Home » Infectious Diseases » Why the world needs to start managing TB as a healthcare crisis

Mustapha Gidado

Executive Director, KNCV TB Plus

Increased political will and financial investment — plus the application of lessons learned from the ongoing COVID-19 pandemic — are vital in tackling the scourge of tuberculosis (TB).

Every year, the world looks for evidence that it is winning the fight against tuberculosis — a lethal disease which is preventable, treatable and curable. And every year, the world is gravely disappointed.

“I would like to have good news for you,” says Mustapha Gidado, Executive Director of KNCV TB Plus (formerly known as KNCV Tuberculosis Foundation), which contributes to a TB-free world by developing effective, efficient and sustainable strategies that accelerate the decline of the epidemic. “Unfortunately, based on the 2022 WHO Global TB Report, we are seeing an increase in TB deaths for the first time this decade.”

The prevalence of tuberculosis: how bad is it?

In 2021, 1.6 million deaths were recorded from TB, up from 1.5 million in 2020. “There has also been an increase in the number of people affected by TB to an estimated global total of 10.6 million (up from 10.1 million in 2020),” says Gidado.

“Sadly, because of the impact of the global COVID-19 pandemic and other crises, we have only been able to detect and notify 6.4 million.” The remainder, known as ‘the missing millions,’ are undiagnosed, not receiving care and transmitting TB.

The sobering fact is that — despite a commitment from world leaders to end TB by 2030 — tuberculosis targets had been blown off course before COVID-19 struck. Since the pandemic, however, political and financial attention has been significantly diverted from the TB cause.

“We have also seen significant disruptions in healthcare services,” says Gidado. “The area most hit was the utilisation of health services and laboratory services, and there was an increase in fear and stigma of visiting healthcare facilities during the pandemic. All these variables set progress in reverse.”

We need to bring back a sense of urgency,” he says. “We need to manage TB as a crisis, and we must stop ‘normalising’ TB.

Interventions that will make a difference in TB eradication

There is some encouraging news. Last year, international financing and partnership organisation — The Global Fund — announced that its Seventh Replenishment would total $15.7 billion to fight AIDS, malaria and tuberculosis.

But Gidado is clear that if the world is ever to reverse the alarming TB trends, more must change. “We need to bring back a sense of urgency,” he says. “We need to manage TB as a crisis, and we must stop ‘normalising’ TB.”

Three key interventions will make a huge difference, he explains. “First, we need to scale up the use of our existing tools because they are working. Secondly, we need game-changing rapid point-of-care tests to ensure early diagnosis and break the transmission of TB. And, of course, the third is vaccines.”

“The only effective vaccine we have was introduced over 100 years ago. But there has been a significant amount of attention and energy in this direction — and, right now, there is optimism that, before 2025, we may see a new vaccine.”

Reviving political will and increasing financial investment

While we are waiting, a massive screening programme is vital. We must screen the people who are in contact with every TB patient, says Gidado; while anyone with a TB infection should have the opportunity to receive preventive treatment.

Ultimately, success rests on reviving political will and increasing financial investment — but the world can also take on board the lessons learned from COVID-19. “The pandemic proved that, if we come together, we can overcome a major health crisis,” notes Gidado.

“It highlighted the need for good screening tools, a good surveillance system and a good laboratory network and showed the importance of community engagement, community awareness and engagement with the media. It also demonstrated that if the political will is there, finances will follow — and if science is given the appropriate resources, it will come up with the solution. If that happens with TB, I am optimistic that we can end this disease in my lifetime.”

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