World TB Day 2020: As coronavirus spreads, preventing and treating TB must remain a priority
As the world grapples with the global pandemic of coronavirus, Doctors Without Borders/Médecins Sans Frontières (MSF) is concerned for vulnerable groups worldwide, like people with tuberculosis (TB), whose lungs are often damaged and immune systems weakened.
This World TB Day, it’s more critical than ever to maintain and safeguard prevention, diagnosis, treatment, and care for people with TB worldwide. Coronavirus disease, or COVID-19, typically affects the lungs and people who contract it may show similar symptoms to TB, such as coughing and fever. The lung damage caused by TB and the toll it takes on the immune system means people living with the disease are at a heightened risk of becoming seriously ill from COVID-19, the contagious disease caused by the coronavirus.
TB is the world’s leading infectious disease killer, with nearly 10 million people affected and 1.5 million deaths in 2018. Half a million people have drug-resistant forms of TB (DR-TB), for which the treatment is long and toxic and safer, more effective options are often priced out of reach. In addition, many patients with TB live in densely populated areas—like overcrowded settlements with little access to clean water or health care—and this close proximity further increases their risk of spreading COVID-19.
This already worrisome situation will become even more grave if
diagnosis and treatment for TB is interrupted. Because of this,
MSF supports the World Health Organization’s (WHO)
information note
on strategies to maintain continuity of essential
services—prevention, diagnosis, treatment, and
care—for people living with TB and DR-TB during the
COVID-19 pandemic.
Health care systems, particularly those in low-resource
settings, will be dangerously strained by COVID-19. MSF knows
from previous epidemics that reduced access to care, medicines,
and diagnostics for people with life-threatening conditions like
TB can lead to an increase of deaths from these underlying
conditions. In Guinea, one of the countries at the epicenter of
the 2014–2016 Ebola outbreak in West Africa, reduced
health services
led to a 53 percent decrease
in the diagnosis of TB—and a doubled mortality rate from
it.
In addition to the global response needed to tackle COVID-19,
health authorities, implementing partners, and international
funders must make every effort to maintain essential services
while reducing the risks for vulnerable populations, like
implementing additional infection prevention measures.
To reduce the risk of COVID-19 infection amongst people living
with TB, we will need to see innovative changes to the ways in
which health care is provided. This includes decentralized and
outpatient treatment, access to treatment through community and
physically distant models of care, and follow up of patients
through telemedicine and the use of web apps. The implementation
of all-oral treatments for DR-TB as recommended by the World
Health Organization is now more urgent than ever, as is the
introduction of community-supported treatment to reduce contact
with hospitals and other health structures, where patients are
more likely to contract coronavirus.
Given the high risk of severe disease in TB patients, efforts to
minimize the impact of COVID-19 should also include the
provision of protective measures for medical staff and those in
contact with TB patients and the testing and isolation of
confirmed or suspected COVID cases to avoid transmission.
Global solidarity is essential to tackling a global pandemic:
Avoiding excessive stockpiling and export bans will ensure
essential medicines and supplies—including personal
protective equipment—can reach all countries in need. Such
collaboration and sharing will reduce the likelihood that people
with TB are put at additional risk because of a lack of
necessary drugs or an inability to test. Without such an
approach the pressure on countries with already fragile health
systems will be doubled.
As countries struggle to deal with the COVID-19 pandemic, we
must take all necessary steps to ensure that the impact of this
pandemic does not create a second tragedy for vulnerable
communities worldwide—including people with TB.
MSF is one of the largest nongovernmental providers of TB care
in the world. In 2018, in projects in more than 20 countries
across the globe, MSF started 16,500 people on treatment for TB
and 2,840 people for DR-TB in 2018. Together with partners, MSF
is running two clinical trials for DR-TB (TB PRACTECAL
and
endTB) aiming to find effective and short treatments with more
manageable side effects.
Source:
Médecins Sans Frontières
