Reducing Tuberculosis Globally and the Impact of COVID-19

November 8, 2022|CHEST Physician
Patricio Escalante, MD, MSc, FCCP;Paige K. Marty, MD

In 2020, more than 1.5 million people died of tuberculosis (TB), and 10 million people contracted the illness globally.1 The World Health Organization (WHO) End TB Strategy aimed to reduce the number of deaths by 35% between 2015 and 2020, yet reduction was just 9.2% (one-quarter of the goal) during this period.2

TB remains the 13th leading cause of death worldwide and is second only to COVID-19 in terms of pathogen-related mortality.1 In fact, due to a significant shift in attention and resources to COVID-19, the death toll for TB has risen for the first time in over a decade.2,3 This disruption has led experts to take a closer look at the characteristics and disparities surrounding those deaths. Areas of focus are the health and socioeconomic consequences of TB and COVID-19 as they relate to TB-related deaths and biosocial inequities in access to essential care. These factors are predicted to lead to a 20% increase in TB death in high-burden countries.4,5

TB management needs to improve at the clinical and public health levels. Adults and children exposed to patients with TB or subclinical pulmonary TB, open with their own conditions that affect their immune response, are at a particularly high risk for acquiring latent tuberculosis infection (LTBI) and developing active TB. Thus, improved prevention, screening, and treatment strategies are urgently needed.6-8 While efforts are ongoing to improve TB vaccines, recent discoveries and technical developments have shown the potential to substantially improve TB prevention efforts through rapid and accurate diagnostic management and innovation that can benefit people at risk of developing TB in resource-limited settings.9-11 Despite this recent progress, multiple challenges remain, including suboptimal investment in global TB control efforts and innovation, increasing rates of drug-resistant TB, as well as lack of and unequal access to services to patients and individuals in need in many countries across the world.1-3,11

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