Covid Lessons for TB

Context

• World TB Day 2022 – March 24

What the editorial is about?

• How best we can leverage the lessons learnt from Covid-19 to help gain new momentum in TB control.
• The need to focus on the epidemiological triad: Agent, host and the environment.

The need to use Covid lessons for TB control

• Covid-19 and tuberculosis (TB) are remarkably similar.
• They are transmissible, airborne infections.
• Both are more likely to spread in crowded settings and harm people with immuno-compromising conditions.

The impact and response: Covid VS TB

• In the first year of the Covid-19 pandemic, 1.8 million people were reported to have succumbed to the virus.
• In the decade between 2010-20, 1.5-2 million individuals died every year because of tuberculosis.
• Yet, we seldom see the word “pandemic” used in the context of TB.
• The amount of money spent by governments for research and development in the first 11 months of the Covid-19 pandemic was 162 times the corresponding amount spent on TB in 2020.
• The difference in responses to the two pandemics can only be explained by the differences in the profiles of those who get infected.
• TB disproportionately affects people in low-income nations, the poor and the vulnerable.

How can we use the lessons from Covid-19 for TB control?

Epidemiological triad

• There is a need to focus on the epidemiological triad:
  • Agent
  • Host
  • The environment

Strategy

• Test, treat and track have been a strategy successfully employed for Covid.

Testing

• There is a need to aggressively scale up testing with innovative strategies such as
  • Active surveillance
  • Bidirectional screening for respiratory tract infections using the most sensitive molecular diagnostics, and contact tracing.

Vaccination

• The biggest victory against Covid has been the speed with which vaccines were developed, scaled up and deployed.
• There is a need to replicate the same for tuberculosis, lobbying for funding from governments and industry to develop a successful vaccine for TB.

Social security programs

• Malnutrition, poverty and immuno-compromising conditions such as diabetes are some of the factors strongly associated with TB.
• Social security programs that work towards the prevention of modifiable risk factors would possibly pay richer dividends than an exclusive focus on “medicalizing” the disease.

Environmental factors

• Environmental factors which have been neglected include ventilation of indoor spaces, educating individuals to avoid crowds when possible and encouraging voluntary masking, especially in ill-ventilated and closed spaces.
• We must not lose this opportunity to invest in these measures, at a time when the sensitization to their need is high.

Investment and actions

• Covid has been a stellar example of how investments and actions can be swift, and public education can transform behaviour.
• Similar aspirations for TB can help turn this crisis into an opportunity to re-imagine our overburdened and underfunded systems.

Private sector

• There is a need to actively engage the private sector, build bridges and partnerships as we did in the case of Covid.

Some suggestions

Investments

• India needs to invest in state-of-the-art technologies, build capacity, expand its health workforce and strengthen its primary care facilities.

Telemedicine and remote support

• India also needs to consider telemedicine and remote support as important aspects of health services.

An open and collaborative forum

• India needs to build an open and collaborative forum where all stakeholders, especially affected communities and independent experts, take a lead role.

Practice Question for Mains

1. It’s time we acknowledge the magnitude of the TB disease and work harder at offering individuals equitable healthcare access and resources that the disease warrants. Comment. (250 Words, 15 Marks)