New Delhi: A drop of around25-30 per cent in tuberculosis case notifications was reported in three high-burden countries — India, Indonesia and the Philippines — between January and June 2020, compared to the corresponding period in 2019, according to a WHO report released on Wednesday. The COVID-19 pandemic threatens to reverse the recent progress achieved in reducing the global burden of TB, the Global Tuberculosis Report 2020 said, while underlining that urgent and more ambitious investments and actions are required to put the world on track to meet the targets.
The global number of TB deaths could increase by around two lakh to four lakh in 2020 alone, if health services are disrupted to the extent that the number of people with TB who are detected and treated falls by 25-50 per cent over a period of three months, the report noted. "In India, Indonesia, the Philippines and South Africa, four countries that account for 44 per cent of global TB cases, there were large drops in the reported number of people diagnosed with TB between January and June 2020.
"Compared with the same six-month period in 2019, overall reductions in India, Indonesia and the Philippines were in the range of 25-30 per cent," the World Health Organization (WHO) report said. The economic impact of the pandemic is predicted to worsen at least two of the key determinants of TB incidence: GDP per capita and undernutrition. Modelling has suggested that the number of people developing TB could increase by more than 10 lakh per year in the 20202025 period.
The impact on livelihoods resulting from lost income or unemployment could also increase the percentage of people with TB and their households facing catastrophic costs. In line with WHO guidance, the actions that countries have reportedly taken to mitigate the impacts on essential TB services include an expanded use of digital technologies for remote advice and support (108 countries, including 21 high-TB burden nations) and reducing the need for visits to health facilities by giving preference to home-based treatment and providing TB patients with a one-month supply of drugs (100 countries, including 25 high-TB burden nations).
The negative impacts on essential TB services include the reallocation of human, financial and other resources from TB to COVID-19 response, the report said. Globally, an estimated 29 lakh TB cases went unreported to national TB programmes across the world in 2019, according to the report.
In India, of the estimated 26.4 lakh TB cases emerging in 2019, 24 lakh were reported to the Union government — a gap of 2.4 lakh patients who are going unreported, it showed. However, the notifications have seen a significant increase in the last few years — from 17.4 lakh in 2015 to 24 lakh in 2019.
The total TB incidence rate in India has decreased by almost 50,000 patients over the last one year. In 2018, India had an estimated 26.9 lakh tuberculosis patients, which has come down to 26.4 lakh in 2019 — incidence per one-lakh population has decreased from 199 in 2018 to 193 in 2019. In India, notifications of people newly diagnosed with TB rose from 12 lakh in 2013 to 22 lakh in 2019.
Drug-resistant TB continues to be a public health threat. In 2019, around five lakh people developed rifampicin-resistant TB (RR-TB) worldwide, of which 78 per cent had multidrug-resistant TB (MDR-TB), the report said. The three countries with the largest share of the global burden were India (27 per cent), China (14 per cent) and the Russian Federation (eight per cent), it added.