Tuberculosis cases rise as resources redirected to fight Covid-19

WHO estimates that millions are undiagnosed as access to treatment declines

A doctor attends to Anwar, 4, infected with tuberculosis at the Kashi Vidyapith hospital in Kotawa near Varanasi, India. Tuberculosis remains a stubborn problem in India, which has more than a quarter of the world’s new TB cases. Children are especially at risk. Rajesh Kumar Singh / AP Photo

Rama Shanker sleeps in the sun inside the complex of Lal Bahadur Shastri Government Hospital at Ram Nagar in Varanasi. Rajesh Kumar Singh / AP Photo

Neha, 11, sits in the sun with her mother Jehana outside Lal Bahadur Shastri Government Hospital at Ram Nagar in Varanasi. The disease kills about 300,000 people every year in the country. Rajesh Kumar Singh / AP Photo

A man has an x-ray taken of his chest for diagnosis of tuberculosis. India saw the greatest increase in multidrug-resistant TB between 2011 and 2012. Rajesh Kumar Singh / AP Photo

Nurses help the tuberculosis patient Manjeet Mishra, 18, walk towards his ward at Lal Bahadur Shastri Government Hospital in Varanasi. Another factor contributing to TB’s growing drug resistance: many patients, weary of TB drugs’ harsh side effects, stop their treatment once they feel better instead of taking the full course. Rajesh Kumar Singh / AP Photo

Tuberculosis deaths have increased for the first time in a decade as resources have been directed to tackling the Covid-19 pandemic, the World Health Organisation said.

In 2020, 1.5 million died from the disease, up from 1.4m the year before. But WHO said problems related to the access and provision of services meant many more of those infected were likely undiagnosed.

Newly-diagnosed patients and cases reported to national governments dropped from 7.1m in 2019 to 5.8m in 2020, but the WHO estimated that some 4.1m people suffered from the disease in 2020 and were undiagnosed or reported to the authorities, compared with 2.9m in 2019.

“This report confirms our fears that the disruption of essential health services due to the pandemic could start to unravel years of progress against tuberculosis,” said Dr Tedros Adhanom Ghebreyesus, WHO's Director-General. “This is alarming news that must serve as a global wake-up call to the urgent need for investments and innovation to close the gaps in diagnosis, treatment and care for the millions of people affected by this ancient but preventable and treatable disease.”

Two main challenges were identified; human, financial and other resources have been redirected to fighting Covid, and access to care has been limited due to lockdowns.

WHO also reported a fall in the provision of preventive treatment. While about 2.8 million people accessed this in 2020, that marked a 21 per cent reduction from 2019. The number of people treated for drug-resistant tuberculosis fell by 15 per cent, from 177,000 in 2019 to 150,000 in 2020. That amounts to only about 1 in 3 of those in need.

There are 30 countries which bare the highest burden of tuberculosis: Angola, Bangladesh, Brazil, Central African Republic, China, Congo, Democratic People’s Republic of Korea, Democratic Republic of Congo, Ethiopia, Gabon, India, Indonesia, Kenya, Lesotho, Liberia, Mongolia, Mozambique, Myanmar, Namibia, Nigeria, Pakistan, Papua New Guinea, Philippines, Sierra Leone, South Africa, Thailand, Uganda, United Republic of Tanzania, Vietnam and Zambia.