Updated Sunday, 16 January 2022-13:35

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Covid-19 has become an ally of tuberculosis.

Due to the pandemic, the progress made in recent years against this infectious disease has been reversed, taking an important step backwards.

In 2020, deaths increased, diagnoses were delayed and access to treatment fell, according to the latest report from the World Health Organization (WHO).

For the first time in 10 years, deaths from tuberculosis rose in 2020, reaching

1.5 million people


In the same period, the number of diagnoses decreased, going from

7.1 million notified in 2019 to 5.8 in 2020


According to WHO estimates, today 4.1 million people in the world live with undiagnosed active tuberculosis, a figure that is one million more than the data from the previous year.

Access to preventive treatments has also fallen due to the pandemic.

21% fewer people were able to take them in 2020 compared to 2019. The same thing happened with therapies for multidrug-resistant tuberculosis: access fell by 15% between 2019 and 2020. And what is worse: WHO forecasts still predict worst figures for 2021 and 2022.

With its emergence, Covid stole tuberculosis from first place in the ranking of infectious diseases that cause the most deaths. But, far from being a handicap for the disease, the pandemic has only contributed to its spread and expansion.

"Tuberculosis is a public health problem of the first order,"

says Joan Pau Millet, head of tuberculosis surveillance at the Barcelona Public Health Agency and one of the participants in the recent XXV International Conference on Tuberculosis, held at the Catalan capital. Tuberculosis affects 10 million people every year, kills the population equivalent of the city of Barcelona, ​​and we know that one in three people is infected with the bacillus that causes the disorder, he explains. However, it is a neglected disease and continues to be surrounded by stigma. And the coronavirus has only made that reality worse. Centers were closed, resources and professionals were diverted to Covid, patients stopped consulting and the fundamental surveillance of the disease was curtailed.

Tuberculosis has many things in common with Covid-19.

Both are infectious diseases, both are airborne, and case tracing and contact tracing are essential for both.

"In the pandemic, tuberculosis specialists have been very useful when it comes to starting screening, tracing, how to trace contacts... Their experience has been used. And now the interesting thing would be for the same thing to happen, but in reverse." "

The entire

task force

that has been built for Covid should be

used for tuberculosis

. Because this disease needs a lot of field work, to go looking for cases, tracking. That is essential and much needed," says Alexis Sentís, Epidemiologist of the Epiconcept Public Health project in Paris.

"We demand more human and economic resources in what is the poor brother of the health system: epidemiological surveillance and public health. I think that the importance of prevention, surveillance and control of these diseases is finally beginning to be understood And it is necessary to be able to count on the necessary resources", agrees Millet.

Tuberculosis is caused by the bacterium

Mycobacterium tuberculosis,

also called Koch's bacillus in honor of its discoverer. This germ is capable of surviving in the body without causing disease and only shows its face when the immune system is weakened. An infected person has a 10% risk of developing the disease throughout his life, but given the volume of infected, the number of people susceptible to getting sick is very high. The good news is that effective and safe treatments exist. It is a preventable and curable disease, but to combat it, it is essential to diagnose it as soon as possible and track, locate and treat those who may be affected.

The problem, Sentís and Millet underline, is that the

stigma surrounding the disease

, which is erroneously associated only with poverty or marginality, makes diagnosis difficult in Spain.

"You don't think about the disease," says Millet, who adds that estimates of diagnostic delay in our country are around 60 days.

This delay is due, on the one hand, to the patient, who takes time to consult when symptoms compatible with the disease begin, such as long-lasting severe cough, fever, weakness, etc.

But, in addition, tuberculosis is also a neglected disease in the health system.

"Any person with a cough lasting more than two/three weeks should be tested for tuberculosis infection, but this often does not happen," says Millet.

The specialists consulted also regret that tuberculosis is considered a second-class disease also in access to drugs. For example,


is one of the most useful drugs in cases of multi-resistance, it is approved by the Spanish Medicines Agency and the WHO guidelines indicate it as first order. "And yet, it is not financed," they lament. "The stigma even extends to drug financing."

Tuberculosis needs urgent attention, worldwide.

"In the end, this is like with Covid. Until we put an end to it everywhere, it will not end," says Sentís, who recalls that although the main sources of tuberculosis are in Eastern Europe, sub-Saharan Africa, Latin Latin America and Southeast Asia, Spain is one of the first countries in the euro zone.

"We need global action,"

he claims.

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