The number of new Tuberculosis (TB) cases reported by India went down by 41 per cent between 2019 and 2020 while the actual number of infected cases in the country could be way higher, a World Health Organisation (WHO) global report on TB shows.
The report also showed that the number of TB deaths increased for the first time in a decade, globally. In 2020, approximately, 1.5 million people died from TB, highest in a decade. The WHO believes that the deaths caused due to TB will worsen in the year 2021 and 2022.
Along with the deaths, the WHO also said that the COVID-19 pandemic affected the diagnosis and reporting of TB cases as well as the availability of the necessary services for treating the same.
There exists a wide gap between the reported TB cases and those who would have actually been infected by the disease. This gap will make it difficult for the countries to meet the WHO and UN's Sustainable Development Goals to reduce TB deaths. Tuberculosis caused by the Mycobacterium bacteria is the second most deadly disease followed by COVID-19. Its multi-drug resistant and extensively drug resistant forms require extreme levels of care and treatment.
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Children are given the BCG vaccine to prevent TB. The Indian Council of Medical Research has just launched a clinical trial for a TB vaccine which is to be given to close contacts of a TB patient.
Less Reporting Of TB Cases
The report also highlighted that as the services were disrupted, the COVID-19 pandemic has reversed the fight against TB and many countries will have to start from scratch. Although the number of new cases reported dropped from 7.1 million cases in 2019 to 5.8 million cases in 2020, the WHO believes that this is not an actual reduction but one caused due to missed reporting because of the pandemic. The WHO's assumption is based on the fact that these are the numbers from 2012 and it believes that approximately 10 million people were actually infected.
The gap between missed reporting and those actually infected stands at approximately 4.1 million, globally.
India's gap in reporting was the largest in the 30 countries that have the highest burden of TB across the world. The global report findings corroborate with the findings of the Ministry of Health and Family Welfare's annual TB report released in March 2021. The Ministry reported that the TB notifications in the country between the months of January and December 2020 had fallen by 25 per cent.
Disruption Of TB Prevention and Treatment Services
While the situation in reporting is dim, the report highlights that the situation in providing appropriate treatment is not any better in the same period. The cumulative number of people treated between 2018 and 2020 was 19.8 million, only 50 percent of the five-year target of treating 40 million set by the WHO.
Preventive measures to ensure that close connections of those who have already tested positive were also disrupted. The global number of people who were provided with TB preventive treatment increased from 1.0 million in 2015 to 3.6 million in 2019, but this positive trend was reversed in 2020, with a 21% reduction to only 2.8 million people availing of preventive measures.
Decreased Funding
As COVID-19 treatment shifted attention from TB, so did its funding. Globally, TB funding was hit by at least 9 per cent. The WHO hoped that the annual spending for TB globally would be US$ 13 billion by 2022, but the actual spend was only US$ 5.3 billion equivalent to the 2016 figure. In 2019, TB programs had managed to collect US$ 5.8 billion.
The BRICS- Brazil, Russian Federation, India, China, and South Africa accounted for about 65 per cent of the total domestic funding of US$ 4.3 billion.