5.5. TB and health emergencies

Health emergencies, such as the COVID-19 pandemic, are associated with a disruption in health service delivery, either directly due to the focused attention given to the emergency or indirectly due to the actions taken to control the emergency.

The COVID-19 pandemic has reversed years of progress in providing essential TB services and reducing the disease burden of TB. There has been a large global drop in the number of people newly diagnosed with TB. Reduced access to TB diagnosis and treatment has resulted in an increase in the number of TB-related deaths.

Indirect impacts of health emergencies, such as reduced household income, increased poverty, food insecurity, malnutrition, missed health checks, missed vaccinations and missed work or schooling, may affect TB diagnosis and care.

In May 2021, WHO updated its information note on COVID-19 – considerations for tuberculosis (TB) care to guide countries on approaches to maintaining TB services (89). For instance, both COVID-19 and TB have respiratory symptoms, which provides an opportunity to diagnose both COVID-19 and TB (90).

Programmes should make sure that there are enough stocks of TB preventive therapy for the predicted increased need for this therapy resulting from people with undiagnosed TB and increased associated exposure because of COVID-19-related lockdowns. NTPs should ensure that supplies of TB medicines are not interrupted and that people with TB are provided with adequate refills to enhance treatment completion and minimize frequent trips to health facilities, where there may be an increased risk of infection from COVID-19. This may be achieved via multi-month dispensing or community delivery of TB medicines. Efforts should be made to ensure that neonatal and infant Bacillus Calmette–Guérin (BCG) vaccination continues uninterrupted.

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