April 1, 2021
Setbacks and Opportunities in India’s Fight Against TB
As the world responds to COVID-19, we can’t forget the ongoing TB epidemic, which killed 1.4 million people worldwide in 2019. India faces a high incidence of TB cases and considerable TB deaths, accounting for over 25% of global TB cases. In 2019, there were 2.64 million new TB cases and 124,000 new drug-resistant or multidrug-resistant cases in India. However, the COVID-19 pandemic halted India’s tuberculosis program and threatened previous gains as the delivery of TB care was impeded by lockdowns, hospital restrictions, health worker diversions and patient fears. Globally, the STOP TB Partnership projects 6.3 million more people will develop TB and 1.4 million more will die from TB between 2020 and 2025 because of similar setbacks.
Despite these service disruptions, TB infrastructure and investments in India have helped support India’s response to COVID-19. Community-based organizations and community health workers that worked on TB had the expertise and skills to engage communities through education and contact tracing during the pandemic. Integrated and simultaneous screening and diagnostics programs for COVID-19 and TB were an essential component of the rapid response plan the Indian government developed last August to integrate the TB and COVID-19 responses. COVID-19 vaccination drives have utilized India’s universal immunization program and infrastructure that vaccinates 25 million children yearly against many diseases, including TB.
Global TB expert Madhukar Pai, of the McGill International TB Centre, pointed to the disruptions in TB care due to COVID-19 as a chance to be transformative and innovative in the fight against TB, saying: “There cannot be a more opportune moment for the TB community to leverage COVID-19 innovations to reimagine TB care.” Pai points to areas including global partnerships, medical research, social safety nets, data systems and public-private partnerships as opportunities to not only rebuild TB care, but enhance national health systems and the global health infrastructure.
India has long had a valuable partnership with the Global Fund. The Global Fund has consistently partnered with India in the fight against TB through funding for programs including the Joint Effort for Elimination of TB and collaboration with the India Health Fund. In 2019, India contributed $22 million to the Global Fund’s efforts to end AIDS, TB and malaria. Last year, the Global Fund approved over $29 million to help diminish the impact of COVID-19 on HIV, TB and malaria programs and reinforce the national response to COVID-19. The COVID-19 pandemic has highlighted the need for sustained investment in health systems strengthening and the fight against TB. Without a reinvigorated push to address TB in India, millions could die in the coming years.