Image: Community consultation meeting on TB in Daru, Papua New Guinea
To commemorate World TB Day 2020, we reflect on important lessons from the response to TB and how they can be applied to COVID-19.
World TB Day 2020 falls in the middle of the global pandemic of SARS-CoV-2 that is threatening lives and disrupting life as we know it in all countries rich and poor.
In an interconnected world, both tuberculosis (TB) and COVID-19 demonstrate the importance of investments in health systems and research to end epidemics and prevent the emergence of new diseases.
Tuberculosis remains the world’s deadliest infectious disease with 1.5 million deaths in 2018. The airborne epidemic spread of TB, particularly drug-resistant TB (DR-TB), is a threat to individuals, communities and global health given the catastrophic human and economic costs of this infection.
Investment in TB research and science has been a missing ingredient in the global response. To accelerate the response, Heads of State came together and made strong commitments to end TB by 2030 at the first-ever UN High Level Meeting in September 2018.
Following this, the Stop TB Partnership and Burnet Institute convened a round table with Australian and regional leaders in 2019, producing a joint statement with key actions to end TB in the Asia-Pacific Region.
Members of the Western Province TB team, supported by the RID TB project, demonstrate the ‘tippy tap’, an innovative, low cost and hands-free solution for hand hygiene in settings without running water. First developed in Zimbabwe in the 1970s, ‘tippy taps’ have been used in similar settings around the world and have recently been implemented by the team in Daru as an important preventative strategy in the fight against COVID-19.
A key site of action for accelerating TB responses in the Asia-Pacific region is PNG which faces an unprecedented outbreak of TB and DR-TB in Daru, Western Province.
The PNG National Department of Health (NDoH) convened an emergency response to DR-TB in Western Province with funding support from the Australian government and mobilisation of international partners, including Burnet Institute.
Like COVID-19, TB is spread through the air when people mix and socialise. Unlike COVID-19, TB spreads much more slowly and almost all cases worldwide (95 percent) are found in low-middle income countries, particularly the poorest and most vulnerable communities.
Nonetheless, there are lessons from Burnet’s responses to TB in PNG that can be readily applied to COVID-19:
An epidemic response paradigm with the best application of existing tools is essential to reduce transmission. A comprehensive epidemic response involves active case finding, tracing of contacts of cases, rapid diagnosis, effective treatment with patient support, and prevention of infection in hospitals and communities.
Research can be integrated into health programs and services to promote the uptake of novel tools and strategies and tailor the response to the local epidemic. Novel tools include molecular diagnostic tests close to the point of care, shorter all-oral DR-TB treatment regimens scaled up under careful operational research, and preventive measures such as vaccines and TB preventive treatment focused on those at high-risk.
The capacity and quality of the health systems and the health workforce can be built to create a resilient health service that serves the broader health needs of the community.
Placing communities at the centre of the TB response with decision making power, genuine responsibility and with a focus on the most vulnerable members of the community is vital for controlling a respiratory-borne pathogen.
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Burnet Institute (Australia) is located on the traditional land of the Boon Wurrung people and we offer our respects to their Elders past and present. We recognise and respect the continuation of cultural, spiritual and educational practices of Aboriginal and Torres Strait Islander peoples of this land.
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