The Covid-19 pandemic has reversed the hard-won progress against tuberculosis (TB) achieved over recent decades. Only 5.8 million of the 10 million cases were identified and reported in 2020, an 18% decrease compared to 2019, Mel Spigelman, president and CEO of TB Alliance, says. India has the world's biggest TB problem, with 2.6 million cases and close to 450,000 deaths each year.
In an interaction with Fortune India, Spigelman said 2020 also saw the first year-over-year increase in TB deaths since 2005, as well as a 15% reduction in the number of people treated for drug-resistant tuberculosis, despite the introduction and increasing availability and adoption of new therapies for highly drug-resistant forms of the disease. The need to invest significantly more in TB research and development has been highlighted by the pandemic he says. "Both TB and Covid are each tremendous threats to global public health. These two pandemics represent the number 1 and 2 largest single infectious disease killers in the world today. TB afflicts more than 10 million each year. About 1.5 million people die from TB each year, and the situation with TB has only worsened due to Covid-19," he explains.
Spigelman said that while the mission of TB Alliance, to discover, develop, and deliver new and improved treatments for people with TB, and to one day eradicate the disease, has not changed, the Covid-19 pandemic has reinforced the fact that new tools – diagnostics, drugs, and vaccines – can rapidly be brought to bear on the TB pandemic with the right amount of funding and political will. "Any end to TB can't be met without new treatments. In 2019, TB Alliance received the first regulatory approval for pretomanid as part of the BPaL (bedaquiline, pretomanid and linezolid) regimen for the treatment of highly drug-resistant TB. Data from clinical trials studying the BPaL regimen has shown sustained favorable outcomes for about 90% of patients. To date, 16 countries or regulatory bodies have approved pretomanid as part of the BPaL regimen for the treatment of patients with highly drug-resistant forms of TB, including India, which was the second country to grant regulatory approval. More than 30 countries have procured pretomanid for use in the regimen," he explained.
Sandeep Juneja, senior VP, Market Access, TB Alliance, said India is included on the WHO's list of high TB burden countries and accounts for a quarter of the world's multidrug-resistant tuberculosis (MDR-TB), with less than 50% having successful treatment outcomes. According to Juneja, global investments in TB research and development total about $0.9 billion, far shy of the $4 billion that the Stop TB Partnership estimates is needed annually to develop and deliver new tools, such as more effective drug regimens, vaccines, and diagnostics, that are necessary to end the TB pandemic. In comparison, within two years, more than $100 billion has been invested in the development of Covid-19 vaccines alone, with diagnostics and therapeutics also being funded at unprecedented levels. However, Juneja said that while the technological progress in combating the COVID-19 pandemic has been truly remarkable – even this degree of investment does not guarantee equitable distribution of the necessary tools to end a pandemic.
