By Dr. Vineeta Gupta MD, JD, LL.M
"We wish to make 2021 the year of tuberculosis,’ said Dr. Harsh Vardhan, Union Minister of Health and Family Welfare, at a high-level meeting in Delhi, India, held on Feb 24, 2021. The high-level meeting included government officials and representatives from World Health Organization (WHO), Bill and Malinda Gates Foundation, and USAID. It is a powerful statement in times of COVID19. The news is being received with hope and encouragement by those in global health who are working hard to bring focus on the deadly duo of TB and COVID19. The need to prioritize TB services during the COVID-19 pandemic cannot be overemphasized.
ACTION Global Health Advocacy Partnership (ACTION) has been at the forefront of advocating on the need to address TB globally, including India, through collaborative and evidence-based advocacy. ACTION partners collaborate with governments, policymakers, decision-makers, civil servants, donors, global institutions, civil society organizations (CSOs), and affected communities to build political support, mobilize resources, and improve TB policy. The work includes mobilizing support and securing ambitious pledges to the Global Fund to Fight AIDS, TB and Malaria, securing bold commitments at the United Nations High-Level Meeting (UNHLM) on TB and working directly with governments to improves policy. ACTION played a pivotal role in shaping the Delhi End TB Summit, where the Prime Minister reaffirmed the Indian government’s commitment to ending TB by 2025. ACTION’s continued work with the National TB Elimination Program of India and other stakeholders resulted in the first formal inclusion of TB elimination as a specific item in India’s Union Budget speech.
Tuberculosis causes more deaths than any other infectious disease in the world. TB and COVID19 make a deadly combination and pose additional challenges as TB and COVID-19 both affect the lungs. Globally, there is mounting evidence that patients with chronic respiratory diseases, including TB, are at increased risk for severe illness or death from COVID-19. According to U.S. Centers for Disease Control and Prevention (CDC), “Global estimates suggest that unless additional measures are put in place, the lockdowns that have been implemented across the world to prevent the spread of COVID-19 infection, and the slow return to services after these lockdowns, could lead to an additional 6.3 million cases of TB during 2020–2025 and an additional 1.4 million TB deaths. This will set the world back five to eight years in the global fight against TB.”
COVID-19 has caused significant disruptions to TB services across the world. According to the WHO report, TB case notifications dropped 25-30% in India, Indonesia, and the Philippines between January and June 2020 compared to the same 6-month period in 2019. ACTION’s global survey on the impact of COVID-19 on TB last year found that COVID has had an enormous impact on the number of people seeking and receiving TB care. 75% of the advocates in Global Fund eligible countries (including India) reported decreased TB testing during the pandemic. 73% of people with TB reported facing significant challenges accessing treatment, while 36% of people with TB in India reported that health facilities they usually visit closed.
Against this dire backdrop, Dr. Vardhan’s leadership is crucial not only in India but also globally. Dr. Harsh Vardhan said, “The pandemic has brought the focus back on the role of focused and rigorous messaging in creating an appetite for accurate information and appropriate behaviours and hygiene practices. Similar nation-wide messaging on TB symptoms can drive notification levels up and build awareness on the precautionary behaviour related to control of TB infection in the country.”
COVID19, like TB, disproportionately affects socio-economically marginalized groups who have historically experienced tremendous obstacles to health. The pandemic has exposed the existing disparities in health within countries and among countries. The enormous resources and focus needed to respond to the pandemic have further exacerbated the already fragile health systems' failure to meet the need of the existing health burden. It has also presented us with an opportunity to learn and adopt proactive approaches to address disparities and ensure no one is left behind. India’s initiative to learn from the pandemic and address TB is an encouraging global event.
We, at ACTION, are celebrating our partners’ advocacy wins to keep us inspired in these challenging times!