Tuberculosis (TB) remains one of the world’s deadliest killers. Nearly 4,000 people die to TB every day and almost 28,000 people fall ill with it, yet it is preventable and curable. In fact, before the Covid-19 pandemic, TB was the world’s leading cause of death from an infectious disease, killing 1.4 million people worldwide in 2019 (WHO). Today on World TB Day (24th March) we are raising awareness to TB and showing you how HealthNet TPO is joining global efforts toward ending this epidemic. The theme this year is ‘The Clock is Ticking’ - the world is running out of time to act on commitments made by global leaders to end TB, particularly as the Covid-19 pandemic has slowed progress made.

TB is an infectious disease which mainly affects the lungs. It is caused by a bacteria called Mycobacterium tuberculosis, which is inhaled into the lungs causing a prolonged cough, chest pain and coughing up blood. From here the bacteria can spread to other parts of the body including the brain, kidneys and spine and can lead to TB-meningitis, infertility and death.

TB is spread through the air when an infected person coughs, spits or speaks. It is a disease that is greatly associated with poverty, and spreads more easily in cramped and overcrowded spaces with poor ventilation. People who already have low immune systems, particularly people who live with HIV, or lack access to good healthcare, are more at risk of developing TB. Whilst it is treatable, there is also growing resistance to the drugs used to treat it, something which public health experts around the world call one of the world’s biggest health threats.

In 2019, close to 10 million people worldwide were diagnosed with TB, including 206,000 people with drug-resistant TB.

TB remains a major public health concern in Afghanistan. In 2019 (the latest estimated figures by the WHO), Afghanistan had 73,000 infections, with 2,400 cases of drug resistant TB. The true burden of the disease is thought to be much higher considering the growing number of detected cases, the stigmas associated and limited access to care services.

With treatment, TB can be cured, and the success rate is 91% in Afghanistan. The biggest barrier to receiving treatment is access to adequate services and people being willing to seek them. There are still many regions where communities do not have access to TB care services and where health facilities and laboratories do not have the technology required to accurately diagnose and treat drug susceptible and drug resistant TB (currently only 2.7% of labs can provide the molecular testing required).

Women are also more likely to get TB in Afghanistan than men, something which is not seen worldwide, where TB affects more males than females. Health experts say that gender inequality could be a major factor to this disparity, as women are more likely to be confined to the home and less likely to have access to quality health services.

More and more children are also being detected with TB in Afghanistan and the Afghanistan National TB Program has prioritised addressing child TB, covering more than 120 child wards in hospitals and improving contact investigations across the country. This means more children are being detected, diagnosed and treated for TB then ever before.

For those people who are detected with TB, it is vital that their known contacts are traced and examined for symptoms to stop the spread of the disease. This involves visiting a patient’s household, school or workplace to screen all potential contacts. Contacts who are identified with symptoms suggestive for TB are further investigated with sputum smear examination and chest X-ray as well as for HIV/AIDS. Children who are found symptom free with active TB receive preventive therapy to prevent the risk of developing TB illness.

HealthNet TPO has focused on the control of communicable diseases including TB, HIV and Malaria for almost three decades. Since 2018, we having been working with the UNDP TB programme and contributing to the Afghanistan National TB Programme for a 'TB-free Afghanistan', aiming to reduce TB deaths by 75% by the end of 2025 .

From screening to laboratory diagnostics, we are helping to reduce the prevalence and improve access to treatment. By improving the detection of TB through widespread screening in children, prisoners, internally displaced persons and in rural areas, we are able to identify and refer cases to clinics and hospitals.

Community engagement is an essential part of eradicating the disease, and HealthNet TPO is working with communities and building trust necessary to deliver effective TB care, improve knowledge on TB and dispel harmful stigmas that are associated.

At the same time, we are strengthening health services, building capacity of health workers to detect and refer TB presumptive cases and improving the quality of lab services and diagnostics.

Despite the achievements Afghanistan has made in controlling TB over the past few years, there is still a lot of work to do. An estimated 27% of cases are not being detected and we need to close this gap. This can only be done through improving detection, improving diagnosis and treatment and engaging with communities.

Support us today to help end TB in Afghanistan.