A survey conducted by a civil society-led Tuberculosis (TB) and COVID-19 working group has found that the COVID-19 pandemic has gravely affected healthcare allocation to combat tuberculosis. Taking inputs from healthcare workers around the globe and talking to TB survivors and advocates, a report titled ‘The impact of COVID-19 on the TB epidemic: A community perspective’ has been published.
The report states that during the COVID-19 pandemic, more than 70% healthcare workers reported a decrease in the number of people coming to health facilities for TB testing. And, 70% of officers from the Global Fund-implementing countries reported a decrease in the number of people with TB receiving treatment.
The report also showed that people with TB from India and Kenya reported significant challenges in accessing TB services during the pandemic and associated lockdowns.
“Difficulty finding transport to access TB care, changes in TB services, and fear of contracting COVID-19 during a healthcare visit were cited as key barriers. People with TB also reported expe- riencing increased stigma due to the similar symptoms of both respiratory diseases,” the report said, adding that 36% of people with TB in India reported health facilities they normally visit closed.
Globally, 50% of workers reported that the healthcare facility they worked for has reduced TB care services. However, 50% of TB patients surveyed in India and Kenya said they had received additional medicines to continue their treatment at home amid the viral outbreak.
Responses from 58 TB patients were taken from India and the report said that most people with TB surveyed in India sought care in public (31%) or private (29%) hospitals. Fewer participants visited clinics; 15 (26%) said they visited public clinics, and 10 (17%) reported visiting private clinics. Eight individuals (14%) sought care in NGO/charity clinics.
In addition to healthcare systems struggling to meet the needs of people and programs, health-care workers speculated that lockdown measures, stigma, and fear of COVID-19 were discourag- ing people with TB from attempting to access care and support. According to the report a fear of policing authorities was a unique factor in Global Fund implementing countries, with a healthcare worker from India saying people were “scared to come for follow-up due to risk of being punished by [the] authorities.”
Organisations involved in conducting the study include ACTION Global Health Advocacy Partnership, TB PPM Learning Network, McGill TB Center, KANCO, Global TB Caucus Secretariat, Global Coalition of TB Activists, Global Coalition of TB Activists, TB People, Stop TB Developing NGO Delegation, Results Canada.
The report suggested that providing social protection is critical. It noted that COVID-19 has emphasized the critical importance of social protection systems and that there is an urgent need to promote equity and access to financial support, transportation, healthcare and food for all people with TB, free from discrimination.
The report noted that there is an urgent need for a recovery plan and that TB responses have to get back on track in order to achieve the Sustainable Development Goal commitments of ending Tuberculosis by 2030. It added that the pandemic must be looked at as an opportunity for national TB responses to become more people-centred and to involve communities.
“This report shows that the COVID-19 pandemic is absolutely devastating for our quest to end TB. If we were climbing a mountain before COVID-19, that mountain has now become Mount Everest. We need to work extra hard to mitigate the damage and stay focused on TB for the long haul. Collaboration and solidarity within the TB community are critical if we are to have any hope of getting back on track to reach the SDG goals,” said Madhukar Pai, an epidemiologist and the director of the McGill International TB Centre in Canada, in the report.
Tuberculosis is the world's leading infectious disease, killing around 1.5 million people annually.