COVID-19 has diverted scientific attention from killer diseases such as TB, says Health Minister Harsh Vardhan

COVID-19 has derailed decades-long painstaking efforts and diverted scientific attention away from killer diseases, with tuberculosis treatment for example, witnessing interruptions, delay in diagnosis and imposition of physical barriers making travel to clinics for medication difficult in the last 10 months, Union Health Minister Harsh Vardhan said on November 18.

Vardhan, who digitally addressed the 33rd Stop TB Partnership board meet, noted that from January to October, only 14.5 lakh tuberculosis cases were notified in the country, which is 29 percent lower than the same period in 2019, with the decline being over 35-40 percent in states such as Maharashtra, Tamil Nadu, Andhra Pradesh, Manipur and Goa, a statement issued by the health ministry said.

The minister also highlighted the silver lining in states like Sikkim, Telangana, Haryana, Arunachal Pradesh, Kerala, Himachal Pradesh and Odisha, which witnessed less than 20 percent impact even during the lockdown period.

"These states strategised to integrate their TB case-finding activities with the COVID-19 preventive measures," he was quoted as saying in the statement.

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Acknowledging that COVID-19 has turned the clock back by many years, if not decades, in the fight against infectious diseases, Vardhan said, "The deadly virus has derailed our painstaking efforts of many decades and diverted scientific attention from many infectious killer diseases like TB.

"The lockdowns have raised insurmountable barriers for patients and people are still living in fear of the coronavirus. We all know that the last 10 months have seen treatment interruptions, hindrances in the availability of drugs, a shrinking supply of diagnostic tests, delayed diagnosis, interruptions in the supply chains, diversion of the manufacturing capacity, and imposition of physical barriers for patients who must travel to distant clinics to pick up medications."

Congratulating the Stop TB Partnership for proactively contacting countries regarding the implementation of their tuberculosis programmes during the pandemic, the minister highlighted India's "TB Harega, Desh Jeetega" campaign that targets to achieve the sustainable development goal target related to TB by 2025, five years ahead of the global target of 2030.

The country has nearly trebled its efforts on increasing TB notifications and managed to close the gap in "missing million TB cases", the statement said.

Elaborating on the steps taken to mitigate the impact of the COVID-19 pandemic, Vardhan mentioned the health ministry's recommendation of bi-directional TB-COVID screening, screening among ILI and SARI cases, intensifying private sector engagement, re-deployment of the re-purposed HR and CBNAAT and TrueNaT machines back to the TB programme.

He, thereafter gave an account of how TB services are gradually recovering with the measures undertaken.

"Health facilities are opening up and more and more people are presenting themselves before government and private health clinics to get tested. Case finding through outreach activities in the community has also picked up.

"With the gradual return of the staff, who were diverted for COVID activities, public health actions such as counselling, contact-tracing and disbursement of nutritional support are also picking up," Vardhan said.

Speaking on India's strategy of turning the crisis into opportunity, he said, "COVID-19 has provided us with an opportunity to boost TB elimination activities through health system strengthening and infectious diseases control."

Specifically, he highlighted that several dedicated infectious diseases hospitals have come up as a part of the pandemic response measures, which would contribute in a major way towards tuberculosis care and management.

The molecular diagnostic capacity of the country has increased multi-fold. These multi-platform devices based on cartridge and chip-based technology can decentralise TB diagnosis, the minister said.

Behavioural changes acquired during the pandemic such as cough hygiene, use of masks, physical distancing will further help reduce the transmission of tuberculosis, which is a respiratory illness.

The increased uptake of telemedicines and teleconsultation during the pandemic will provide channels of consultation for tuberculosis, he said.

Exhorting the health leadership of the world to drive government policy, raise investments in the healthcare sector and also raise the awareness of the general masses towards the loss of precious lives that is happening through uncontrolled infectious diseases like TB, Vardhan ended his address by noting: "TB elimination is not so difficult if we can create a mass movement against the disease. It needs strategised advocacy, thought leadership and disruptive social entrepreneurship. It needs mass mobilisation, aggressive campaigns, powerful partners and deep commitments. And most of all, it needs a powerful societal and political commitment."