he World Tuberculosis Day is observed every year to raise public awareness about the devastating health, social and economic consequences of tuberculosis (TB) and to step up efforts to end this global epidemic. The day is observed on March 24, marking the day in 1882 when Dr Robert Koch discovered the bacterium causing TB. The theme for this year – Yes! We can end TB! – aims to inspire hope and encourage high-level leadership, increased investments, adoption of innovations, accelerated action collaboration to fight the TB epidemic, which is preventable and curable.

Tuberculosis occurs in every part of the world. It is an airborne disease that spreads like a nefarious whisper in the wind when infected people cough, sneeze, spit or speak. It is the second most common cause of death from infectious diseases globally, killing almost two million people annually. An estimated eight million new TB cases occur every year, of which 80 percent are among people in the most economically productive age groups representing a major economic burden for individuals and countries. In 2021, 1.2 million children fell ill with TB globally. Children and adolescents with TB are often overlooked by health providers and can be difficult to diagnose and treat. Children in countries where TB is common often get the BCG vaccine.

The year 2023 calls for comprehensive and universal care efforts for those affected with tuberculosis. The 2023-UN High-Level Meeting on TB at the General Assembly in September will bring together heads of states to provide the opportunity to mobilise political and social commitment to ramp up progress against the disease. A collective responsibility will be explored to confront inequalities and put an end to this preventable and curable disease as one of the major objectives of the meeting.

More than 95 percent of deaths caused by TB occur in low- and middle-income countries. It is one of the three diseases most closely linked to poverty, the others being malaria and HIV/ AIDS. Eighty percent of TB cases occur in 22 developing countries in Africa, Southeast Asia and the Western Pacific. India, China, Pakistan, South Africa, Nigeria and Indonesia have the largest number of cases. In developed countries, TB is more common in urban areas.

This is especially critical in the context of the Covid-19 pandemic that has drawn attention to the deep disparities that persist between and within countries. People with TB are among the most marginalised and vulnerable, facing barriers to accessing care. This situation has put The End TB Strategy (adopted by the World Health Assembly in 2014 as part of the newly established Sustainable Development Goals) at risk. The SDGs aimed for a 90 percent reduction in deaths caused by tuberculosis by 2030. This has become a challenge.

The stigmatisation of TB in Pakistan is mainly a consequence of a lack of public knowledge and misconceptions about the disease. A recent study found that 88.7 percent of surveyed patients did not know about the risk factors of TB or the protective measures people with the disease should take.

TB is mostly concentrated in settings beset by poverty and other social and economic challenges and in the most vulnerable populations. Poverty, undernourishment and poor living and working conditions, among others, affect how people fall ill, develop TB and cope with treatment demands. Thus, progress in combating TB and its drivers cannot be achieved by the health system alone. It requires firm political commitment at the highest level.

Pakistan is ranked fifth amongst the high-burden-of-tuberculosis countries in the world. TB is one of the major public health problems in the country. According to the latest WHO estimations, the incidence, prevalence and mortality caused by TB in Pakistan are 230 per 100,000. TB is a curable disease but can be fatal if not detected and treated properly. Key reasons for high risk include delays in diagnosis, unconfirmed, inappropriate and inadequate drug treatments, poor follow-up and lack of social support programmes.

The National TB Control Programme (NTP) was revived under the Ministry of Health subsequent to the declaration of TB as a national emergency in Pakistan in 2001. It is currently working along with the National Institutes of Health. National TB Control is a parallel programme of the National Institutes of Health and stands out as one of the public health programmes on track towards the achievement of SDG targets. It acts as a collaborating body at the central level for the development of uniform policies and strategies, facilitating donor liaison at national and international levels.

The stigmatisation of TB in Pakistan is mainly a result of a lack of public knowledge and misconceptions about the disease. A recent study found that 88.7 percent of surveyed patients did not know the risk factors of TB or the protective measures people with the disease should take. Moreover, less than half of the respondents could not accurately identify TB symptoms.

Pakistan has taken steps to reduce the number of infections. National TB Control Programme (NTP) is actively working to achieve a TB-free Pakistan. NTP re-launched in 2001 after TB became a national emergency in Pakistan. Since then, the organisation has worked alongside the National Institute of Health to fight TB in the country. The main objective of NTP is to cut the number of TB cases present in 2012 to half by the year 2025.

Dr Tereza Kasaeva, the Global TB Programme director at the World Health Organisation, has said in her message for the Day, “2023 is a pivotal year to push forward the agenda towards ending TB. Several high-level opportunities are being provided to raise visibility, increase political commitment and enhance investments for the TB response. We, at WHO, collectively recommit to keep the promises made to the millions affected by TB each year – despite any hardships, challenges or crises that come our way. We cannot falter in our commitment till we reach and save every person, family and community impacted by this deadly disease.“

The writer is a playwright and freelance journalist. He can be reached at pashajaved1@gmail.com and his blogging site: soulandland.com