We often hear how COVID-19 has changed the way we do things, from managing our lives to talking about how the pandemic could have been addressed. As a global health advocate I see  an opportunity to press the reset button. So what would that look like in terms of learning from COVID-19 to address other pandemics like tuberculosis (TB)?

By the end of October, COVID-19 passed 45 million infections globally and over 1.2 million deaths. In 2019, 1.4 million people died due to TB according to the WHO’s latest Global TB report, making it the world’s deadliest infectious disease for the fifth year in a row. 

Even after some pleasing progress in TB over the last eight years these deaths are pre-COVID figures and, with lockdowns, job losses and the diversion of health resources over the last six months, these figures are set to get worse. According to recent analysis from the UN’s Stop TB Partnership, between 2020 and 2024 another 6.3 million more people will fall ill with TB and an additional 1.4 million more will die. Both TB and COVID-19 spread by close contact between people, although the exact mode of transmission differs (see page 6 of this WHO infonote).

Also last month, the UN Secretary-General mid-term progress report on global TB targets confirms that global progress is insufficient to meet any of the HLM targets by the agreed 2022 deadline. These targets were agreed by world leaders at the UN High-Level Meeting (HLM) on TB in September 2018. Key among the commitments was to treat at least 30 million people for TB globally by 2022, including latent TB infection, and we are not yet even a third of the way there. 

The report further raises an alarm that the COVID-19 pandemic threatens to unwind the gains made over recent years. According to Dr Tedros, WHO Director-General, “COVID-19 is demonstrating that health is not only an outcome of development: it is also a prerequisite to social, political and economic stability”.

Mitigate the damage

So what has been done so far to mitigate the damage? In May 2020, the WHO released an operational guideline recommending practical actions that countries can take to reorganise and maintain access to high-quality, essential health services during the pandemic. The Global Fund, major funding for international TB funding, approved $700 million for 103 countries to support COVID-19 response and ensure TB services don’t get affected. Civil society organisations developed several guiding documents for activists and communities. (For more resources visit STOP TB)

Building back better

Dr Madhukar Pai, a TB researcher at  McGill University in Canada, recently published an article that highlights some recent  rapid innovations for COVID-19. His examples include: (1) use of mobile applications and services for patient education, risk assessment and screening, (2) rapid development of point-of-care COVID diagnosis (3) innovations in service delivery and (4) better data, data visibility and usage. 

The key message I see is that if we can do it for COVID-19 we certainly can do it for TB.The global solidarity, investments and co-operation we have seen for COVID-19 have demonstrated that with political will we can achieve a lot in record-breaking time. And that is what we need for TB as well. We know that this doesn’t end for anyone until it ends for everyone and the same is true for TB, which is still in every country and is a risk to anyone who breathes (i.e. all of us).

What does it mean for us going forward?

2020 has not been a good year; as South African Home Minister and TB champion Aaron Motsoaledi has said, we should just start it again. But short of being able to do that, there are two things that we global health advocates need to do:

  1. ensure that health services are not impacted by COVID-19 and 
  2. continue advocating for the urgent need for more resources for TB. 

To address the first point RESULTS Australia, along with other partners, have been advocating with the Australian government: the #EndCOVIDForAll campaign, initiated by Micah Australia and supported by over 150 organisations including RESULTS, has so far secured commitments of over $800m for our region. These investments will ensure that any vaccine will be available to everyone, and that health systems – the cornerstone of delivering any health services (including for TB) – are stronger.

On the second point, there is still more to do. We must ensure that we remain alert to other pandemics, even while the world is busy dealing with COVID-19. The bigger question is also how we ensure that COVID-19 investments and the lessons we have learned from this pandemic are used to address other global health issues in the future.

As Secretariat of the Australian TB Caucus, RESULTS has been advocating for more Australian investments in TB  since 2015, when the Caucus was formed. In that time we have seen pleasing increases in Australian commitments for TB through multilateral programs like the Global Fund to Fight AIDS, Tuberculosis and Malaria, through bilateral programs, and an increase in TB research and development funding. But Australia can do more, and the path ahead is going to be difficult. 

Now is the time if you want to make a difference

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By RESULTS Head of Campaigns, Shiva Shrestha