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Why there is no time to lose in tackling tuberculosis

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Dr Tereza Kasaeva

Director, Global Tuberculosis Programme, World Health Organization

Dr Dennis Falzon

Team Lead, Prevention, Research and Innovation, World Health Organization

Dr Cecily Miller

Technical Officer, Research and Innovation, World Health Organization

The world pledged to end tuberculosis by 2030 — but the global pandemic has put that at risk. It’s time to refocus and redouble efforts.


Dr Tereza Kasaeva, Director, Global Tuberculosis Programme, World Health Organization (WHO), has a stark warning. Despite a commitment from world leaders to end TB by 2030, this preventable and curable disease kills around 1.4 million people a year. Now, tragically, the havoc wrought by COVID-19 has made a bad situation worse. It’s why the worrying theme of this year’s World Tuberculosis Day is: “The clock is ticking.” 

Before the global pandemic, many countries had made steady progress in tackling TB. “Even so, we weren’t on track to hit 2020 milestones,” cautions Dr Kasaeva. “By 2020 we wanted a 20% reduction in TB incidence, a 35% reduction in TB mortality and no catastrophic costs for people or families affected by TB. Instead, there was only a 9% reduction in TB incidence and a 14% reduction in TB death, 80% of affected people and families still face catastrophic costs.” 

Because of COVID-19, global progress is now severely under threat. “In almost all countries with a high burden of TB, we have seen an average 30% drop in TB case notifications,” says Dr Kasaeva. “This means more people are missing diagnosis and care and transmitting TB.” 

Despite a commitment from world leaders to end TB by 2030, this preventable and curable disease kills around 1.4 million people a year.

Why screening is vital in the fight to end TB 

For World Tuberculosis Day, WHO have launched new TB screening guidelines which it hopes will help reach the ‘missing millions’ — the estimated three million people who fall ill with the disease every year but go unreported, many of whom remain untreated. Community-wide screening in high burden settings (at least 0.5% TB prevalence) is vital because it can significantly reduce the prevalence of TB and reduce transmission, notes Dr Cecily Miller, Technical Officer, Global TB Programme, WHO. “The new guidelines also include recommendations for new screening tools, such as computer-aided detection software for automated detection of TB on digital radiographs,” she says. “This is an exciting development which allows screening to be implemented and brought to scale in locations that lack trained personnel.” 

Further, such innovation is urgently required in the field of TB diagnostics — and prevention. After all, it’s telling that 2021 marks the centenary of the world’s only available licensed TB vaccine.

Yet, Dr Dennis Falzon, Team Lead, Prevention, Research and Innovation, WHO, believes lessons can be learned from the rapid development of COVID-19 vaccines and diagnostics to benefit TB. “There are significant differences between development of vaccines for TB and development of vaccines for viruses,” he admits. “But the response to COVID-19 shows that research can advance swiftly when different stakeholders put their heads together to overcome seemingly insurmountable challenges.” 

Time, however, is critical. “To end TB, the world needs to redouble its efforts — now,” stresses Dr Kasaeva. 

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