KNCV Tuberculosis Foundation sounds the alarm: COVID-19 will cause even more TB deaths

The coronavirus has grabbed the attention of the world. Yet with 4,000 deaths a day worldwide, tuberculosis (TB) is holding the macabre top position as the world’s most deadly treatable infectious disease. This means 1,5 million deaths a year. And due to the coronavirus an estimated 20 percent more TB patients are expected to die between now and 2025. KNCV Tuberculosis Foundation (KNCV) is therefore sounding the alarm. “Millions of TB patients worldwide are fighting for their lives and now have to cope with COVID-19 as well. Extra support for these vulnerable people and their families is needed”, says Agnes Gebhard, technical director of KNCV. Like COVID-19, TB knows no borders. Worldwide, 1.5 million people, including 205,000 children, die of TB every year mainly in Africa and (Central) Asia. TB in most cases, damages the lungs, which also makes TB patients more vulnerable to the Coronavirus. In addition, Coronavirus has many indirect consequences for TB patients. Research from Stop TB Partnership predicts that between now and 2025, a staggering 6.3 million more people will develop TB and 1.4 million more people are expected to die, as cases during lockdown go undiagnosed and untreated. This will set back global efforts to end TB by five to eight years. Gebhard: “We work in 11 countries and see with our own eyes that TB patients are not getting the care they need at this moment. We are very concerned about these people.” The lockdowns, closed borders, and the fact that health care systems need almost all their capacity to fight the COVID-pandemic interfere with TB services, for example:

• fewer patients with presumptive TB report themselves because they fear becoming infected with COVID-19 at the hospital;
• in many places active detection and testing of people with presumptive TB has come to a standstill;
• support for patients at home is under pressure because people are no longer allowed and afraid to walk on the street;
• it has become difficult or sometimes even impossible to collect medication daily, or weekly, at a health facility, as patients commonly do in many countries;
• the production and supply of TB drugs and diagnostics are getting disrupted.

As a result, many TB patients can’t continue their treatment appropriately, causing their TB symptoms to worsen, they may remain contagioustoothers and the right treatment can come too late. With timely and proper treatment, however, TB can be cured. KNCV is currently making every effort to support TB programs with alternative approaches to ensure all TB patients get their medicines without interruption of care. For example, by offering and helping to roll out digital solutions with which nurses can continue to support their patients. KNCV and its partners also contribute to ensuring that TB tests, if possible, are still carried out despite the pressure on health centers. Gebhard: TB is a disease of poverty and affects the most vulnerable people in many countries. The COVID pandemic is also hitting hardest among more impoverished populations worldwide. Moreover, without testing, it is sometimes difficult to distinguish between the two diseases. We must prevent these people from becoming further affected and from having no access to TB tests, medicines, and care. ” At the same time, KNCV is also committed to fighting COVID19. Because where the diseases reinforce each other, the TB and COVID19 experts do the same. Infection prevention and contact investigation are two pillars of TB control. These experiences are used worldwide to combat the COVID pandemic. Gebhard: “We are committed to helping combat TB as well as COVID19, strengthening health systems to face both epidemics. To be able to do so, extra and continued support from institutional and bilateral donors as well as the general public are much needed.”