GENEVA – On World TB Day, 24 March, the Global Fund is urgently calling for the world to reignite the fight to end tuberculosis (TB) by 2030. The COVID-19 pandemic has upended years of progress in the fight against TB. Deaths from the disease rose for the first time in more than a decade, fueled by a surge in undiagnosed and untreated cases.
“If we fail to step up the fight against TB, we must accept that we are effectively abandoning the 2030 goal to end the disease as a public health threat,” said Peter Sands, Executive Director of the Global Fund. “We must mount a massive effort to diagnose people quickly and get them the necessary treatment. TB is deadly and is the top infectious disease killer after COVID-19.”
TB programs helped the COVID-19 response
In many countries, COVID-19 overwhelmed health systems, lockdowns disrupted service provision, and critical resources were diverted from the fight against HIV, TB and malaria to fight the new pandemic.
But decades of effort fighting TB were not in vain. With the additional resources deployed [ download in English | Français ] countries leveraged some of the best assets in the fight against TB to combat COVID-19. Community health workers, laboratories, diagnostic equipment, disease surveillance systems and other TB investments put in place over the years gave countries a leg up in the fight against the new pandemic.
The Global Fund partnership has also supported the roll-out of bidirectional testing, where people are simultaneously screened and tested for TB and COVID-19. In the future, it is likely this approach will be expanded to other diseases.
“Community health workers are on the front line of detecting and treating diseases, whether that’s for COVID-19 or TB, HIV or malaria,” said Dr. Eliud Wandwalo, the Global Fund’s head of tuberculosis programs. “They are trusted members of the community and we have seen their critical role during the COVID-19 pandemic.”
Drug-resistant TB
In most cases, TB is treatable and curable. However, standard TB treatment requires up to six months of drugs that can cause nausea, vomiting and stomach pain. The duration and side effects drive some people to abandon their treatment, which in some cases can lead to drug resistance – when TB bacteria is resistant to at least one of the main TB drugs.
Drug-resistant TB is part of the growing challenge of antimicrobial-resistant superbugs that do not respond to existing medications, resulting in fewer treatment options and increasing death rates for illnesses that would ordinarily be curable – including TB. Drug-resistant TB now accounts for one-third of the world’s deaths from antimicrobial resistance.
Because of stretched resources during the COVID-19 pandemic, between 2019 and 2020, the number of people treated for drug-resistant TB in the countries where the Global Fund invests dropped by a staggering 19%; those on treatment for extensively drug-resistant TB registered an even bigger drop of 37%; and the number of HIV-positive TB patients on antiretroviral treatment as well as TB treatment dropped by 16%. Overall, around 1 million fewer people with TB were treated in 2020, in countries where the Global Fund invests, compared with 2019.
The Global Fund is the largest external source of financing for drug-resistant TB in low- and middle-income countries, working with partners to support the introduction of new drugs that provide better and faster treatment. The amount of funding for drug-resistant TB available through the Global Fund has more than tripled over the last six years.
Rapid response to TB in Ukraine
According to the World Health Organization (WHO), in 2020, 30 countries accounted for 86% of new TB cases around the world. Eight countries account for two-thirds of the total, with India leading the count, followed by China, Indonesia, the Philippines, Pakistan, Nigeria, Bangladesh and South Africa.
In the European region, Ukraine is one of the countries with a high prevalence of TB. The disease re-emerged as a public health challenge in the 1990s. According to WHO, while new cases have significantly decreased over the last 15 years, TB prevalence, as well as TB deaths, remain high in the country. Drug-resistant TB also remains a public health threat in Ukraine. Over the last two decades, the Global Fund has invested more than US$850 million in Ukraine for HIV and TB testing, prevention and treatment programs and to fight COVID-19.
“We are extremely concerned for the health of people on HIV and TB treatment in Ukraine who are fleeing conflict in very stressful situations,” said Sands. “The Global Fund is fast-tracking US$15 million in emergency funds and working with partners in Ukraine and some of the nearby countries to ensure patients in their programs continue to get the treatment and support they need to be healthy.”
The Global Fund Replenishment campaign
Last month, the Global Fund launched its Seventh Replenishment campaign, aiming to raise at least US$18 billion to fight TB, HIV and malaria, build stronger systems for health and reinforce pandemic preparedness. In the countries where the Global Fund invests, the largest increase in projected funding needs is for TB care.
The Global Fund is the leading international funder of TB programs – providing 77% of all international financing for the disease. From January 2021, the Global Fund has increased TB grants by 24% on average, and the partnership is committed to deploying more than US$2 billion to fight the disease over the next three years.
To get the world back on track toward ending TB as a public health threat by 2030, urgent efforts are needed to prevent and treat TB, including a renewed focus on finding “missing” people with TB and successfully treating them.
Some Ontario doctors have started offering a free shot that can protect babies from respiratory syncytial virus while Quebec will begin its immunization program next month.
The new shot called Nirsevimab gives babies antibodies that provide passive immunity to RSV, a major cause of serious lower respiratory tract infections for infants and seniors, which can cause bronchiolitis or pneumonia.
Ontario’s ministry of health says the shot is already available at some doctor’s offices in Ontario with the province’s remaining supply set to arrive by the end of the month.
Quebec will begin administering the shots on Nov. 4 to babies born in hospitals and delivery centers.
Parents in Quebec with babies under six months or those who are older but more vulnerable to infection can also book immunization appointments online.
The injection will be available in Nunavut and Yukon this fall and winter, though administration start dates have not yet been announced.
This report by The Canadian Press was first published Oct. 21, 2024.
-With files from Nicole Ireland
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
ISLAMABAD (AP) — Polio cases are rising ahead of a new vaccination campaign in Pakistan, where violence targeting health workers and the police protecting them has hampered years of efforts toward making the country polio-free.
Since January, health officials have confirmed 39 new polio cases in Pakistan, compared to only six last year, said Anwarul Haq of the National Emergency Operation Center for Polio Eradication.
The new nationwide drive starts Oct. 28 with the aim to vaccinate at least 32 million children. “The whole purpose of these campaigns is to achieve the target of making Pakistan a polio-free state,” he said.
Pakistan regularly launches campaigns against polio despite attacks on the workers and police assigned to the inoculation drives. Militants falsely claim the vaccination campaigns are a Western conspiracy to sterilize children.
Most of the new polio cases were reported in the southwestern Balochistan and southern Sindh province, following by Khyber Pakhtunkhwa province and eastern Punjab province.
The locations are worrying authorities since previous cases were from the restive northwest bordering Afghanistan, where the Taliban government in September suddenly stopped a door-to-door vaccination campaign.
Afghanistan and Pakistan are the two countries in which the spread of the potentially fatal, paralyzing disease has never been stopped. Authorities in Pakistan have said that the Taliban’s decision will have major repercussions beyond the Afghan border, as people from both sides frequently travel to each other’s country.
The World Health Organization has confirmed 18 polio cases in Afghanistan this year, all but two in the south of the country. That’s up from six cases in 2023. Afghanistan used a house-to-house vaccination strategy this June for the first time in five years, a tactic that helped to reach the majority of children targeted, according to WHO.
Health officials in Pakistan say they want the both sides to conduct anti-polio drives simultaneously.
WASHINGTON (AP) — Millions of people with private health insurance would be able to pick up over-the-counter methods like condoms, the “morning after” pill and birth control pills for free under a new rule the White House proposed on Monday.
Right now, health insurers must cover the cost of prescribed contraception, including prescription birth control or even condoms that doctors have issued a prescription for. But the new rule would expand that coverage, allowing millions of people on private health insurance to pick up free condoms, birth control pills, or “morning after” pills from local storefronts without a prescription.
The proposal comes days before Election Day, as Vice President Kamala Harris affixes her presidential campaign to a promise of expanding women’s health care access in the wake of the U.S. Supreme Court’s decision to undo nationwide abortion rights two years ago. Harris has sought to craft a distinct contrast from her Republican challenger, Donald Trump, who appointed some of the judges who issued that ruling.
“The proposed rule we announce today would expand access to birth control at no additional cost for millions of consumers,” Health and Human Services Secretary Xavier Becerra said in a statement. “Bottom line: women should have control over their personal health care decisions. And issuers and providers have an obligation to comply with the law.”
The emergency contraceptives that people on private insurance would be able to access without costs include levonorgestrel, a pill that needs to be taken immediately after sex to prevent pregnancy and is more commonly known by the brand name “Plan B.”
Without a doctor’s prescription, women may pay as much as $50 for a pack of the pills. And women who delay buying the medication in order to get a doctor’s prescription could jeopardize the pill’s effectiveness, since it is most likely to prevent a pregnancy within 72 hours after sex.
If implemented, the new rule would also require insurers to fully bear the cost of the once-a-day Opill, a new over-the-counter birth control pill that the U.S. Food and Drug Administration approved last year. A one-month supply of the pills costs $20.
Federal mandates for private health insurance to cover contraceptive care were first introduced with the Affordable Care Act, which required plans to pick up the cost of FDA-approved birth control that had been prescribed by a doctor as a preventative service.
The proposed rule would not impact those on Medicaid, the insurance program for the poorest Americans. States are largely left to design their own rules around Medicaid coverage for contraception, and few cover over-the-counter methods like Plan B or condoms.
