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As the world impatiently looks for an end to the COVID-19 pandemic, another tenacious pandemic, tuberculosis, has gained new strength and threatens millions of people around the world, health experts say.
With less funding for its detection and care programs, and more deaths resulting from it, the global fight against TB has seen major setbacks.
"We've lost five years of progress or more in the fight against TB because of the disruptions of the COVID-19 pandemic," David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, told VOA.
Dowdy's assessment is echoed by the World Health Organization. "The COVID-19 pandemic has reversed years of global progress in tackling tuberculosis and for the first time in over a decade," said Amna Smailbegovic, a WHO spokesperson.
More than 66 million lives have been saved through TB treatment programs since 2000, and the WHO had expected to treat 40 million TB cases between 2018 and 2022, cutting deaths in half over the 10 years ending in 2025.
Not only have these targets been pushed back several years, but whether they can be achieved at all depends on how and when the world effectively ends the COVID-19 pandemic, the experts say.
"The situation continues to look bleak according to the data reported monthly from 90 countries," Smailbegovic said. "There has been insufficient progress made in closing case detection gaps, with still far fewer people diagnosed and treated or provided with TB preventive treatment compared with 2019 before the COVID-19 pandemic. There remains a shortfall of 13% in notifications of people with TB compared with before the onset of the pandemic."
TB deaths up
TB, which has existed some 9,000 years in human societies, is an airborne disease spread by coughing or sneezing, and the pathogen is carried by an estimated 1.8 billion people or one-quarter of the world population, according to the WHO.
More than 1.5 million people died from TB in 2020, up from 1.4 million the year before.
With the marked reduction in detection and care during the COVID-19 pandemic, it is feared that as many as an additional 500,000 deaths could be added to the TB mortality rate, which will push "the world back a decade, to the level of TB mortality in 2010," the agency has warned.
A major cause for this is that many countries have directed most health resources to deal with the COVID-19 emergency.
Over the past two years, hospitals that treated TB patients turned to COVID-19 cases, and TB specialists, who were also diverted to COVID-19 patients, could not follow up with their TB patients, according to TB Alliance, a nongovernmental research organization.
"In spite of the fact that it has almost forever been the greatest global pandemic, unfortunately COVID has taken over in terms of the number of deaths caused by an infectious disease over the last couple of years. So now TB, from the point of view of deaths, is No. 2 behind COVID," Mel Spigelman, president and CEO of TB Alliance, told VOA.
COVID-19 has caused more than 6.16 million deaths so far worldwide with more than 982,000 deaths alone in the United States, according to Johns Hopkins University, which has been tracking cases globally.
Drop in funding
While the response to COVID-19, particularly the relatively quick development of several highly effective vaccines, has been commended widely, the approach has come at a cost of reduce funding for TB programs.
Annually, about $13 billion is needed to diagnose, treat and research TB, and even before the COVID-19 pandemic, the global TB programs received less than half that.
Funding dropped to $5.3 billion in 2020, about $500 million less than 2019, according to WHO figures.
Meanwhile, governments and other donors spent more than $100 billion on developing COVID-19 vaccines.
While India, Indonesia, the Philippines and China carry the highest TB burden, TB incidences increased 9.4% in the U.S. last year compared with 2020.
The COVID-19 pandemic has led to severe economic recessions around the world, forcing millions of already vulnerable people deeper into poverty. This, experts say, has created an environment conducive for a resurgence of TB, which has historically seen increases during times of war and widespread hunger.
"What we've learned from the history is that TB will definitely get worse in the settings of war, hunger, famine, etc.," said Spigelman, adding, "TB anywhere is TB everywhere."