By PAUL OGONGO

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‘Invest to End TB. Save Lives’ is the theme for this year’s and the 25th celebrations of World TB Day. This theme is not only timely but also a reminder that unwavering financial and political commitments can lead to triumph of health over disease and hope over despair.

When the world was at the lowest moments of Covid-19 pandemic — groping in the dark to find any remedy while dead bodies piled up; bodies of family, colleagues, neighbours, the people we had connections with — we can now ‘breath’ again. We can now see each other’s smile sitting across the table having overcome the barrier imposed by the ravenous SARS-COV-2 infection.

But the theme is also a reminder that while we responded to an emerging epidemic, the pandemic of tuberculosis disease never stopped.

For the first time in 20 years, a report from the World Health Organisation noted a reversal in the trend of global TB deaths — deaths due to TB had been on an encouraging downward trend making ambitious goals like End TB by 2035 look within grasp.

The WHO report confirmed what professionals involved in TB care had feared immediately the world went into lockdowns as a mitigation for the spread of Covid-19.

Whereas TB is spread mainly outdoors in shared community spaces like in public transport and schools, lockdown meant that people who were on TB treatment and ran out of their medication failed to get their drugs on time while new cases were not diagnosed because people were afraid of seeking medical care.

TB case notifications also went down because the machines used for TB diagnosis, Gene X-pert machines, were reassigned and dedicated to SARS-COV-2 diagnosis. Simply, we could neither diagnose nor effectively provide medication to TB patients at the height of Covid-19 pandemic.

This year’s World TB Day — observed on March 24 — comes exactly a month after the 6th Global Forum on TB Vaccines held in Toulouse, France, where scientists showcased data to reaffirm that the search for better TB vaccines is not only overdue but also achievable.

Despite TB being an ancient disease, we have only one licenced vaccine — BCG — that is given at birth. While BCG has saved many children from TB related deaths, its effectiveness reduces with age and BCG fails to protect adults from TB.

The current funding for TB research is a meagre one percent of the amount invested in the fight against Covid-19. Yet, in 2020 alone, TB was responsible for 1.5 million deaths worldwide. National governments must put their monies where their mouths are.

Signatures at international meetings are not enough to find better diagnostics for childhood TB neither do they provide the wholistic care needed by TB patients.

But it’s not all gloom and despair. A recent study led by University College London together with partners in South Africa, Zambia, Uganda and India in children with TB has led to a change in WHO global guidelines for managing the disease.

It will now be possible to treat children with non-severe (the main form of TB in children) TB for only four months from the previous six-month duration.

This short course treatment will save an average $17 per child, which can be used to improve the screening coverage and find the missing children with TB.

There is no doubt that Covid-19 disruptions have been bad for TB control efforts, but the research community can learn how to conduct rapid and large-scale responses because that is what TB needs now. For example, TB trial studies that were put on hold can benefit from the infrastructure laid out for Covid-19. There must be a deliberate effort by the national TB control programs to bring back TB patients into their care to not only ensure treatment compliance but also check those who may need changes in their regimens because of being off treatment for some time.

Paul Ogongo is a postdoctoral scholar at the Division of Experimental Medicine, University of California