Mitigating the impact of the COVID-19 pandemic on progress towards ending tuberculosis in the WHO South- East Asia Region

ABSTRACT

Almost half of the deaths worldwide caused by tuberculosis in 2018 occurred in the World HealthOrganization (WHO) South-East Asia Region, home to around a quarter of the global population.Maintaining robust progress in this region is therefore essential if the global goal of ending thetuberculosis epidemic is to be realized. Substantial gains have been made in the region, but the threatto health worldwide posed by the coronavirus disease 2019 (COVID-19) pandemic includes not onlythe direct effects of the pandemic but also the potential eclipsing of the global tuberculosis emergency.The results of modelling studies present stark warnings of a reversal of years of progress and asignificant resurgence in deaths from tuberculosis. The COVID-19 pandemic has had variable impactsin the WHO South-East Asia Region to date, but in the countries most affected there has been targeteddiversion and repurposing of tuberculosis services, health-care workers and diagnostic equipment.The combined effects of COVID-19, containment measures and fragmentation of tuberculosis serviceshave resulted in delays in diagnosis or non-diagnosis and disruption in treatment resulting in increasedmorbidity, mortality, transmission and drug resistance. Countries of the region have made attemptsto ensure continuity of services and civil society and nongovernmental organizations have instituteda range of innovative mechanisms to support national programmes. However, a comprehensiveapproach – including scaling up successful initiatives, empowering community leadership, harnessingdigital tools, and implementing easily accessible cash transfers and nutrition support – will be criticalto success. As COVID-19 recedes, countries will need “catch-up plans” to deploy supplementarymeasures to address the increased tuberculosis burden. Urgent, targeted and agile responses havethe potential to mitigate and reverse the impact of the COVID-19 pandemic on tuberculosis in South-East Asia.