Op Ed for World TB Day from the HPP Federation
It’s time to test, treat and terminate TB
On 24 March, the world commemorates World TB Day, and this year’s theme is ‘It’s Time’. TB is the leading infectious killer of people with HIV and the second leading infectious cause of death for adults globally. Now, more than ever, it’s time to accelerate action and efforts to test, treat and terminate TB.
TB kills more than two million people a year, impacting the poorest of families, communities and countries. World TB Day was launched to raise public awareness on the causes, effect and impact of TB around the world.
Fighting disease and health promotion is a central theme underscoring the efforts of the Federation Humana People to People and its members in the global south, so we join hands in celebrating this important commemoration. Our members have been actively involved in TB programming for more than 15 years now in high burden countries across Africa and Asia. Education has been a priority focus for the response to TB, but this must be coupled with accurate information and communication, as well as solutions to enhance the fight against TB. Ninety-eight per cent of TB deaths occur in the global south.
Humana People to People works in alignment with the United Nations (UN) Sustainable Development Goal (SDG) 3, which calls for an end to TB by 2030. In addition, the World Health Organisation (WHO) End TB program aims to achieve a 95% reduction in TB deaths, 90% reduction in TB incidence rates, and zero catastrophic costs. To this end, we adopt a community-centered approach to TB programming including behavior change, health systems strengthening and TB treatment. This is achieved by integrating innovation-driven approaches through family-based support engaging a TRIO system (infected person and two family members); door-to-door screening; and health education with nutrition support.
More than 20 TB prevention and treatment projects were implemented across nine countries in the global south by our members in 2019; these are Angola, Congo, Botswana, Laos, India, Malawi, Mozambique, South Africa and Zimbabwe. Projects applied a community-centred approach, working with the most vulnerable including adolescent girls and young women in the remotest locations.
This year alone, TB efforts by our members resulted in the screening of 390,000 people, testing of 24,000 people and referral of 5,000 patients for TB treatment. Key to all project efforts was enabling communities to own HIV and TB, breaking down associated stigma, better understanding disease symptoms, and adopting measures to live positively with a support structure and continued awareness and behavior change.
TB in time of COVID-19
Global pandemics are the new threat to human life, affecting all sectors of society - from individual, to household, community, national, regional and international levels. According to the United Nations, the number of outbreaks per year around the globe has more than tripled since 1980. Factors such as climate change, large concentrations of populations and excessive travel have increased our vulnerability to pandemics today, compared to 100 years ago.
An infection in one end of the world can make its way to the remotest location in another part of the world in a very short time as seen with COVID-19, popularly known as the coronavirus, the world’s latest disease threat. From an initially slow yet chronic health crisis in Wuhan City, China where it emerged in December2019, to a devastating outbreak, declared a public health emergency of international concern and soon after a pandemic by the World Health Organization (WHO) on 11 March 2020.
As of 21 March 2020, WHO globally recorded 267,013 confirmed COVID-19 cases, 11,201 deaths and 185 countries with cases. The virus poses a danger not only to those already infected but has the potential to heavily impact existing healthcare systems that are already overstretched, underfunded, weak and fragile, particularly in the global south.
COVID-19 is a new virus that can be passed on to anyone, regardless of age, gender or socio-economic status. The older generation is at greater risk of contracting COVID-19, especially those experiencing respiratory problems, says WHO. However, over the last few days, new studies emerging from USA, UK and Italy have seen COVID-19 also affecting the younger generation, meaning that this population group may be very vulnerable to infection as well.
It is yet to be established by scientists or researchers how COVID-19 will affect people with TB, although there is a definite risk from a health perspective, given the respiratory discourse of both diseases. Furthermore, it is true to assert that thousands of people have succumbed to COVID-19 through pneumonia, the lung disease, long associated with TB.
In resource-limited settings and poorer countries with rural populations and increased population density, COVID-19 remains a severe threat; this is exacerbated by scarcity of clean water, poor nutrition and lack of access to medical facilities. Awareness and prevention efforts are therefore critical to avoid infection or cross-infection.
The global response
At a global level, governments are proactively fighting COVID-19 through detection and surveillance strategies, contact tracing, social distancing and isolation, travel bans, shutting borders and public education. In New Zealand, France and many European countries, self-isolation is now self mandatory; India has called for nationwide curfews, with a lockdown in Delhi and suspension of public trains in Mumbai, while the Olympics move closer to postponement. The New York stock exchange is now fully electronic and lawmakers in the U.S. have created a relief plan, whilst Germany has called for limited gatherings of two people only, with stores and restaurants now closed in the UK.
In Africa and Asia, governments have imposed travel restrictions and self-quarantine measures on countries worst affected by COVID-19. However, given that these countries have limited health resources, the most effective strategies rely fully on simple actions carried out by us at individual, household and community level, including schools and workplaces.
Here are some basic protective measures against COVID-19, as advised by WHO:
- Wash your hands frequently with soap for 20 seconds
- Cover your mouth and nose with your bent elbow when coughing and sneezing
- Maintain social distance with anyone who is coughing or sneezing
- Avoid touching your eyes, nose and mouth
- Avoid crowded spaces and social gatherings of people
- Seek medical care if you have a fever, cough or breathing difficulties
- Stay informed and follow advice given by your health care provider
Humana People to People stands in solidarity and with resilience in the fight against TB and COVID-19. Stay safe, stay hygienic. Together, we will win this battle!
To learn more about our global and national efforts in fighting TB, HIV and AIDS, and malaria, check out www.humana.org.