The United Nations Office at Geneva
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Despite being preventable and curable, tuberculosis remains one of the deadliest infectious diseases in the world.
Amidst the ongoing COVID-19 crisis, World TB Day on the 24th of march marks the occasion for the international community to call for more action to eliminate tuberculosis (TB) as a public health burden by 2030.
Every day, nearly 4000 people die from TB according to the WHO and close to 30 000 people fall ill with TB. In 2019, 10 million people suffered from TB and close to 1.5 million people — over 95% of whom were living in lower- and middle-income countries — died due to the disease. TB remains the leading cause of death of people living with HIV.
The COVID-19 pandemic has exacerbated the problem and threatens to unwind the gains made over recent years. Restrictions on movements have resulted in sharp drops in TB case notifications in 2020 and limited access to TB treatments and services.
Global progress in TB prevention is also lagging behind. According to the WHO, only 1 in 5 of the 30 million people targeted for access by 2022 have started a TB preventive treatment.
“About 1/4 of the world’s population, roughly 7 billion people are infected with TB in a latent form” says Robert Matiru, Director of Programmes at Unitaid. “If this is not treated with preventive measures and therapies it can become active and people will become sick and die”.
Unitaid’s supported project IMPAACT4TB helps to facilitate access to affordable and easier to use TB preventive treatments for people at risk including people living with HIV in low- and middle-income countries.
One of those treatments is called “3HP”, a short course preventive therapy combining two TB drugs - rifapentine and isoniazid. This has reduced patients’ treatments from one daily dose between 6 to 24 months to one weekly dose for 3 months.
In February, a new fixed-dose combination of this preventive treatment has started to be rolled-out in 5 high burden TB countries with the financial support of Unitaid.
This new version reduces the pill-burden from 9 pills a week to 3, making it even easier for patients to stick to their treatments with better health outcomes.
The rollout of this new treatment has started in February in five African countries with high rates of the disease: Ethiopia, Ghana, Kenya, Zimbabwe and Mozambique.
In Mozambique, the roll out will first target 3 provinces in the South of the country with a high TB incidence: the City of Maputo, the Province of Maputo and the Province of Gaza.
“If we want to have any chance of ending, we need to prevent it in the first place” said Robert Matiru, Director of Programmes at Unitaid.
- Various shots, patients waiting at the Highfield Polyclinic, Harare, ZIMBABWE
- SOUNDBITE (English) Robert Matiru, Director of Programmes at Unitaid: “Despite being preventable and curable, tuberculosis is one of the deadliest infections in the world killing 1.5 million people each year. 10 million people fall ill with tuberculosis each year as well and many of them are children almost 900 000 and mostly in low and middle-income countries and some of the poorest countries in the world. It’s also the leading killer of people living with HIV. About a quarter of the world’s population, roughly 1.7 billion people are infected with TB, the latent form. However, if this is not treated with preventive measures and therapies it can become active and people will become sick and die. To make matters worse, COVID-19 has exacerbated the problem and set many national programs back in their efforts to respond to the TB pandemic in their countries.”
- Various shots, Jakarta, INDONESIA, Irma Rosita, pharmacist at the Puskemas Senen, preparing and giving tuberculosis preventive therapy drugs to a patient.
- SOUNDBITE (Bahasa Indonesia) Patih Natawijaya, patient at the Kramat Pulo Health Center: “At first I did not know what preventive therapy was. I was advised by the healthcare workers from Puskemas Kecamatan Senen to start on TB preventive treatment because my mother in law who currently lives with us has pulmonary tuberculosis. The healthcare workers explained to me that my wife, my children were household contacts and could potentially be infected by tuberculosis. I was explained the importance of taking preventive treatment to prevent the germs from developing in active TB”.
- SOUNDBITE (English) Robert Matiru, Director of Programmes at Unitaid: “If we are going to have any chance of ending TB in the next ten to twelve years, we have to prevent it in the first place. Unitaid has been at the forefront working with many partners, governments, manufacturers, civil society, activists and the WHO to bring a new treatment to prevent TB : 3HP. We are combining two treatments into one which reduces how many pills someone has to take a day from 9 to 3. It is easier to do this, it reduces the logistics and packaging and we have also lowered to the cost by almost 70% for this treatment which is very important”.
- Med shots, nurses at Highfield Polyclinic in Harare, ZIMBABWE reading leaflets
- SOUNDBITE (English) Nurse at Highfield Polyclinic in Harare: “Our clients are complementing 3HP. Since it’s a shorter course, most of them are embracing 3HP. They say it is well tolerated than INH. INH is a six months course but for 3HP it is only taken once weekly so pill burden is lesser. So, most of our clients they are appreciating 3HP over other preventive therapies. And also our clients are reporting less side effects”.
- Exterior view of the Malhangalene Health Center, Maputo, MOZAMBIQUE
- Various shots : interior views of the Malhangalene Health Center, Maputo, patient consulting a doctor with a baby in her arms
- SOUNDBITE (English) Ivan Manhiça, National TB Control Program Director at the Ministry of Health, Maputo: “Tuberculosis is one of the three main causes of death in Mozambique. It is a disease that causes long death. It can also prevent people from going to work and so even if it can be cured, it is better to prevent it than to treat it. Prevention is being implemented at national level. Three types of medicines have been approved in the country among which isoniazid that we have used for a long time. But also now since 2020 we have approved the 3HP that we are starting to introduce in the country next week and gradually in all the country”.
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Responding to a question about whether the changing global water cycle might have contributed to the deadly Nepal-China flooding disaster, Ms. Saulo explained that melting ice and rock was just one factor in the chain of events that ultimately sent a massive and deadly wall of water and debris downstream on 26 August, killing at least 1,367 people.
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“After this point, the glacier gives less meltwater each year simply because there is less ice left to melt. That matters for every community downstream that relies on water during hot, dry summers,” he explained.
Narelle van der Wel, WMO’s Head of Cryosphere Monitoring, Predictions and Services, stressed that while some further glacier loss is unavoidable, the eventual scale of the decline is not predetermined.
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Mr. Jenkinson said governments need to prepare for “moving baselines” as historical patterns become less reliable.
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