Regaining Lost Progress in the Fight to End TB
USAID is committed to helping countries recover from COVID-19’s devastating impact on TB diagnosis and care services
Despite being preventable and curable, tuberculosis (TB) has long been the world’s deadliest infectious disease and continues to kill more people in low- and middle-income countries than any other infectious disease. While COVID-19 has had a devastating global impact over the past year, TB has been silently sickening 10 million people and killing 1.4 million every year.
Although significant gains have been achieved in the fight against TB, in a matter of months, COVID-19 has threatened to reverse years of progress. The pandemic and associated measures to control it have severely disrupted TB diagnosis and care services in the world’s highest TB burden countries, resulting in an alarming drop in reported TB cases.
To add to this, people who suffer from airborne respiratory infections, such as TB, are more likely to have severe cases of COVID-19. Recent data shows that people with COVID and TB are about three times more likely to die than those with only TB.
TB and COVID-19 share the burden of being societal diseases that spread through the air, and the world’s poorest populations — who are more likely to be undernourished and living in densely populated areas — are at increased risk for both.
The stigma and discrimination faced by those who suffer from TB has been compounded by sharing similar symptoms, such as cough and fever, with COVID-19. Fear in seeking care can result in advanced disease and further transmission in communities.
As the U.S. Government lead for global TB efforts, USAID works with governments and partners around the world to reach every person with TB, cure those in need of treatment, and prevent the spread of new infections.
In the 23 countries where USAID focuses TB programming, preliminary analysis estimates that 1 million fewer people with TB had access to diagnosis and treatment in 2020 compared to the previous year— representing a staggering 23 percent decline. As a result of this, the pandemic’s impact on TB is projected to sicken an additional 6 million people and cause an additional 1.4 million TB deaths between 2020 and 2025.
To address COVID-19’s impact on TB programs, USAID is working with country governments and partners on urgent recovery plans in the most impacted countries. Key to these efforts are USAID’s in-country partners, who have been able to rapidly implement on-the-ground solutions to maintain TB services throughout the COVID-19 pandemic.
At the beginning of the COVID-19 pandemic, the Kyrgyz Republic’s National TB Center was converted to begin treating COVID-19 patients. As those suffering from TB are particularly vulnerable to COVID-19, this posed the serious risk of patients contracting both diseases. To mitigate this risk, USAID partners supported the country’s National TB Program in strengthening the center’s infection control measures, such as providing personal protective equipment and establishing teams to work in two-week shifts, alternating with two weeks of self-isolation.
In Nigeria, when COVID-19 started to spread, USAID partners quickly implemented a series of interventions to maintain TB services, such as converting health workers who normally screened for TB in clinics to “roaming screeners” within communities. These roaming screeners were assigned to work at pharmacies and other facilities close to where they lived, enabling people with TB symptoms to continue to be examined and tested during pandemic-related lockdowns.
And in Cambodia, when social distancing and movement restrictions impacted access to healthcare facilities, USAID’s local partner was able to maintain TB services through mobile outreach screenings. These efforts have been vital in continuing to find active TB cases, referring patients for treatment, and curbing the spread of the disease.
Alongside governments, the Global Fund and other partners, USAID is helping countries recover from this setback in fighting TB, while also building their capacity to respond to future airborne infectious diseases. In countries facing both COVID-19 and TB, addressing the two diseases simultaneously can curb both and reduce the threat of future airborne pandemics.
By investing in efforts such as testing for COVID-19 and TB at the same time, joint contact investigations and community screenings, and implementing infection prevention and control measures, these efforts will provide vital foundations to also respond to future pandemics.
About the Author
Andrea Gavin is the Senior Communications Advisor for Tuberculosis in the Infectious Disease Office in USAID’s Global Health Bureau.
