When it comes to preventing TB, we can and must do better
By Gavin Churchyard
We’ve known how to prevent and treat TB for over 70 years. Yet, in 2017 an estimated 10 million people fell ill from the disease, and every day more than 4,000 people die from TB. Many of these deaths can be prevented.
Almost a quarter of the globe is infected with the bacteria that causes tuberculosis (TB). People with latent TB infection have no symptoms, are not contagious and most of them don’t know they’re infected—but they are at risk of developing TB disease at some point in their life.
While not all TB infections will become an active disease, the World Health Organization (WHO) states that without treatment up to 15 per cent of infected people (https://auruminstitute.us8.listmanage.com/track/click?u=ebb0b8aca497581021d1c60ea&id=38a51d3daf&e=30c637ea78) will develop TB disease. The risk of progression to active disease is highest in children under five and in people living with HIV, who are 20 to 30 times more likely to move from infection to active TB. Even living with TB patients is associated with a much higher risk of becoming infected with TB and progressing from infection to active TB than the general population.
Today, at the United Nations High-Level Meeting on TB, world leaders are expected to commit to preventing TB for at least 30 million people most at risk of infection by 2022, including four million children under the age of five, six million people living with HIV and AIDS and 20 million people who live in a household with someone affected by TB.
The pledge to provide preventive treatment to all of these people has the potential to stave off millions of life-threatening cases of TB disease.
World leaders are right—to end TB, we need to stop the disease in its tracks by attacking the reservoir of infection. But the current approach to the treatment of TB infection is failing. We can and must do better.
Currently, only half of the 30 countries with the largest number of TB/HIV infections use the preferred treatment for latent TB infection. And less than a quarter of children under five years—the group with the highest risk of progression from infection to disease—who are eligible for it start preventive therapy. Most of the current treatment options are complex and long, with people required to take a pill daily for six to 36 months.
To deliver on the commitments that will be made at the UN meeting today, we need new, short-course TB preventive therapies, and we need them to be available at an affordable cost—one that will allow governments to purchase the drugs for years to come.
Tuberculosis is a disease that tears through impoverished, vulnerable and marginalized communities. It is time to move past words, fill in the details on how these commitments will be implemented, roll up the sleeves and get to work saving lives.
The writer is the , CEO of Aurum Institute