Low funding and COVID-19 hold back TB fight in Africa – Reuters

Brazzaville- Inadequate investment and funding for tuberculosis (TB) control in Africa undermines efforts to reach the global goal to end the disease by 2030, as the COVID-19 pandemic threatens to set back progress made so far on the continent, according to an assessment by the World Health Organization (WHO).

Every year, the African region needs at least US$1.3 billion for TB prevention and treatment. However, countries contribute 22% of the necessary budget while external funding represents 34%. The rest of the budget remains unfunded, seriously compromising efforts to eliminate the disease. This year, World TB Day is celebrated under the theme “Investing to end TB. Save lives.”

Underfunding of TB programs has a significant impact on disease detection, for example. Of an estimated 2.5 million TB cases in 2020 in Africa, only 1.4 million were detected and put on treatment. On average, 56% of cases were detected and enrolled on treatment between 2015 and 2020.

The COVID-19 pandemic has also slowed progress against tuberculosis. Globally, deaths from tuberculosis have increased for the first time in a decade. Africa reported 549,000 deaths in 2020, an increase of around 2,000 from 2019. The number of newly detected TB cases has also declined in high-burden African countries due to the disruption caused by the coronavirus pandemic. COVID-19 on health services. Gabon reported the steepest decline, with the number of new cases detected falling by 80% in 2020 compared to the previous year. Botswana reported a decline of 20% and Lesotho 35%.

In addition, 28% fewer patients with drug-resistant tuberculosis were detected in Africa in 2020 compared to the previous year. In South Africa, which detects the highest number of drug-resistant TB cases on the continent, 48% fewer people with the drug-resistant strain were detected in 2020 compared to 2019.

“TB is preventable and treatable, and millions of lives have been saved. We must end the chronic underinvestment that keeps the burden of TB high, leaves large numbers of cases undetected and undermines prevention and treatment,” said Dr Matshidiso Moeti, Regional Director of the WHO for Africa. “Africa has so far made good progress in the fight against TB and we cannot afford to lose sight of what is needed to ease the burden and save lives.

The African region is home to 17 of the 30 high TB ​​burden countries in the world. The estimated 2.5 million cases in the region in 2020 represented a quarter of the global burden, with more than half a million African lives sadly lost to this treatable and preventable disease.

However, African countries have made progress against tuberculosis. South Africa, for example, has steadily increased its domestic funding to fight TB, allocating 81% of financial resources, while Zambia has increased its domestic funding sevenfold since 2015.

As part of the WHO strategy to end TB, countries should aim to reduce TB cases by 80% and deaths by 90% by 2030 compared to 2015. The strategy also sets targets key milestones countries must meet by 2020 and 2025 if they are to end the disease. .

The 2025 milestone targets a 50% reduction in cases and a 75% drop in deaths. Tuberculosis cases would need to decline by 10% each year to reach the 2025 target, but the current rate of case decline is 2%. From 2025 to 2030, countries are expected to reduce cases by 17% each year.

The TB strategy also includes a key objective to reduce the catastrophic cost of TB treatment for families. However, a WHO survey of the cost of TB treatment in 10 African countries showed that 49% of TB-affected households suffered catastrophic costs. No country in Africa has yet demonstrated that it has achieved the goal of no TB-affected household facing catastrophic costs.

“The road to ending TB is likely to be long and difficult as key milestones are likely to be missed. Countries must scale up and accelerate the response and remain committed to reducing the suffering and death caused to millions of people by TB,” said Dr Moeti.

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