Tuberculosis is poised for a deadly global surge, as progress slips due to pandemic-induced disruptions. Urgent action and investment are needed to protect progress made and to meet the 2022 TB targets agreed to by UN Members States.

Time is running out to stop growing waves of tuberculosis (TB), as disruptions to health services continue to erode global progress against this deadly respiratory disease. In fact, new estimates reveal that the COVID-19 pandemic has reversed 12 years of hard-won gains.

Before COVID-19, TB was the leading cause of death from infectious diseases globally. In 2019, approximately 25% of the world’s population had TB, and it claimed the lives of nearly 4,000 people every day.

But progress was being made.

The number of people being treated for TB was on the rise — over 14 million people received care in 2018 and 2019. And the number of people provided with preventive treatment for TB quadrupled, from 1 million in 2015 to over 4 million in 2019.

Enter COVID-19.

National lockdowns led to a surge in unidentified TB cases circulating in communities. At the same time, access to treatment and support services for people living with TB was severely restricted. A modeling analysis commissioned by the Stop TB Partnership estimated that a three-month lockdown for COVID-19 could lead to an additional 1.4 million TB deaths and 6.3 million cases between 2020 and 2025.

Patient records at the TB hospital in Mykolaiv, Ukraine. Photo: Christine McNab/TB Partnership

The clock is ticking for governments to hold each other accountable and accelerate their collective actions to mitigate the impacts of the COVID-19 pandemic on rising TB incidence and mortality.

By 2050, multidrug-resistant TB — a form of TB that does not respond to known antibiotic treatments — alone is predicted to cause 2.5 million deaths, costing approximately $17 trillion if it is not adequately addressed and controlled in the next few years. This is a human and economic cost the world cannot withstand.

In 2018 world leaders came together at the High-Level Meeting (HLM) at the UN General Assembly to spur global commitments and actions to reduce the burden of TB on communities around the world. The resulting 2022 Global Targets for Tuberculosis represented the first time that UN Member States set and agreed upon specific global targets for funding TB prevention, treatment and care, and research.

But now, with the 2022 deadline fast approaching, the world is falling further off track. COVID-19 has placed enormous pressure on health systems around the world — from supply chain delays to overburdened health workers to limited access to diagnostic tools and treatments — which has underscored the need for increased investment.

By investing in health system infrastructure, rebuilding the health care workforce, and ensuring health care providers have the resources they need to prevent and respond to the multiple global health threats of today, we can not only spur progress toward the 2022 TB targets but we also can actively prevent and limit the impact of future epidemics.

We have seen what the cost of inaction and underinvestment can yield: a global pandemic that can upend economies and take millions of lives around the world. Health threats like TB cannot continue to be ignored.

New tools for TB prevention, treatment, and care are urgently needed if the world hopes to get back on track to meet TB targets. At the HLM on TB in 2018, leaders promised to spend $15 billion every year on TB prevention, diagnosis, treatment, and research. Less than half of that target has been met.

After the COVID-19 pandemic has been subsided, political leaders can demonstrate their commitment to improving global health security and ensuring global economic stability by rededicating themselves to stopping the spread of TB through: 

  • Expanding patient-centered care, active case detection, increased availability of rapid sensitivity tests and other diagnostic tools.
  • Increasing bilateral and multilateral investments in the development of new TB diagnostics, treatments, and vaccines.
  • Implementing national policies that preserve the rights of communities with heightened vulnerability to TB.

The past year has been an alarming wake-up call for political leaders and policymakers around the world to reprioritize and strengthen global actions to combat and prevent airborne respiratory diseases such as TB, SARS, and now COVID-19 — which can escalate from epidemics to global pandemics in a matter of weeks.

As countries become increasingly hyperfocused on accelerating the distribution of COVID-19 vaccines, we cannot afford to lose sight of the 2022 TB targets and to let the progress made against this equally deadly respiratory disease slip away. The health and well-being of millions of people around the world are on the line.


Photo:  Christine McNab/ Stop TB Partnership