… TB cases drop

Nima Wangdi

Bhutan has seen a gradual drop in Tuberculosis (TB) cases in the past few years. However, multi-drug resistant (MDR) TB is on the rise according to the recent report of Department of Public Health (DoPH).

Officials said it is becoming a public health concern.

The department’s record showed that of 809 TB cases detected in the country, 61 were MDR TB in 2022. Of the total, 72 percent of the TB patients are within the productive age of 15 to 44 years.

There were 1,016 cases in 2019 of which 946 were drug susceptible TB cases and 70 MDR TB cases. The number of cases dropped to 919 in 2020 with 65 MDR cases. In 2021, there were 862 cases of which 55 were MDR.

A total of 26 people died due to TB or associated diseases in 2022 alone according to the record.

MDR TB is caused by TB bacteria that are resistant to at least isoniazid and rifampin, the two most potent TB drugs. These drugs are used to treat all persons with TB disease.

On World TB day yesterday, World Health Organisation (WHO) called for intensified actions in the South-East Asia Region to end TB. The member countries and partners are also asked to strengthen high-level leadership and investments.

Globally, the Covid-19 pandemic has not just stalled but reversed years of progress towards the End TB milestones according WHO. In 2021, the estimated burden of new and relapse TB cases globally was 10.6 million. It is an increase of half a million compared to 2020.

Mortality from TB and TB-HIV co-infection stood at 1.6 million, which is an increase of around 200,000 from pre-Covid-19 levels.

Going by the records, the South-East Asia Region bears the world’s highest TB burden. “In 2021, the Region accounted for more than 45 percent of global TB incidence and more than half of global TB deaths.”

South-East Asia Region’s regional Director, Dr Poonam Khetrapal Singh’s message on World TB day stated that the region prioritised maintaining essential health services, including for TB throughout the Covid-19 pandemic. “2020 notified 2.6 Million (M) new and relapse TB cases, a 24 percent reduction from 2019.”

“The Covid-19 crisis has exacerbated key social and economic determinants of TB such as poverty and undernutrition.” She said it is estimated that across the Region, the overall impact of the crisis could lead to over 7M additional TB cases and 1.5M additional TB deaths between 2022 and 2026.

In 2022, budget allocation for the TB program in the region reached a cumulative total of nearly US$ 1.4 Billion (B).

The second UN High Level Meeting on TB is scheduled for September 2023.

WHO estimates that the region needs at least US$ 3B annually to avert nearly 4.5M new TB cases and prevent more than 1.5M TB deaths by 2025. Countries and partners are asked to increase funding and also initiate multi-sectoral collaboration.

WHO targets to end TB in the world by 2030.