Leveraging the COVID-19 response to fight tuberculosis in China

March 24, 2020 by PATH

Tackling tuberculosis in China through structural changes in service delivery, financial policy reform, new diagnostic tools, and delivery innovations.

PATH diagnostics training China COVID-19 TB

As part of its partnership with the Chinese government, PATH trained laboratory technicians in new diagnostic techniques for tuberculosis. Photo: PATH/Haiyan Dong

COVID-19 isn’t the only disease that threatens public health in China. The country has the world’s second-highest burden of tuberculosis—an infection also characterized by a persistent cough, fever, and fatigue. Although TB is curable and preventable, in 2018 approximately 866,000 people in China fell ill from the disease and 40,000 died.

Over the last decade, the country has made impressive progress in confronting TB, with a 32 percent reduction in incidence and an 80 percent reduction in mortality. However, those efforts are threatened by the current pandemic.

“I fear the shadow of COVID-19 will extend for many years,” says Moe Moore, PATH’s director of TB strategy and business. “Interruptions in TB treatment could lead to higher mortality rates and more patients developing drug-resistant strains of the disease.”

The pandemic has already complicated the TB response in China. Lung and pulmonary hospitals, including those designated for treatment of multidrug-resistant TB, have been converted to emergency centers for the COVID-19 response. In the absence of heroic efforts, TB patients in areas under quarantine face disruptions in their treatment and are unable to access their physicians and other medical personnel.

For health care workers, COVID-19 has consumed much of the world’s stocks of personal protective equipment. This situation puts service providers—already a high-risk group for TB—at greater personal risk of contracting and developing the infection.

Leveraging COVID-19 tools to fight TB

Despite the challenges, the COVID-19 response presents fresh opportunities for improving TB control in China. Funders are investing substantial sums in new diagnostic tools and delivery methods, spurring private-sector engagement and innovation. We must take these chances to leverage current investments beyond COVID-19. Following the Ebola outbreak in West Africa, funding was used not just to combat Ebola, but also to prepare health systems for future epidemics.

Drive-through testing facilities could be replicated in high TB burden areas during outreach campaigns. Production lines for COVID-19 diagnostics could be repurposed to support manufacture of TB diagnostics. Also, the overlap in symptoms between the two diseases means many people who may have TB will seek COVID-19 testing. These individuals could also be screened for TB.

For two decades, PATH has partnered with the Chinese government to fight TB with new tools, innovative strategies, and multisector collaboration. Our work spans the full range of the patient experience, from initial symptom screening to treatment completion. PATH is ready to work with governments and partners to ensure innovations and investments made for COVID-19 are brought to bear in the fight against TB.

“We must not lose sight of the progress we’ve made,” says Mr. Moore. “China has been a global leader in combatting both TB and COVID-19. The novel coronavirus response cannot be allowed to disrupt the progress against this persistent, deadly disease.”