june, 2020 | The Health
07
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Aim to save
millions of lives
A quarter of the world‘s population is estimated
to be infected with TB bacteria. These people are
neither sick nor contagious. However, they are at
greater risk of developing TB disease, especially
those with weakened immunity. Offering them TB
preventive treatment will not only protect them
from becoming sick but also cut down on the risk of
transmission in the community.
As we mark World TB Day 2020, the disease
remains the world’s top infectious killer. In 2018,
10 million people fell ill with TB worldwide and 1.5
million people lost their lives to this disease.
“COVID-19 is highlighting just how vulnerable
people with lung diseases and weakened immune
systems can be,“ said Dr Tedros Adhanom
Ghebreyesus, WHO Director-General. “The
world committed to end TB by 2030; improving
prevention is key to making this happen. Millions
of people need to be able to take TB preventive
treatment to stop the onset of disease, avert
suffering and save
lives”.
Dr Tedros
highlighted
the importance
to continue
efforts to tackle
longstanding
health problems,
including
TB during global
outbreaks such
as COVID-19. At
the same time,
programmes already in place to combat TB and
other major infectious diseases can be leveraged to
make the response to COVID-19 more effective and
rapid.
Although some progress has been made towards
targets set at the UN high-level Meeting on TB in
2018, TB preventive treatment has been largely
neglected. Global leaders committed to ensuring
access to TB preventive treatment to at least 24
million contacts of people with active TB and 6
million people living with HIV by 2022. To date
only a fraction of that target has been reached, with
countries putting less than 430,000 household
contacts and 1.8 million people living with HIV on
TB preventive treatment in 2018.*
TB remains the top cause of death among
people with HIV. TB preventive treatment works
synergistically with antiretroviral therapy to
prevent TB and save lives. Reinvigorated efforts by
governments, health services, partners, donors and
civil society will be needed to increase access to TB
preventive treatment to the levels targeted.
The new consolidated guidelines recommend a
range of innovative approaches to scale up access to
TB preventive treatment:
WHO recommends a scale-up of TB preventive
treatment among populations at highest
risk including household contacts of TB patients,
people living with HIV and other people at risk
with lowered” immunity or living in crowded
settings.
WHO recommends an integration of TB
preventive treatment services into ongoing case
finding efforts for active TB. All household contacts
of TB patients and people living with HIV are
recommended to be screened for active TB. If active
TB is ruled out, they should be initiated on TB
preventive treatment.
WHO recommends that either a tuberculin skin
test or interferon-gamma release assay (IGRA)
be used to test for TB infection. Both tests are
helpful to find people more likely to benefit from
TB preventive treatment but should not become a
barrier to scale-up access. Testing for TB infection
is not required before starting TB preventive
treatment in people living with HIV, and children
under 5 years who are contacts of people with active
TB. — The Health