“COVID-19 is highlighting just how vulnerable people with lung diseases and weakened immune systems can be,“ said Dr Tedros Adhanom Ghebreyesus, World Health Organization (WHO) Director-General. “The world committed to end tuberculosis (TB) by 2030: improving prevention is key to making this happen. Millions of people need to be able to take TB preventive treatment to stop the onset of disease, avert suffering and save lives”.
Marking World TB Day 2020, India’s progress against the disease has seen both highs and lows. As a country possessing one of the highest global case counts, how India deals with the disease is crucial.
Globally, of the 500,000+ people who develop drug-resistant tuberculosis (DR-TB) each year, India currently contributes to over 25 percent of cases. This is a critical point in India’s fight against the disease, as a failure to tackle these drug-resistant strains could allow the proliferation of TB cases that are far more difficult to address. On an annual basis, there are over 100,000 new cases of DR-TB in India.
Union Health Minister Dr Harsh Vardhan affirmed in February that the Centre is working towards its goal of TB elimination ahead of global targets. “By 2025, we wish to eliminate tuberculosis from India,” the Minister informed the press on the sidelines of the Rotary India Centennial Summit in Kolkata. The deadline of 2025 puts India five years in advance of the WHO goal of 2030. Such a goal is ambitious, especially considering the scope of the problem in India.
India lags far behind on targets aimed at reducing disease incidence by ninety percent and mortality by 95 percent by 2035 as compared to 2015, as the Lancet Commission on Tuberculosis noted in a report issued last year. These targets are expected to be met by 2124, should the current trajectory of progress continue to be followed.
The WHO recommends “a scale-up of TB preventive treatment among populations at highest risk including household contacts of TB patients, people living with HIV and other people at risk with lowered immunity or living in crowded settings.” They have also suggested an integration of TB preventive treatment services into ongoing case finding efforts for active TB.
The WHO also recommends that either a tuberculin skin test or an interferon-gamma release assay (IGRA) be used to test for infection — stating that both tests are helpful to find people more likely to benefit from TB preventive treatment but should not become a barrier to scale-up access.
“As people around the globe come together to commemorate World TB Day, WHO is calling on governments, affected communities, civil society organizations, health-care providers, donors, partners and the industry to unite forces and step up the TB response – notably for TB preventive treatment – to ensure no one is left behind,” said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme. “The new WHO guidance shows the way forward for millions to rapidly access new tools and shorter, safer options for preventive treatment. The time for action is now.”