague of TB. But choosing to ignore TB again would erase at least half a decade of hard-earned progress against the world’s most deadly infection and make millions more people sick,” Dr Ditiu added.

The new study was commissioned by the Stop TB Partnership in collaboration with the Imperial College, Avenir Health and Johns Hopkins University, and was supported by USAID. The modeling was constructed on assumptions drawn from a rapid assessment done by The Stop TB Partnership on the impact of the COVID-19 pandemic and related measures on the TB response in 20 high-burden TB countries – representing 54% of the global TB burden.

According to Stop TB Partnership, the modeling focused on three high burden countries – India, Kenya, and Ukraine – and extrapolated estimates from those countries to create global estimates of the impact of COVID-19 on TB. The authors note that the model can be replicated in any other country and that the findings can be used by countries for data-driven decisions and financial requests.

TB is said to be a forgotten respiratory disease that still kills 1.5 million people each year, more than any other infectious disease. Scientists say that incidence and deaths due to TB have been declining steadily over the last several years as a result of intensified activities by high burden countries to find people with TB early and provide appropriate treatment.

In 2018, during the UN General Assembly (UNGA) High-Level Meeting on TB, Heads of States and governments committed to significantly scale up the TB response. In 2018, this resulted in identifying an additional 600,000 people who could access TB care. In 2019, the world also saw a rather promising progress.

The COVID-19 pandemic, especially considering the mitigation measures put in place, has reportedly proven to be a major setback in achieving the UNGA targets, as TB case detection has dramatically fallen, treatments have often been delayed and the risk of interruption of treatment and potential increase of people with drug-resistant TB has increased.

According to the new study, with a three-month lockdown and a protracted 10-month restoration of services, global TB incidence and deaths in 2021 would increase to levels last seen in between 2013 and 2016 respectively, implying a setback of at least five to eight years in the fight against TB.

“To minimise the impact of the COVID-19 pandemic on TB, save millions of lives and get the world back on track in achieving the UNGA targets, national governments need to take immediate measures that ensure the continuity of TB diagnostic, treatment and prevention services during the lockdown period and undertake a massive catch-up effort to actively diagnose, trace, treat and prevent TB.,” declared Stop TB Partnership.

The group called on leadership of all countries – particularly those with high TB burdens – to ensure the continuity of the TB response in the time of COVID-19, to take proactive measures that include those who are most vulnerable and to provide protection against economic hardship, isolation, stigma and discrimination.

“We urge governments to secure the human and financial resources needed for seamless continuation of TB services amid the COVID-19 response.”

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