Roll Up, Roll Up: It's 'World TB Day'

A Future 'Free of TB' by 2030

At 1.01am this morning the World Health Organisation sent me an email. Today is ‘World TB Day.’

The press release contains 370 words worth of quotes from a video presented by WHO Regional Director for Europe, Dr Hans Henri P. Kluge.

The link leads to a YouTube video posted eight days ago, which had 186 views early this morning. Comments are disabled.

The WHO video begins with an animated graphic of the WHO emblem, which is a spike or needle driven deep down into a globe - representing the world – around which a snake or serpent curls itself. It might remind one of the Spike or Spire, inserted into Dublin’s O’Connell Street, much to the chagrin of Dubliners, twenty years ago last year.

This article tells of a time capsule inserted into the foundations of the Spire, which contains amongst other things, a box of cigarettes.

Stigma

In the WHO TB video, Dr Kluge tells us he is ‘saddened’ by the 230,000 people falling ill with Tuberculosis across the European region, according to the latest WHO figures, but World TB Day gives him hope, he says, since TB is ‘preventable, treatable, and curable.’

“Under the latest WHO guidelines, most TB patients find the treatment process more comfortable and easier to complete,” he says.

TB patients, previously treated in isolation units in hospitals due to the contagious nature of the disease, will now be treated, at home. They won’t be visited by nurses or doctors, but dealt with by ‘healthcare workers’ via video link.

“They are mainly treated at home, avoiding lengthy hospitalization or daily visits to a clinic, instead they receive video calls from health workers to support them taking their medicines – now all oral. This puts people at the center of care and eliminates stigma and discrimination,” Dr Kluge says.

Curious in case this might have made sense fifty years ago, I put the question to my mother, who worked as a TB nurse in a hospital in England in her younger days.

“Were you stigmatised as a nurse working on a TB ward in England?” I ask.

“Never,” she answers. “Who would stigmatise me?”

“Were the patients stigmatised?” I ask.

“No” she replies. “We wore gowns and masks and had a laugh with them every chance we could. They were lonely.”

The TB patients got a bottle of Guinness after their dinner on a Sunday, to ‘build them up’ she said.

Revolutionary treatment

Dr Kluge is adamant that it is every TB patient’s right to have access to ‘safe, quality, affordable care’ – just not in hospital, unfortunately. And not from doctors or nurses.

“I can’t say it in stronger terms; it is every TB patient’s right to have access to safe, quality, affordable care - free of charge and stigma,” he says.

Next, Dr Kluge tells us that new TB treatments are far more effective than previous treatments, something he declares a revolution! But we’re not informed what the treatment actually consists of.

“Drug-resistant TB treatment used to take 18 months with only a 55% success rate. Treatment now takes only 6 months in most cases and success rates are set to rise thanks to new drugs. This is a revolution!”

Dr Kluge then makes a curious statement, in telling us that ‘Our Region’ is still suffering the ‘after effects’ of Covid 19.

“Our Region is still suffering the after-effects of the COVID-19 pandemic, which caused 7,000 extra deaths from TB in 2021 and 2022,” he says.

But how exactly did covid cause 7,000 extra deaths from TB? Did these people die of TB or from covid? Surely, since all deaths within 28 days of a positive PCR test were deemed ‘covid deaths,’ these people could not have possibly died from TB?

Dr Kluge’s concluding comments contain one final curiosity, that TB patients will not only be able to stay at home with their family (and presumably infect the family also) but they will also be able to ‘earn a living’ while doing so.

“That is why I urge all countries to make the most of the latest WHO patient-centered guidelines, helping people stay with their loved ones and continue to earn a living and stay active,” he says.

“Remember; every cured TB patient brings us a step closer to a future free of tuberculosis.

“As a doctor who spent years focusing on tackling TB, I am filled with hope that yes - we can end TB, together.”

Does that sound a little familiar?

“We are all in this together,” became a mantra for the media during covid.

But was that actually the case?

From the Irish Times

Projection

In the Irish Times during the week, we read a more detailed breakdown of TB figures, which are actually lower at present than pre-covid.

“Case numbers remain below Covid-19 pandemic levels of more than 300 annually,” Health Correspondent Paul Cullen writes.

Cullen goes on to clarify that covid did not in fact cause 7,000 additional TB deaths, ‘disruptions to treatments’ did.

The Irish Times Health Correspondent further clarifies that these 7,000 ‘excess deaths from TB’ may not have happened at all, since they were based on a projected pre-2020 estimate.

“Nearly 7,000 excess deaths from tuberculosis occurred in the WHO European Region as a result of the pandemic from 2020 to 2022, compared with what experts had expected based on pre-2020 estimates, the two organisations say,” Cullen writes.

“Rates of TB – a bacterial infection that primarily affects the lungs – are almost 13 times high (sic) in people born outside Ireland compared with those born in the State, the figures, from the Health Protection Surveillance Centre (HPSC) figures show.”

Cullen then imparts a detail that readers should be aware of:

“Sixty-six per cent of cases last year were in people born outside Ireland.”

“Across Europe, there were more than 36,000 TB cases in the EU in 2022, and 166,000 in the wider World Health Organisation European region, which includes Russia and Ukraine, according to the WHO.”

It appears what we are reading is actually good news, that we have fewer cases in Ireland than pre-Covid, but this is presented as bad news, because the WHO has set a target for us to reach by 2030. The target is the elimination of TB.

From the Irish Medical Times

A Rapid Test

The Irish Medical Times, in an article published on Friday, develops the details of this target further, informing readers of a WHO-recommended ‘rapid test’ to be used as ‘the first method of diagnosing TB.’

The IMT article tells us of the provision of a ‘health and social benefit package’ to all people with TB. And finally, it tells us of endeavours to ensure the availability of ‘at least one new vaccine that is safe and effective.’

From the Irish Medical Times

Politics

The WHO has a Global Tuberculosis Programme, Dr Tereza Kasaeva is its director. This doctor talks helpfully about the ‘critical need for political momentum’ on TB to be translated into ‘concrete actions.’

“WHO will continue to provide global leadership for the TB response, working with all stakeholders until we reach and save every person, family and community impacted by this deadly disease,” she says.

From the Irish Medical Times, we learn that the publication of ‘Ireland’s first national TB strategy 2024 - 2030’ by the Health Service Executive (HSE) is imminent.

From the Irish Medical Times

A quick search on the development of this new TB vaccine, reveals the following:

And then a reader sent me this:

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Watch the WHO TB video here

Further reading on the WHO: