Fighting tuberculosis will protect us from the next global health threat
One of the best ways to prepare for future pandemics is to turbocharge the fight against tuberculosis and stop considering it the “pandemic of the poor”, writes Dr. Eliud Wandwalo, head of TB at the Global Fund to Fight AIDS, Tuberculosis and Malaria, on the occasion of International Tuberculosis Day.
As a young doctor working in Mwanza, Tanzania, in the 1990s, I came face-to-face with the desperation of people affected by HIV and tuberculosis (TB) in my country. Those were desperate days, as the tools to fight these diseases were few and rudimentary. I saw many people lose their lives because of this. In many countries, contracting TB, especially a severe form such as drug-resistant TB, was a death sentence.
In the intervening years, investments by countries, the Global Fund partnership and other partners have made a remarkable difference in the fight against these diseases.
I have witnessed a significant evolution in the way countries are able to respond to TB, through sustained investments in the infrastructure that ensures more people with the devastating disease are found, treated and cured. These resources were game-changing in the fight against Covid-19 and will play a crucial role in confronting any other respiratory disease of the future – including pathogens of pandemic potential.
Take mobile diagnostic units – or vans that have been converted to include cutting-edge tools that can detect TB and other respiratory infections – for example. Across countries such as Tanzania, these vans bring high-tech testing facilities to the most remote parts of the country. Once aboard the van, people receive a chest X-ray and may be asked to give a sputum sample, which a clinician then feeds into a GeneXpert or Truenat™ test that can quickly detect the presence of tuberculosis – or Covid-19. This kind of bidirectional testing – or screening for more than one disease at the same time – can stop the onward transmission of both diseases and ensure that people are diagnosed, treated and cured.
Or consider the role of community health workers. They are leading the charge in the effort to fight TB in the most remote locations. These health workers are also trained to spot unusual happenings – like an unusual respiratory illness including Covid-19 – that could lead to outbreaks and report them.
They comb the last mile in search of people who are at a greater risk of diseases, or who may be already exposed and need treatment. In countries like Tanzania with a large rural population, community health workers serve as the first line of defence in the fight against current (and future) infectious diseases.
Some of them collect samples that they ferry back to the local labs for testing to ensure that the people they serve are not ill with TB. Throughout the Covid-19 pandemic, these community systems that were initially established to fight TB have proven themselves to be effective in fighting other diseases too.
The Global Fund has been fighting HIV, TB and malaria for over 20 years. That experience coupled with the recent fight against Covid-19 has taught us valuable lessons, including the fact that investing in resilient and sustainable systems for health is the tide that helps lift every boat.
We can end TB. But only if everyone, including the public, governments and civil society groups, recognises our common humanity and no longer consider tuberculosis the “pandemic of the poor” but a disease that concerns us all. An estimated two billion people – a fourth of the global population – are already infected by the bug that causes TB. Every year, over 10 million people get sick and 1.6 million people die from it. It remains the world’s leading infectious disease killer.
By strengthening our response to TB today by building strong and resilient health systems that can fight it, we also prepare for the next pandemic. An all-in response to TB today actively contributes to building a safer, healthier and more equitable world tomorrow.
Dr. Eliud Wandwalo is the head of tuberculosis at the Global Fund to Fight AIDS, Tuberculosis and Malaria.