COVID-19 jeopardises tuberculosis progress

The COVID-19 pandemic has risked progress on the global control of tuberculosis, experts will warn today.

Speaking at a special TB event, organised by the Royal College of Physicians of Edinburgh, Dr Derek Sloan, senior lecturer at the University of St Andrews and consultant in infectious diseases, will say: “Tuberculosis is one of the oldest infectious diseases known to man. Despite the existence of effective antibiotics, it still kills up to two million people per year, particularly in poor and marginalised communities around the world. COVID-19 has made the task of beating tuberculosis even more difficult.”

The event is being organised to commemorate the 110th anniversary of the birth of Professor Sir John Crofton, a leading pioneer in the early development of combination antibiotic treatment to cure TB in Edinburgh, and then around the world.

Sir John Crofton was born in Dublin, Ireland, where his father was a doctor. When he moved to Edinburgh in 1952, TB cases were rising, treatment was chaotic and there were huge waiting lists and many deaths.

Within two years, Sir John brought in new consultants and removed barriers between outpatient and hospital care, while his team looked at how treatment was failing and started using all three available drugs from the outset, closely monitoring each patient’s progress.

As a result of Sir John’s work, Edinburgh achieved the world’s sharpest fall in TB notifications between 1954 and 1957. For the first time, almost all TB patients were being cured.

The Edinburgh method became the gold standard treatment in affluent countries and much effort has been made to extend this to the rest of the world.

That progress is now in jeopardy. There were large annual increases in the global number of TB case notifications between 2017 and 2019, while data from the World Health Organization (WHO) showed an 18% drop between 2019 and 2020, from 7.1 million to 5.8 million.

This, coupled with continued disruptions in 2021 and 2022, means that the United Nations’ (UN) target of treating 40 million people ‘ with TB in the five-year period 2018–2022 is no longer on track.

Professor Andrew Elder, president of the Royal College of Physicians of Edinburgh said: “As we struggle to manage a new infectious disease in COVID-19, it is important that we remember both the lessons to be learned from our past management of other infectious diseases and the fact that, as is the case with tuberculosis, and possibly COVID-19, they do not usually entirely disappear.

“Clinicians in all parts of the world can benefit from the reflections and updates in this symposium, timed to coincide with the anniversary of the birth of our past president and champion of the treatment of tuberculosis, Sir John Crofton.”

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