COVID-19 has redefined how we look at “global health” which, given that we have experienced it both locally and globally, now feels more personal. Today, I want to share why I think tuberculosis (TB) deserves equal attention and my hope for a future where global health including infectious diseases like TB gets the limelight.
How TB has missed the attention it deserves
Before COVID-19 came into picture TB advocates including me were disturbed with the little attention this preventable disease received despite being the world’s top infectious disease killer. Yes, you read that right: TB kills one person every 20 seconds: a whopping 1.45 million deaths every year, and more people than HIV/AIDS and malaria combined. Yet how often do you read about TB in the news or hear a world leader talking about the need to act on it urgently? TB has never received the attention it deserves.
If you thought TB was only a problem of poor countries, think again. No country in the world is TB-free. In Australia, there are around 1400 active TB cases each year. What’s worse, one-third of the world’s population is infected with latent (dormant) TB. In Australia, it is estimated that 1 million people have latent TB.
How has COVID-19 made things worse?
Firstly, research from South Africa shows that people living with HIV, TB have a two- to three-fold higher risk of dying from COVID-19.
Secondly, there is clear evidence of the impact COVID-19 has on TB services. It’s not surprising that COVID-19 has diverted healthcare resources away from routine TB services – for instance, TB wards have been converted to COVID-19 wards and diagnostic machines used to test for TB are now being used for COVID-19. Patients either can’t visit clinics because of lockdowns or won’t go because public transport isn’t running or they’re afraid of being exposed to COVID-19 in the clinic. As a result, the number of TB tests has reduced and you can’t find what you aren’t looking for.
To put this into perspective, a study conducted by the Stop TB Partnership and Imperial College highlighted that, without decisive action, the world may lose up to 8 years of progress against TB.
Cumulatively, what this means is that unless broad immediate action is taken, the world will not meet the targets agreed in the Political Declaration from 2018’s UN General Assembly High-Level Meeting (HLM) on TB (to be met by 2022) or the Sustainable Development Goals TB targets (to be met by 2030) and TB will continue to be a major public health problem.
But there is hope…
An unprecedented global crisis has received unprecedented global attention – and funding. Over the past months, the global community has committed over US$20 trillion to over 1000 initiatives for COVID support control, containment and relief efforts. This demonstrates that resource mobilisation is possible if there is a collective will.
In stark contrast, the annual global funding gap for TB (between national TB budgets, and what is cumulatively available for TB) is approximately $ US$1.6 billion – less than 0.01% of the total funds mobilised for COVID-19 this year.
So there is hope as well as an opportunity: hope that our leaders will continue prioritising the health agenda, and an opportunity for health advocates to capitalise on the sense of solidarity, equity and collaboration.
Why is your advocacy so critical now?
The way forward will be challenging. With global economic decline, governments will have to juggle many competing issues and there is a risk that TB will once again be left behind. Our approach should be to continue:
- advocating for global health as a good public good and
- sensitising governments about the impact of COVID-19 on TB services and advocating for funding to restore TB services and minimise the adverse impacts.
What can I do?
Join RESULTS’ TB campaign this year! Please visit our TB campaign page to know more.
We are asking the Australian government to invest in TB in line with what was promised at the 2018 United Nations High-Level Meeting. In particular, we seek
- Increased funding for TB through the bilateral aid budget in 2020 to high-burden countries in our region (e.g.PNG, Timor Leste, Indonesia)
- Increased funding for TB research and development (R&D) to meet Australia’s ‘fair share’ target of 0.1% of its gross expenditure on R&D (GERD). Australia currently spends US$9.578 million per year on TB R&D; its target, from the Declaration of the 2018 HLM, would be US$21.2 million annually.
When the going gets tough the tough get going. As global health advocates, we have a long way to go. The journey is not going to be easy for sure, but there is hope. We must stand together.