Covid-19 Has Made Tuberculosis Even More Of A Forgotten Pandemic
I write about prescription drug value, market access, healthcare systems, and ethics of distribution of healthcare resources
The impact of the Covid-19 pandemic goes well beyond the disease itself. It extends to neglected tropical diseases, as well as the so-called “big three” infectious diseases malaria, HIV/AIDS, and tuberculosis, by crowding out R&D funds and disrupting non-Covid-19 related healthcare services.
The rapid and unprecedented national and international response to Covid-19 after he virus was first reported in December 2019 led to massive R&D outlays. In 2020 alone, well over $100 billion was spent on Covid-19 diagnostics, vaccines, and therapeutics. Judging from the numbers of products developed at warp speed, the money was well spent. SARS-CoV-2 was first sequenced in January 2020. Since then, at least 25 vaccines have been licensed for use worldwide.
On the other hand, tuberculosis was first identified in 1882. Since then, a grand total one vaccine has been registered for use to prevent tuberculosis. In 2020, total research funding worldwide for tuberculosis was less than $1 billion.
For the first time in more than a decade, tuberculosis mortality increased in 2020; from 1.4 to 1.5 million deaths. Preliminary World Health Organization (WHO) modelling projections indicate the number of tuberculosis deaths could be substantially higher in 2021 and 2022.
Because the distribution of tuberculosis has invariably been highly skewed towards developing nations and so-called emerging market countries, pharmaceutical firms haven’t exactly prioritized drug development targeting the disease. As a result, tuberculosis has been mostly a forgotten pandemic, in spite of its status as a global health emergency since 1993 when the WHO declared it as such.
Since 2000, philanthropic foundations, non-governmental organizations, and government agencies, such as the U.S. Agency for International Development, have picked up some of the slack. From the Gates Foundation to Médecins Sans Frontières to the TB Alliance and many others, resources allocated towards case detection and treatment, as well as drug and vaccine development, have increased. Several large pharmaceutical companies have also responded to the call for additional funds to be poured into R&D, particularly with respect to the big three infectious diseases. Some of the collaborative work has paid off. In 2012, Sirturo (bedaquiline) was approved as the first new therapeutic agent indicated for tuberculosis in 50 years.
But, while more attention has been devoted to tuberculosis in the last 20 years, it is still one of the world’s deadliest diseases. Worldwide, tuberculosis is now the second leading infectious disease killer after Covid-19. And since 2000, tuberculosis has