Tuberculosis: A Silent and Parallel Pandemic

The impact of TB is not only on individuals but also on economies, writes Dr Vijay Soni, Researcher, Weill Cornell Medicine, New York

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About the author: Vijay Soni, Ph.D. is a tuberculosis researcher and currently working as a junior research faculty at Weill Cornell Medicine, New York. He is studying bacterial metabolism and biology of antibiotic to prevent antimicrobial resistance. He has published several research articles, book chapters, book and reviews around tuberculosis research and drug development.

Tuberculosis, also known as TB, is one of the world’s oldest and deadliest diseases. Despite the fact that it is curable and preventable, TB remains a significant public health problem. According to the World Health Organization (WHO), TB is the leading cause of death from a single infectious agent, causing an estimated 1.6 million deaths in 2021 alone. World TB Day, observed annually on March 24th, is a day to raise awareness about TB and the efforts being made to eliminate it. This year’s theme is “The Clock is Ticking,” which emphasizes the urgency of the global response to end TB.
TB is caused by the bacterium Mycobacterium tuberculosis (Mtb) and primarily affects the lungs. It can spread through the air when an infected person coughs, sneezes, or talks. However, TB can also affect other parts of the body, such as the kidneys, bone, spine, and brain. It is a silent and parallel pandemic that disproportionately affects marginalized communities, such as people living in poverty, migrants, and refugees. These groups are more likely to be exposed to TB, have limited access to healthcare, and experience barriers to treatment. The COVID-19 pandemic has further exacerbated the TB crisis. The pandemic has disrupted TB services, leading to delays in diagnosis and treatment. The WHO estimates that the COVID-19 pandemic could result in an additional 1.4 million TB deaths by 2025. The impact of TB is not only on individuals but also on economies. TB primarily affects people of working age, which can result in lost productivity and increased healthcare costs. The challenges to cure TB are complex and require a multifaceted approach to overcome. Here are some of the global challenges to cure TB:
  • Drug-resistant TB:The emergence of drug-resistant strains of TB is a major challenge to curing TB. Drug-resistant TB is more difficult to treat and requires longer and more expensive treatment regimens.
  • Poverty and inequality:Poverty and inequality are key drivers of TB. People living in poverty are more likely to be exposed to TB and have limited access to healthcare, which makes it harder to diagnose and treat the disease. Socioeconomic factors, such as malnutrition and overcrowding, also increase the risk of TB.
  • Limited access to healthcare:Many people living in low- and middle-income countries have limited access to healthcare. This makes it harder to diagnose and treat TB, leading to delays in care and more severe disease. In addition, inadequate healthcare infrastructure, lack of trained healthcare workers, and inadequate funding for TB programs further exacerbate the problem.
  • Stigma and discrimination:TB is often associated with stigma and discrimination, which can lead to delays in seeking care and treatment. Stigmatization and discrimination also make it harder for people living with TB to adhere to treatment, which can lead to treatment failure and the emergence of drug-resistant strains.
  • Co-infections:TB is often associated with co-infections, such as HIV. Co-infections can complicate the diagnosis and treatment of TB and increase the risk of treatment failure. In addition, co-infections can make it harder to manage TB programs, as they require specialized care and treatment.
To overcome these challenges, a comprehensive and coordinated approach is needed. This includes increasing funding for TB programs, improving healthcare infrastructure and access to care, addressing poverty and inequality, reducing stigma and discrimination, and addressing co-infections. In addition, research and development of new TB drugs, vaccines, and diagnostics are essential to overcoming the challenges of drug-resistant TB and improving treatment outcomes. Further, global partnerships and collaboration are key to advancing the fight against TB and achieving the goal of ending TB as a public health threat by 2030. TB can be prevented by ensuring that people have access to clean air, adequate nutrition, and proper sanitation. It can also be cured with a combination of antibiotics and support services. However, treatment requires a long-term commitment and adherence to medication, which can be challenging for many people. We need to prioritize the most vulnerable communities and ensure that everyone has access to affordable and quality healthcare.
On this World TB Day, let us remember the millions of people affected by TB and renew our commitment to ending this silent and parallel pandemic. We call on governments, civil society organizations, and the private sector to prioritize the elimination of TB, invest in research and development, and work together to end this deadly disease once and for all. Let us work towards a world where TB is a thing of the past, and everyone has access to the healthcare they need to live healthy and fulfilling lives. The clock is ticking, and we must act now to ensure that no one is left behind.

*The views expressed by the author in the above article are his own.