Mounting Effective TB Responses: Lessons from COVID-19 Pandemic

//Mounting Effective TB Responses: Lessons from COVID-19 Pandemic

A trait common in both Tuberculosis (TB) and COVID-19 (Corona Virus) is the characteristic fast and easy spread in the absence of – or non-adherence to – strict prevention measures. Their highly communicable nature can easily overwhelm a health system with adverse fountain effects to normal life.

Over the last one month, most of the world’s crucial activities have wound down with some countries and cities completely ground to a halt following the exponential spread of COVID-19.

With the pandemic having grabbed total global attention, the World TB Day 2020 may pass unnoticed or receive very little attention if any.

The World TB Day is an important marker of the global TB response where countries take stock of their achievements, challenges, highlight plans and recommit, yet again, to ending TB.

If WTBD 2020 passes silently, as it may likely do with all the attention directed to COVID-19, we may miss a good chance to reflect on our proactiveness, and/or readiness to deal with such diseases.

Historically, most countries capitalize on March 24 (World TB Day) and the run up days to create awareness, galvanising political goodwill, setting targets and outlining goals in efforts to eliminating the menace.

Without overemphasizing on the attention given to COVID-19, it is almost unfair that the much older and more persistent TB has not drawn such immense response. 

As a matter of fact, mortality due to TB, largely compounded by poor housing and living conditions in low income communities, has not triggered as much enthusiasm in addressing the squalid living conditions or the weak health systems and extremely limited political will, supplies and human resources to catapult preparedness as its younger counterpart COVID-19 has done.

Whereas this comparison may be criticised, the uniqueness in the COVID-19 response lifts the lid on our shortcomings in salient responses towards strengthening the fight against communicable diseases like TB.

First, it has managed to garner global attention and concerted efforts not just by leveraging great political good will across global leaders, but also has revolutionised research efforts globally, with scientists working round the clock to find relief / cure for this virus.

Secondly, it has reinvigorated philanthropy towards combating it as well as great citizen support for the cause.

Thirdly, there has been a remarkable breakthrough in technology and health systems strengthening. China set the pace with the construction of a state of the art quarantine facility in a record 10 days. I use the word quarantine emphatically given that its one of the biggest challenges we have in African health systems in the TB response, despite being an important structure in the TB management and control we still are lagging behind being in setting out this isolation facilities.

Fourth, the information flow through concerted global media efforts has been commendable. Citizens have had real time updates both from global and national media on the disease evolution, with messages on prevention, spread and who is vulnerable circulating every second.  These efforts have gone a long way in spreading awareness and inspiring citizens to be cautions but also in underscoring the implications of their actions on the wellness of their communities. It is however worth mentioning that in this internet age, this period has also seen the fuelling of many untruths and stereotypes especially on social media, detrimental to the global efforts in the fight against the virus.

Fifth, there is a general increase in health seeking behaviour, citizen heath policing, an array of emergency health hotlines and greater communications on the preparedness of the health systems to offer services related to the COVID-19 response. In Kenya, there is an emergency 24 hour hotline for the COVID-19 response in all the 47 counties as well as a clear and continuous communication on the risk factors and what needs to be done. There are general community and health systems coordinated efforts in the response. Furthermore, government efforts on contact tracing have been commendable, a strategy that has been traditionally used in TB management albeit not with such   thoroughness. The briefing on the death toll and the full understanding of the implications of the epidemic and our individual actions may have been instrumental in promoting citizen vigilance on the pandemic.

Back to TB. Drawing comparison with the COVID-19 response, TB claimed 1.5 million people in 2019, and there is an estimated 10 Million cases of TB per year while COVID-19 had claimed nearly 10,000 deaths as at March 20, 2020 and over 250,000 infections since it broke out according to WHO.

Further, for TB, a huge number of the new cases go undetected.  This fuels fears that  the WHO’s end TB strategy   by 2020 may not be on track given that only a 6.3 percent drop compared to the 20 percent drop target in 2019 has been recorded. The death toll has fallen only by 11 percent compared to the 35 percent target.

WHO further points out that the fight against TB is chronically underfunded, hampering efforts to strengthen its combat.

Despite decades of ongoing advocacy for increased political good will to end TB, increased resources for TB, strengthening of the health systems to effectively address TB, and bold commitments such as those made at the + United Nation High Level Meeting, globally  we are  still far from ending TB.

Bearing in mind the devastating effects of TB and the catastrophic cost of addressing the disease, one wonders why  we  are yet to pronounce it as a global epidemic to garner  more political goodwill and resources that are needed to make eradicating TB a reality. Sadly, most countries are yet to allocate adequate resources to curb the disease despite being signatories of the global commitments to end TB.

In Kenya, up to 40 percent of all TB cases are still missing (and potentially spreading the disease).  TB literacy still remains very low with new or emerging guidelines in the TB management and control, rarely reaching the communities especially in comparison to the COVID – 19 information flow in the short time it has been here. 

As we mark this rather quiet World TB Day, it is imperative that we truly introspect on what is needed to realistically address TB and what role each person should play to end  it.

As economies take a beating with the World economic Forum, estimating COVID-19  to cost about $1 trillion and as nations  turn to research and faith in effort to defeat this virus, we must remember that TB remains one of the leading communicable diseases, compounded by the evolution of the bacteria to more  multi-drug resistant strains, and truly commit to ending TB for good, because every life matters.

By Wachira Charity-Communications Officer, KANCO


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