The Clock Is Ticking, Time To End TB Is Now Says VP Chiwenga

HEALTH and Child Care Minister, Vice President Constantino Chiwenga has called for collaboration in the fight against Tuberculosis (TB) in the midst of the prevailing COVID-19 pandemic which has largely disrupted TB programming and treatment efforts.

By Michael Gwarisa

According to preliminary data from the World Health Organization (WHO), a total 1.4 Million people  from over 80 countries faced challenges in accessing TB treatment in 2020, which is a reduction of 21% from 2019 and countries with the biggest relative gaps were Indonesia (42%), South Africa (41%), Philippines (37%) and India (25%) due to COVID-19.

Giving his Key-note address during the 2021 Virtual World TB Day commemorations, Vice President Chiwenga said the emergence of COVID-19 in 2020 has had a negative impact on Zimbabwe’s TB response as evidenced by the sharp decline in TB notifications for both drug sensitive and resistant TB.

This negative impact of COVID-19 is mainly related to stigma and reduced accessibility to health services leading to delays in TB diagnosis and treatment initiation. The Clock is Ticking, our efforts and focus on COVID-19 would not make us forget that TB remains one of our major public health threats.

“The realization calls for expansion and acceleration of integrated approaches given the similarity of some symptoms and signs of the two conditions. Now more than ever, we should redouble our support to raise awareness on TB, enhance the community and health system capacities. The initiative will reduce morbidity and mortality from this disease for our population,” said minister Chiwenga.

The WHO Global TB report of 2019 listed Zimbabwe amongst the 30 high-burdened countries for TB, TB/HIV and Multi Drug Resistant TB for the period 2016-2020. VP Chiwenga added that Zimbabwe’s high TB burden was also largely driven by HIV and TB co-infection.

“Women of the reproductive age group (15-44 years) and men are mostly affected. TB incidence rate was 199 per 100,000 population in 2019.”

World Health Organisation Zimbabwe Country Representative, Dr Alex Gasasira said patients across Africa, Zimbabwe included were  faced with huge catastrophic costs in accessing treatment with indications that a number of families end up destitute.

“World TB Day, 24 of March every year, is a stark reminder of the significant burden of this disease despite the existence of effective control interventions. There were an estimated 2.5 million TB patients in the African region in 2019, accounting to 25% of the local burden of TB.

“More that 500,000 African lives are lost every year. Too many people are pushed into poverty when they contract TB due to lost income, transport costs and other expenses. The Democratic Republic of Congo (DRC), Kenya, Uganda and Zimbabwe have conducted TB cost surveys which have revealed that households of people affected by TB are spending over 50% of their income on TB related costs,” said Dr Gasasira.

He however applauded several African countries for reducing TB infections and deaths. He also commended the government of Zimbabwe for its efforts to address TB. He however bemoaned the slow progress with regards the milestones set for 2020 as only 50% of people living with TB are on treatment in the African region and TB control budgets continue to be drastically underfunded.

Meanwhile, Dr Charles Sandy, the Deputy Director AIDS and TB program in the Ministry of Health and Child Care (MoHCC) said there was need to scale up TB screening so as to catch up and initiate all the cases that were missed in 2020 due to COVID-19 on treatment therapy and care.

“Our incidence is also quite high but it has been coming down over the years and our epidemic is driven by HIV. When we look at our treatment coverage, we want to identify all the cases of TB. We have all the incident cases but we managed to reach 72% in 2019 which was a decrease from 83% in 2018, this is according to estimates which the WHO has done for the country.

“The World Health Organization is promoting The End TB Strategy. Almost all the countries have adopted this strategy. The targets of The End TB strategy are focusing on an 85% reduction in TB deaths by 2035, 90% reduction in TB incidence by 2035 again and from the onset, the expectation was that no one should suffer catastrophic costs due to TB,” said Dr Sandy.

He added that Zimbabwe’s TB epidemic was seemingly under control until the late 80s when there was a rise in infections due to the spreading of HIV. He however said there have been a decline in the number of TB cases since the year 2000 at the back of efforts such as increasing treatment options, scaling community TB screening among other interventions.

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