The global Covid-19 pandemic and low levels of funding are hampering efforts to eradicate tuberculosis (TB) by 2030.

Currently, only $6.5-billion a year is available for the TB response globally, less than half of the commitments made at the 2018 United Nations High-Level Meeting (UNHLM) on TB, and 1.2-million fewer people have been diagnosed and treated for TB so far in 2021, compared with 2019, says Stop TB Partnership executive director Dr Lucica Ditiu.

“Based on available TB notification data, the Stop TB Partnership anticipates that the world will fail to achieve the 2018 UNHLM target of diagnosing and treating 40-million people with TB in the period 2018 to 2022,” she says, noting that data from 27 countries, representing about 73% of the global burden of TB, show that less than 85% of this UNHLM target will be achieved.

“While 85% might sound like an achievement, what it means in practice is that more than five-million people with TB will be left behind without treatment.”

“We always knew that ending TB by 2030 was going to be an uphill battle, but Covid-19 and the reduced funding for TB have sent us rolling further down the hill than anyone could have expected,” Ditiu adds.

The Covid-19 pandemic has set the fight against TB back to the levels of 2010 and 2011, she said during a virtual media briefing.

An estimated 5.7-million people received treatment for TB in 2020, a drop of 21% from the previous year, leaving an estimated 4.3-million people with untreated TB.

“Data from 2020 and 2021 will reveal soon how hundreds of thousands of additional people are dying from TB and how TB drug resistance and the TB epidemic are on the rise.”

Further, only about 20% of the UNHLM target of treating 115 000 children with multi-drug-resistant TB is expected to be achieved by 2022. When it comes to TB prevention, less than 30% of the UNHLM target of putting 24-million contacts of people with TB on preventive therapy is expected to be reached.

Cycle of Transmisson

“Untreated TB translates into about a 50% mortality rate, and those who survive will not only suffer the consequences of the disease but will also spread TB to many more, perpetuating the cycle of transmission.”

“The impact of the Covid-19 pandemic has been severe, reversing hard-won gains in the fight against TB. However, this is not a moment to lose hope but to redouble commitments and action for the sake of the millions who face immense suffering and lose their lives to this preventable and curable disease.”

Getting the TB response back on track will require at least a doubling of resources currently being provided to the fight against the disease, including a significant increase in the share of resources the Global Fund to Fight Aids, TB and Malaria allocates to TB.

The Global Fund, which is the largest external donor to TB programmes, only allocates 18% of its resources to TB, even though the disease causes more than half of the deaths from diseases served by the fund, Ditiu says.

In 2019, 1.4-million people died from TB, more than HIV/Aids, with 700 000 deaths, and malaria, with 410 000 deaths, combined.

TB is curable and TB interventions are some of the most cost-effective of all public health interventions.

“Every $1 invested in TB prevention and care yields a return of $43.1. No matter which way you slice it, spending more on TB is one of the world’s best social investments,” says Copenhagen Consensus Centre president Bjørn Lomborg.

“If we want to end the TB epidemic, people affected by TB must be at the centre of the response,” adds Stop TB Partnership board incoming vice-chairperson Austin Obiefuna.

“Countries must step up their efforts to conduct assessments and develop action plans to transform their TB response into one that is equitable, rights-based, gender-transformative and people-centred.”

To avoid further setbacks to the TB response, recover from losses experienced over the past year and ensure that the Global Fund’s allocations are in line with TB’s share of disease burden and deaths, the Global Fund’s financial contribution for TB must be at least doubled.