Fighting TB with lessons learnt during Covid pandemic 

News: Recently, World TB Day was organized. Focus on TB has declined due to Covid-19 Pandemic. 

It’s time we acknowledge the magnitude of the disease, and work harder at offering individuals’ equitable healthcare access and resources that the disease warrants. 

Why should TB be considered serious? 

On one side, 1.8 million people succumbed to the Covid-virus in the first year. On the other hand, 1.5-2 million individuals died every year between 2010-20 due to tuberculosis.  

The government spent 162 times more public money on the Covid-19 than the amount spent on TB in 2020.  

What are the similarities and difference b/w Covid and TB? 

Similarities 

– Both are airborne infections and transmissible in nature. Both can spread in crowded settings, and harm people with immuno-compromising conditions. 

Differences

– Differences only lies in the profiles of those who get infected. TB disproportionately affects people in low-income nations, the poor and the vulnerable. 

How has COVID impacted TB control? 

It has increased the burden on the healthcare facilities.

There has been redirection of human resources within the health system towards the Covid management, leaving TB facilities understaffed, leading to poorer quality and delayed care. 

Due to Covid, TB diagnosis, case detection and treatment has dropped. Now, the proportion of such “missing cases” is likely to have increased. It may also be due to stigma associated with respiratory symptoms  

Covid may lead to an increase in TB cases. Historically, wars, food insecurity, poverty and malnutrition have resulted in surges in the incidence of TB.

Further, Covid may lead to reactivation of dormant TB bacilli. 

What can be learnt from Covid-19 vis-à-vis TB control in India? 

The epidemiological triad: i.e., Agent, host and the environment can be the new approach for TB management in India 

Test, treat and track (TTT) Strategy can be employed in TB Control. The innovative strategies such as active surveillance, bidirectional screening for respiratory tract infections using the most sensitive molecular diagnostics, and contact tracing can be done.  

Vaccine development at war scale can be replicated the same way for tuberculosis. There can be lobbying for funding from governments and industry to develop a successful vaccine for TB. 

Public education can transform behaviour. Therefore, focus on tobacco smokers, educating individuals to avoid crowds when possible, and to encourage voluntary masking, especially in ill-ventilated and closed spaces.  

Social security programmes should be initiated like the health insurance etc. Avoid “medicalising” the disease. 

Adequate focus be given on addressing malnutrition, poverty and immuno-compromising conditions such as diabetes which are strongly associated with TB. 

We need to actively engage the private sector, build bridges and partnerships as we did in the case of Covid. 

The government must increase the public funding for health, nutrition and preventive services including TB. It should invest in state-of-the-art technologies, build capacity, expand its health workforce and strengthen its primary care facilities. For example, telemedicine and remote support for health services can be focused.  

There has to be an open and collaborative forum where all stakeholders, especially affected communities and independent experts, take a lead role.

Source: the post is based on an article “Fighting TB with lessons learnt during Covid Pandemic” published in the Indian Express on 24th Mar 22.