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On World TB Day, the WHO is calling for increased investment in TB services and research
On World Tuberculosis Day, the WHO calls for urgent investment in resources, support, care and information in the fight against tuberculosis (TB). Although 66 million lives have been saved since 2000, the COVID-19 pandemic reversed those gains. For the first time in more than a decade, the number of TB deaths has increased by 2020. Ongoing conflicts across Eastern Europe, Africa and the Middle East have further exacerbated the situation for vulnerable populations.
Global spending on TB diagnosis, treatment and prevention in 2020 was less than half of the global target of $ 13 billion per year by 2022. An additional $ 1.1 billion per year is needed for research and development. “Urgent investment is needed to develop and expand access to the most innovative services and tools to prevent, detect and treat tuberculosis, which could save millions of lives each year, reduce inequalities and prevent huge economic losses.” said Dr. Tedros Adhan Ghebreyesus. “These investments offer a huge return for countries and donors, in avoiding health care costs and increasing productivity.”
Investments in TB programs have shown benefits not only for people with TB, but also for health systems and pandemic preparedness. Building on the lessons learned from the COVID-19 study, there is a need to catalyze investment and action to accelerate the development of new tools, especially new TB vaccines.
Progress towards the 2022 targets set in the UN political summit’s political declaration and the WHO Director-General’s flagship initiative Find.Treat.All is at risk mainly due to a lack of funding. Between 2018 and 2020, 20 million people were reached with TB treatment. This is 50% of the five-year target of 40 million people achieved by tuberculosis treatment for the period 2018-2022. In the same period, 8.7 million people were provided with preventive treatment for tuberculosis. That’s 29% of the 30 million target for 2018-2022.
The situation is even worse for children and adolescents with tuberculosis. In 2020, it is estimated that 63% of children and young adolescents under the age of 15 with tuberculosis were not covered or not officially reported to have access to life-saving TB diagnosis and treatment services; this share was even higher – 72% – for children under 5 years of age. Nearly two-thirds of eligible children under the age of 5 have not received preventive TB treatment and therefore remain at risk for the disease.
COVID-19 had a further negative and disproportionate impact on children and adolescents with or at risk of TB, with increased transmission of tuberculosis in the household, lower demand for care, and access to health services. The WHO warns on World TB Day that countries urgently restore access to TB services, which has been disrupted by the COVID-19 pandemic for all people with TB, especially children and adolescents.
“Children and adolescents with TB lag behind adults in access to tuberculosis prevention and care“, Said Dr. Tereza Kasaeva, Director of the World Tuberculosis Program. “The WHO guidelines released today change the rules of the game for children and adolescents, helping them get diagnosed even before access to care, leading to better outcomes and reduced transmission. The priority now is to rapidly expand the application of the guidelines in all countries in order to save young lives and prevent suffering”
Updated guidelines for the treatment of tuberculosis in children and adolescents
The updated guidelines for the treatment of tuberculosis in children and adolescents published today by the WHO highlight new recommendations for diagnosis, treatment and prevention aimed at patients. The latest recommendations are:
- Diagnostic testing has been extended to noninvasive specimens, such as stools.
- Rapid molecular diagnostics is recommended as an initial test for the diagnosis of tuberculosis for children and adolescents.
- Children and adolescents who have mild forms of drug-sensitive tuberculosis are now recommended treatment for four months instead of six months, as well as TB meningitis, where a six-month treatment regimen is now recommended instead of 12 months. This promotes a patient-centered approach that will reduce the cost of tuberculosis care for children, adolescents and their families.
- The two latest anti-tuberculosis drugs for the treatment of drug-resistant tuberculosis (bedaquiline and delamanide) are now recommended for use in children of all ages, allowing children with drug-resistant tuberculosis to receive oral treatment regimens regardless of their age.
- New models of decentralized and integrated tuberculosis care are also recommended, which will enable more children and adolescents to access care or preventive treatment against tuberculosis, closer to where they live.
TB remains one of the deadliest infectious killers in the world. Every day, more than 4,100 people lose their lives from tuberculosis, and close to 30,000 people get this disease, which can be prevented and cured. Stopping tuberculosis requires coordinated action by all sectors. On World Tuberculosis Day, the WHO calls on everyone – individuals, communities, societies, donors and governments to do their part in the fight against tuberculosis.
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Note to the editor:
The WHO works closely with its offices in Ukraine and neighboring countries, the WHO Regional Office for Europe and partners to respond quickly to conflict-related health emergencies and reduce disruptions in the provision of critical health services. As part of this comprehensive effort, given that Ukraine has a heavy burden of drug-resistant tuberculosis, the WHO is proactively supporting efforts to provide access to tuberculosis care services for people with tuberculosis, refugees and displaced populations at risk.
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