How can we end TB by 2030?

Published February 16, 2022, 7:00 PM

by Manila Bulletin

Southeast Asian nations unite to fight ‘other pandemic’–tuberculosis

As daily life around the world continues to be disrupted by the COVID-19 pandemic, many people remain unaware that we are “missing millions” of individuals to another, less prominent pandemic: tuberculosis (TB). Luckily, medical experts are on a mission to find these missing millions and, with proper education, screening, and treatment, these experts are confident that tuberculosis can be defeated.

This was the highlight of the recently concluded Asia Pacific Tuberculosis Forum, hosted by Johnson & Johnson (Philippines), Inc., which brought together key stakeholders on Nov. 30 and Dec. 7 from across the region to share, discuss, and discover potential collaborations toward achieving the United Nations Sustainable Development Goal of ending TB by 2030.

“Tuberculosis affects millions of people worldwide. In the Philippines, it is considered a major public health problem. If the COVID-19 pandemic will continue to cause health disruptions, an estimated 20,000 Filipinos could die of TB every year for the next five years,” said Dr. Erwin Benedicto, head of medical affairs at Johnson & Johnson (Philippines), Inc. “By coming together in this forum, participants can leverage each other’s knowledge, strengths, and influence to create an action plan that will help meet the needs of healthcare practitioners and patients in battling TB.”

Citing reports by the World Health Organization and the Stop TB Partnership, Dr. Vivian Cox, Johnson & Johnson Global Medical Affairs Leader for TB, says that while there are targets in place to rid the world of tuberculosis, the pandemic and three key factors are hampering societies from achieving these targets. These hurdles are insufficient global tuberculosis spending, lack of access to the latest rapid TG diagnostic tests, and the slow rollout of preventive treatment for TB infection.

Specifically, the Stop TB Partnership report cited that only 30 percent of the target 24 million contacts of people with TB will be provided with the necessary TB preventive treatment by the UN’s committed deadline of December 2022. Moreover, in 2020, Cox says there was a reduction in TB case notifications, as well as a slowing of the decline of TB incidence across the world.

Dr. Erwin Benedicto

Of the 16 countries with the largest contributions to the global shortfall in TB notifications, the Philippines ranked third, after India and Indonesia.

“Even though TB is preventable and curable, it is one of the world’s deadliest infectious diseases, killing 1.5 million people in 2020—more than HIV/AIDS and malaria combined,” said Dr. Benedicto. “With more than 95 percent of TB-related deaths occurring in low- and middle-income countries, underserved communities bear the brunt of the burden, but this airborne disease knows no bounds.”

Sharing their best practices in China, which has one of the highest incidences of TB in Asia, Dr. Li Xiaobei, director of Clinical Center for Tuberculosis China CDC and director of Beijing Chest Hospital, cites four of their key initiatives, which has helped improve the gap between TB notifications and incidences: a strengthened healthcare system, the wide use of internet-based reporting system, rapid scaling up of new diagnostic tools, and enhanced health promotion initiatives.

“While the pandemic led to huge drops in notifications, efforts are underway to narrow the gap between estimated incidence and notifications,” said Dr. Xiaobei.

Of the 16 countries with the largest contributions to the global shortfall in TB notifications, the Philippines ranked third, after India and Indonesia.

Under the Universal Healthcare Act of the Philippines, the Department of Health, on their part, will be conducting bi-directional testing for TB and COVID-19. The country also has its Philippine Strategic Elimination Plan (PhilStep) in place, which focuses on Screening, Testing/Diagnosis, Treatment, and Prevention of TB patients, with the aim of having a “TB-free Philippines.”

Over in Indonesia, the government has rolled out active case finding programs outside health facilities–through villages, investigation activities, screening in controlled populations (e.g. prisons, boarding schools), and mass screening activities in high-prevalence and high-risk areas. Dr. Tiffany Tiara Pakasi, National Tuberculosis program manager in Tuberculosis Sub-directorate of the Indonesia’s Ministry of Health, also gave an overview of how they perform active surveillance of underreported TB cases at hospitals. Data reporting plays a vital role as well in Indonesia’s battle against TB, since they keep a national TB information system.

In Thailand, the country’s Comprehensive COVID-19 Response Team also works on actively finding TB cases, an initiative that is similar to the one in Vietnam, where TB active case finding is integrated into their COVID-19 vaccination program. It is also in Vietnam where Johnson & Johnson established Breath for Life (B4L), a 2016 initiative that aims to enhance health systems in the northern rural mountainous province of Nghe An to accelerate pediatric tuberculosis case detection, treatment, and prevention.

Johnson & Johnson is likewise partnering with USAID to launch a new program to raise awareness and strengthen local capacity in high-TB-burden countries to diagnose and treat pediatric DR-TB. The company will provide technical support, convene stakeholder meetings, and lead workshops involving children’s health workers, healthcare facilities, and others.

With all these initiatives in place, Dr. Nguyen Viet Nhung, Vietnam’s director of the National Lung Hospital and manager of the National Tuberculosis Control Program, recommends that countries leverage their data so that it is easier to come up with a universal approach to fighting TB. He also underlined the importance of standardizing data to aid medical experts and researchers in finding and helping the missing millions living with the disease.