Tuberculosis case numbers increased from 2019 to 2021, reversing years of progress as the COVID-19 pandemic disrupted access to treatment and testing, the World Health Organization said Thursday. 

“For the first time in nearly two decades, WHO is reporting an increase in the number of people falling ill with TB and the drug-resistant tuberculosis, alongside an increase in TB related deaths,” said Tereza Kasaeva, director of the U.N. health agency’s global TB program. 

A WHO report released Thursday stated that more than 10 million people got tuberculosis in 2021, a 4.5% increase from 2020. Roughly 450,000 cases involved individuals infected with the drug-resistant TB strain, a 3% increase from 2020 to 2021. Most of these cases were reported in India, Indonesia, Myanmar and the Philippines.

The COVID-19 pandemic “continues to have a damaging impact on access to TB diagnosis and treatment,” WHO said. COVID-19 restrictions, such as lockdowns and physical distancing, resulted in fewer people being diagnosed and getting the necessary treatment. With fewer people being diagnosed and treated for TB, more patients unknowingly spread the disease to others. As a result, more than a decade of progress was lost, said Dr. Mel Spigelman, president of the nonprofit TB Alliance. 

Tuberculosis is caused by bacteria that attack the lungs. The disease is mainly spread through the air and, after COVID-19, tuberculosis is the world’s deadliest infectious disease. It primarily affects adults, particularly those who are malnourished or immunocompromised, in developing countries. More than 95% of cases are in developing countries.

The downturn of the global economy during the pandemic worsened the problem, as families faced unbearable costs due to their treatment, especially in developing countries. 

Dr. Hannah Spencer, with Doctors Without Borders in South Africa, suggested lowering the prices of tuberculosis treatment to no more than $500 to help low-income patients. WHO also suggested that more countries should cover the cost of TB diagnosis and treatment. 

“If the pandemic has taught us anything, it’s that with solidarity, determination, innovation and the equitable use of tools, we can overcome severe health threats,” WHO Director-General Tedros Adhanom Ghebreyesus said in a news release Thursday. “Let’s apply those lessons to tuberculosis. It is time to put a stop to this long-time killer.” 

Some information in this report came from The Associated Press, Reuters and Agence France-Presse.

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