The COVID-19 pandemic has drastically affected the treatment of care and diagnosis of other diseases such as cancer, Tb, malaria, etc. This is due to the sudden focus and diversion of all medical sources towards COVID-19. The negative impact on Tb is the most worrisome. Although not the same the two diseases have several similarities—airborne respiratory diseases that require effective prevention and control measures for infection. This meant that in many countries including India, TB programs were re-purposed to support the COVID-19 response by using the personnel and equipment of the TB program, which meant that these services were not available to individuals with or at risk of TB. We have also seen early reports showing that the number of people with signs and symptoms of TB and fewer people beginning treatment has fallen dramatically. Despite all the work that has been done to locate the missing cases of TB, we should expect the amount of “missing millions” in TB to increase again.

What impact COVID-19 would have on TB financing is uncertain, but the amount of investment in COVID research and programmatic management leads to fear of a decline in TB investment. Moreover, given the possible economic recession expected in the coming years especially in some of the countries supporting TB research and programs, it is likely that less money will be available to finance TB. Machines used for TB testing in India, such as TrueNat and CBNAT machines, have been redirected to COVID-19 testing. It’s a real problem here. Not only can these tests say whether anyone has TB, but they also provide drug resistance testing, which is vital to ensure that people with TB are given the correct care. There is a real opportunity to reinforce the diagnosis of TB, however. Given the investment in COVID-19, if an investment is made to increase the number of available platforms, the TB software and the TB diagnostic infrastructure will be improved in the long term. We will need to ensure that the method of sample transport is reinforced.

Bi-directional TB and COVID-19 experiments have been suggested by the Indian government. Bi-directional screening has many benefits, but an important factor is the issue of stigma. Nevertheless, now more than ever, we need to make sure that COVID-19 and TB are respiratory infections and can affect everyone. Stigma is a COVID-19 and TB mate. Stigma causes them to spread, so we need to put what we have learned about stigma reduction in TB to ensure that people with respiratory symptoms know that they can receive diagnostic services without stigma in a supportive setting. We are battling TB and COVID-19 by countering the stigma.

The global goal for the elimination of TB has been set for 2030. India has vowed to eliminate TB by 2025. Because of COVID-19, we need not change the timetable for eliminating TB. In reality, we should double down on our efforts to stop TB. What has been shown by the COVID-19 reaction is that there are mechanisms and political will to eliminate a killer respiratory pathogen, and we need to take this energy from the national multisectoral response and ensure that it is transmitted to TB. There has never been a greater need to avoid people dying from a preventable, curable disease [TB]. I hope that the importance of health is seen by policymakers and funders and that investment in health and health services continues. TB will benefit from this and India’s attempt to defeat COVID-19 will turn into an effort to defeat two deadly respiratory diseases: TB and COVID-19.

negative impact on TB