COVID-19, underfunding stalling fight against TB in Africa -WHO

An assessment by the World Health Organisation Regional Office for Africa in Brazzaville, Congo, has revealed that COVID-19, inadequate investment and funding, is threatening to roll back progress made so far to meet the global target of ending tuberculosis by 2030.

According to WHO, at least US$ 1.3 billion is needed every year in the African region for TB prevention and treatment, but countries contribute only 22 per cent of the needed budget, while external funding accounts for 34 per cent.

It noted that the rest of the budget remained unfunded, seriously undermining efforts to eliminate the disease.

The WHO noted that underfunding for TB programmes has a significant impact on disease detection.

“Out of an estimated 2.5 million TB cases in 2020 in Africa, only 1.4 million were detected and put on treatment. On average, 56 per cent of cases were detected and enrolled on treatment between 2015 and 2020.

“The COVID-19 pandemic has also slowed progress against TB. Globally, deaths from TB rose for the first time in a decade. Africa reported 549,000 deaths in 2020, an increase of around 2000 over 2019.

“The number of newly detected TB cases also fell in high burden African countries due to disruptions by the COVID-19 pandemic on health services. Gabon reported the steepest decline, with the number of newly detected cases falling by 80 per cent in 2020 from the year before. Botswana reported a 20 per cent decline and Lesotho 35 per cent.

“Additionally, 28 per cent fewer patients with drug-resistant TB were detected in Africa in 2020 compared with the previous year. In South Africa, which detects the largest number of drug-resistant TB cases in the continent, 48 per cent fewer people with the drug-resistant strain were detected in 2020 compared with 2019,” the assessment showed.

WHO Regional Director for Africa, Dr. Matshidiso Moeti, said while TB is preventable and treatable and millions of lives have been saved, there is a need to end the chronic underinvestment that keeps the burden of the disease high.

“Africa has so far made good progress against tuberculosis and we cannot afford to lose focus on what is needed to ease the burden and save lives,” Dr. Moeti said.

The world health body noted that the African region is home to 17 of the 30 high-burden TB countries globally and that the estimated 2.5 million cases in the region in 2020, accounted for a quarter of the global burden, with more than half a million African lives sadly lost to this curable and preventable disease.

“However, African countries have made progress against TB. South Africa, for example, has steadily increased domestic funding to fight tuberculosis, allocating 81 per cent of the financial resources, while Zambia has increased its domestic funding seven-fold since 2015.

“Under the WHO End TB Strategy, countries should aim to reduce TB cases by 80 per cent and cut deaths by 90 per cent by 2030 compared with 2015. The strategy also sets key milestones that countries should cross by 2020 and 2025, if they are to end the disease.

“The 2025 milestone seeks a 50 per cent reduction in cases and a 75 per cent decline in deaths. TB cases should drop by 10 per cent every year to meet the 2025 target, yet the current rate of decline in cases stands at two per cent. From 2025 to 2030, countries should reduce cases by 17 per cent every year.

“The End TB Strategy also includes a key target that seeks to reduce the catastrophic cost tuberculosis treatment can have on families. However, a WHO survey on the cost of tuberculosis treatment in 10 African countries showed that 49 per cent of TB-affected households experienced catastrophic costs. No country in Africa has yet demonstrated that it has met the target that no TB-affected households face catastrophic costs,” WHO stated.

Dr. Moeti added that the road to ending tuberculosis is likely to get long and hard as key milestones risk being missed, adding that countries must speed up the response and stay committed to alleviating the suffering and death caused to millions of people by tuberculosis.

 

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