As COVID-19 Dips, Tuberculosis is the Most Lethal Infectious Disease Again

Patna: Tuberculosis is one of the most lethal infectious diseases on the rise after the fears and deaths due to the COVID-19 pandemic have come down. As per the latest report by TB Alliance, a not-for-profit organisation, HIV/AIDS is back in second place, and TB is in first place.

“A few years back, tuberculosis overtook HIV/AIDS as the world’s most lethal infectious disease—which is not a cause for celebration, of course. When the COVID-19 pandemic exploded and overtook TB as the most lethal disease in 2020, it became a cause for action. Yet, even as deaths from HIV/AIDS continue to decline (they peaked in 2004) and deaths from COVID-19 drop precipitously, global TB deaths have increased by 100,000 two years in a row now," the TB Alliance report said.

According to the report, the World Health Organization (WHO)’s annual report on the state of the TB pandemic confirmed that the COVID-19 pandemic made the TB pandemic much worse. As per the most recent estimates, TB is killing approximately three times as many people as COVID-19 every day.

TB Alliance highlighted that 4,383 deaths/day due to tuberculosis were reported based on 1.6 million deaths/year in the WHO Global TB Report. On the other hand, 1,781 deaths/day due to HIV/AIDS are based on 650,000 deaths/year according to the World Health Organization (WHO), and 1,446 deaths/day due to COVID-19 (40,515 deaths over past 28 days – via JHU dashboard).

TB Alliance pointed out that the governments, besieged by COVID-19, have redirected resources meant for TB prevention and treatment, even though both diseases hammer the respiratory systems. Progress against HIV/AIDS may have slowed down, but it has not been reversed. As COVID-19 has started to ebb in many places, can the respite allow for a TB recovery without losing the ground on HIV/AIDS or any other diseases?

Further, there will be another meeting in 2023 at the UN General Assembly where new goals will be set to fight against TB, given how the COVID-19 pandemic hammered the TB response. "This fall, we passed the fourth anniversary of a UN High Level Meeting on TB, where many commitments were made to move the world closer to ending TB as a health threat. We are nowhere near achieving these goals," the TB Alliance report said.

One key indication of recovery emerged as the Global Fund to End HIV, Tuberculosis and Malaria announced that, in the countries that it supports, the number of people receiving treatment for TB rebounded after a plummet in the same during the COVID-19 pandemic’s first year. As most of the countries designated by WHO as having a high burden of TB cases receive Global Fund support, this is a promising indication of momentum.

According to the WHO Global TB Report 2022, India was among the eight countries accounting for more than two-thirds of the total TB patient count. The other seven countries were China, Pakistan, Indonesia, the Philippines, Nigeria & the Democratic Republic of the Congo.

After the WHO released the Global TB Report, the Union Ministry of Health and Family Welfare clarified that India has performed far better on major metrics as compared to other countries over time. India’s TB incidence for the year 2021 is 210 per 100,000 population – compared to the baseline year of 2015 (when the incidence was 256 per lakh of the population); there has been an 18% decline which is 7 percentage points better than the global average of 11%. These figures also place India at the 36th position in terms of incidence rates (from largest to smallest incidence numbers).

While the COVID-19 pandemic impacted TB Programmes across the world, India was able to successfully offset the disruptions caused through the introduction of critical interventions in 2020 and 2021. These led to the National TB Elimination Programme notifying over 21.4 lakh TB cases – 18% higher than in 2020.

The WHO’s report said that TB preventive treatment for people living with HIV has far surpassed the global target of 6 million in the period 2018-2022, reaching more than 10 million in only four years. Seven countries – India, Nigeria, South Africa, Uganda, the United Republic of Tanzania, Zambia and Zimbabwe – collectively accounted for 82% of those who started preventive treatment in 2021.

Seven high TB burden countries in the region - Ethiopia, Kenya, Lesotho, Namibia, South Africa, the United Republic of Tanzania and Zambia- have reached or surpassed the 2020 milestone of a 20% reduction in the TB incidence rate compared to 2015.

The report said an estimated 10.6 million people fell ill with tuberculosis (TB) in 2021, which is an increase of 4.5% from 2020, and 1.6 million people died from TB (including 187 000 among HIV-positive people).