Mar 25, 2021 - Health

WHO: Pandemic is prolonging countdown to halt tuberculosis

Illustration of a clock with covid virus at midnight, with tuberculosis cells in the background

Illustration: Sarah Grillo/Axios

Various organizations including the World Health Organization are saying early data indicate there may be a significant increase in diseases like tuberculosis in the years ahead due to the COVID-19 pandemic.

Why it matters: 12 years of progress for worldwide programs to halt TB have been lost over the past 12 months of the pandemic — endangering the goal of eliminating the disease by 2030, some experts say.

What's happening: Steps taken to mitigate the infectious spread of COVID-19, like mask-wearing, social distancing, and shutdowns or lowered mobility, have had a mixed impact on other diseases.

  • They have led to a drop in other respiratory illnesses, like the flu, but they have also prevented people from non-coronavirus visits to doctors and clinics for disease testing and immunizations.
  • The ability to monitor diseases in a community is affected if people aren't going to the clinic for care out of fear of getting COVID-19 or because travel is restricted due to lockdowns, says William Moss, executive director of the International Vaccine Access Center at Johns Hopkins University.
  • For example, in Senegal, there was an almost 80% drop in prenatal visits of mothers and of children under 5 during the initial months of the pandemic, "which was really scary to see," says Aminatou Sar, West Africa hub and Senegal country director for the nonprofit PATH.
  • And the pandemic's challenges to programs to fight mosquito-borne diseases like malaria and dengue are causing concern, although experts are waiting to see its overall impact.

Tuberculosis will likely grow in the pandemic aftermath, WHO warned this week for World TB Day. The bacterial lung disease, which typically claims about 4,000 lives a day globally, has likely killed more than half a million more people in 2020 because they were unable to get the care they needed, per WHO.

  • "We are running out of time. The clock is ticking, and it's time for urgent action to end TB," Tereza Kasaeva, director of WHO's global TB program, said at a press conference announcing their preliminary findings.
  • WHO also issued new guidelines for testing for TB to regularly check those who are at high risk of infection. WHO recommends COVID-19 and TB tests be conducted at the same time in high-risk countries, Kasaeva said.

Between the lines: Last year's 23% average drop in diagnosis and treatment of TB patients presents a serious problem, as 1 million untreated people with TB in 2020 could lead to roughly 15 million new infections in 2021, says Lucica Ditiu, executive director of the Stop TB Partnership, which is a UN-hosted entity. "It's like a snowball effect."

  • "1 million [untreated people with TB] brings us to basically the figure that we had 12 years ago," Ditiu says.
  • She expects to see an "explosion" of community-based TB. "What we already see is more advanced stages of TB at home, because people don't want to go" into the hospital, Ditiu says, leading to increased reports of people with lung cavities coughing blood.
  • Yes, but: One positive outcome of the COVID-19 pandemic, which has mandated mask-wearing in health care settings, is "I have zero doubt that we will see very few, if any, cases of TB among health care workers in 2020 and 2021 due to the masks," Ditiu says.

Meanwhile, a rise in preventable childhood diseases also is a concern, with the WHO and UNICEF issuing an emergency call to action for measles and polio outbreak prevention and response last year.

  • There was up to a 50% drop in uptake of vaccinations in some countries during the pandemic crisis, per WHO.
  • For instance, the CDC warned in April last year that more than 117 million children may miss out on the measles vaccine alone — a disease that already had shown a 556% increase in cases from 2016 to 2019, with deaths climbing 50% during that period.
  • "We really fear that when we deal with this pandemic, there will be a big backlash on the progress we've made in other areas already," Sar tells Axios.
  • However, she adds it's "never too late" to catch up on vaccination schedules and to foster a stronger health care system to prepare for the next pandemic.

What to watch: The mRNA vaccine technology underpinning some COVID-19 vaccines is being used to further develop TB vaccines. And the TB Alliance says there have been unprecedented advancements made in clinical testing of a new treatment regime for drug-resistant TB.

Go deeper:

Go deeper