WHO Urges Immediate Action to Tackle Global Tuberculosis Service Disruptions

Tuberculosis (TB), a contagious and often severe airborne disease caused by Mycobacterium tuberculosis, remains one of the top 10 causes of death globally. Despite being preventable and treatable, TB continues to pose a significant public health threat, particularly in low- and middle-income countries. In recent years, the global fight against TB has made notable progress; however, this hard-fought momentum has been threatened by service disruptions worldwide.

The World Health Organization (WHO) has recently issued a stern warning, calling for urgent action to address the growing interruptions in tuberculosis services. According to WHO, millions of lives are at risk due to the disruptions caused by the COVID-19 pandemic, resource limitations, and other factors affecting TB diagnosis, treatment, and care services globally.

The Impact of COVID-19 on Tuberculosis Services

The COVID-19 pandemic has had a catastrophic impact on health services globally, and TB services are no exception. During the pandemic, resources, both human and financial, were redirected toward the COVID-19 response, leading to significant disruptions in TB services. Lockdowns, fear of contracting COVID-19, and overwhelmed health systems resulted in reduced access to TB diagnostic services, treatment initiation, and continuity of care.

WHO’s recent report highlighted that in 2024, there was a dramatic decline in TB case detection and reporting. Countries that previously made significant strides in TB elimination, such as India, Indonesia, and the Philippines, saw a reversal of progress. According to WHO data, there was a 20% drop in TB case notifications globally compared to pre-pandemic levels.

Delayed diagnosis and interrupted treatment not only lead to disease progression and complications but also increase the risk of drug resistance, making TB harder to treat. The WHO report emphasizes that the world is at risk of losing years of progress made in TB control if urgent measures are not implemented.

Current State of Tuberculosis Services

Globally, TB services include early detection through diagnostic tools, access to effective treatment, and preventive measures such as Bacillus Calmette–Guérin (BCG) vaccination and preventive therapy for high-risk individuals. The WHO calls attention to the fact that these services are currently inconsistent and inadequate across many high-burden countries.

In 2024, an estimated 10 million people developed TB, and approximately 1.5 million lost their lives to the disease. The disruption in services has disproportionately affected vulnerable populations, including people living with HIV, malnourished individuals, and those in low-income regions.

Access to diagnostic tools such as GeneXpert and smear microscopy has been limited in many areas, delaying the diagnosis of TB and drug-resistant TB (DR-TB). Treatment interruptions are another critical challenge, as patients who do not complete their TB treatment are at risk of developing multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB), complicating treatment regimens and outcomes.

WHO’s Call to Action

The WHO’s urgent call to action includes a comprehensive approach to restore and enhance TB services globally. The following key measures are recommended:

1. Immediate Restoration of TB Services: Countries must prioritize the restoration of TB diagnostic, treatment, and care services to pre-pandemic levels or better. Health systems need to ensure TB clinics remain operational and accessible to all patients, even amidst ongoing health emergencies.

2. Increased Funding for TB Programs: The WHO stresses the importance of increased financial investment in TB services by governments and international donors. Currently, there is a funding gap of approximately $6 billion annually required to meet global TB targets.

3. Integration of TB and COVID-19 Services: TB and COVID-19 share similarities in symptoms, such as cough and fever. Integrated screening and diagnostic services can improve case detection for both diseases, reducing missed diagnoses and delays in treatment.

4. Expansion of Digital Health Solutions: Digital platforms can play a critical role in TB management by ensuring patient monitoring, teleconsultations, and treatment adherence. The WHO encourages countries to leverage digital health technologies to support TB patients remotely.

5. Strengthening TB Prevention Programs: Expanding BCG vaccination coverage and providing TB preventive therapy for high-risk populations, including people living with HIV and contacts of TB patients, are essential steps to prevent disease transmission.

6. Community Engagement and Awareness: Community involvement is crucial for TB control. WHO advocates for enhanced community awareness programs to educate the public about TB symptoms, prevention, and the importance of early diagnosis and treatment adherence.

7. Addressing Drug-Resistant TB: Countries must prioritize efforts to detect and manage MDR-TB and XDR-TB by ensuring access to second-line drugs, improving laboratory capacities, and investing in research for new TB treatment regimens.

8. Research and Development: The WHO emphasizes the need for continued research to develop new TB vaccines, diagnostic tools, and shorter, more effective treatment regimens. Current TB treatment courses can last up to 6-9 months, posing challenges in treatment adherence.

9. Reducing TB-Related Stigma: Stigma and discrimination associated with TB discourage individuals from seeking care. Public health campaigns must aim to reduce stigma and promote the importance of TB care services.

The Consequences of Inaction

The WHO warns that if these disruptions in TB services are not urgently addressed, the world could face a significant resurgence in TB cases. According to the WHO’s End TB Strategy, the global community aims to reduce TB deaths by 90% and TB cases by 80% by 2030, compared to 2015 levels. However, the current setbacks may push the world off track from achieving these targets.

An increase in TB cases and deaths will not only impact individuals but also have broader socioeconomic effects, especially in countries where TB is most prevalent. TB predominantly affects people in their most productive years, impacting workforce productivity and economic development.

Additionally, the rise in drug-resistant TB cases will lead to increased healthcare costs, more prolonged hospitalizations, and limited treatment options, further straining health systems globally.

Success Stories: Countries Leading the Fight Against TB

Despite the global challenges, some countries have demonstrated resilience in maintaining and improving TB services. India, which bears one of the highest TB burdens globally, launched the “TB Free India” campaign, emphasizing active case finding, community engagement, and expanded access to diagnostics and treatment.

South Africa has also been successful in integrating TB and HIV services, ensuring patients receive comprehensive care, and adopting new technologies like Xpert MTB/RIF testing for rapid diagnosis.

These success stories serve as examples of how robust policies, political will, and sustained financial investments can make a significant difference in the fight against TB.

 The Need for Global Solidarity

The WHO’s urgent call to action highlights the critical need for global solidarity in the fight against tuberculosis. Governments, international organizations, healthcare providers, and communities must work together to restore and strengthen TB services.

By investing in robust TB control programs, integrating TB and COVID-19 services, expanding access to diagnostics and treatment, and prioritizing research and innovation, the world can get back on track to eliminate TB as a public health threat.

Failure to act now will result in the loss of millions of lives and further setbacks in global TB elimination efforts. The time to act is now—before the tuberculosis crisis worsens.