Context

On World TB day, we need to ask how best we can leverage the lessons learnt from Covid-19 to help gain a new momentum in TB control.

Comparing the impact of Covid-19 and TB

• In the first year of the Covid-19 pandemic, 1.8 million people were reported to have succumbed to the virus.
• In the decade between 2010-20, 1.5-2 million individuals died every year because of tuberculosis.
• The difference in responses to the two pandemics can only be explained by the differences in the profiles of those who get infected.
• TB disproportionately affects people in low-income nations, the poor and the vulnerable.
• The increased burden on healthcare to manage Covid has led to a serious setback in TB control.

Using lessons from Covid-19 for TB control

• To leverage the lessons learnt from Covid-19 to control TB, we need to focus on the epidemiological triad: Agent, host and the environment.
• Test, treat and track has been a strategy successfully employed for Covid.
• Scaling up testing: We need to aggressively scale up testing with innovative strategies such as active surveillance, bidirectional screening for respiratory tract infections using the most sensitive molecular diagnostics, and contact tracing.
• Vaccine: The biggest victory against Covid has been the speed with which vaccines were developed, scaled up and deployed.
• We need to replicate the same for tuberculosis, lobbying for funding from governments and industry to develop a successful vaccine for TB.
• Social security programs for the prevention of risk: Malnutrition, poverty and immuno-compromising conditions such as diabetes are some of the factors strongly associated with TB.
• Social security programmes that work towards prevention of modifiable risk factors would possibly pay richer dividends than an exclusive focus on “medicalising” the disease.
• Environmental factors: Environmental factors which have been neglected include ventilation of indoor spaces, educating individuals to avoid crowds when possible, and to encourage voluntary masking, especially in ill-ventilated and closed spaces.
• Investment and actions: Covid has been a stellar example of how investments and actions can be swift, and public education can transform behaviour.
• Similar aspirations for TB can help turn this crisis into an opportunity to re-imagine our overburdened and underfunded systems.
• Involvement of private sector: We need to actively engage the private sector, build bridges and partnerships as we did in the case of Covid.

Way forward

• The country needs to invest in state-of-the-art technologies, build capacity, expand its health workforce and strengthen its primary care facilities.
• It also needs to consider telemedicine and remote support as important aspects of health services.
• We need to build an open and collaborative forum where all stakeholders, especially affected communities and independent experts, take a lead role.

Conclusion

We have ignored TB for too long. 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.

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