An estimated 1.4 million fewer people received care for tuberculosis (TB) in 2020 than in 2019, according to preliminary data compiled by the World Health Organization (WHO) from over 80 countries- a reduction of 21% from 2019. The countries with the biggest relative gaps were Indonesia (42%), South Africa (41%), the Philippines (37%), and India (25%).

“The effects of COVID-19 go far beyond the death and disease caused by the virus itself. The disruption to essential services for people with TB is just one tragic example of the ways the pandemic is disproportionately affecting some of the world’s poorest people, who were already at higher risk for TB,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “These sobering data point to the need for countries to make universal health coverage a key priority as they respond to and recover from the pandemic, to ensure access to essential services for TB and all diseases.”

Building up health systems so everyone can get the services they need is key. Some countries have already taken steps to mitigate the impact of COVID-19 on service delivery, by strengthening infection control; expanding the use of digital technologies to provide remote advice and support, and providing home-based TB prevention and care.

But many people who have TB are unable to access the care they need. WHO fears that over half a million more people may have died from TB in 2020, simply because they were unable to obtain a diagnosis.

This is not a new problem: before COVID-19 struck, the gap between the estimated number of people developing TB each year and the annual number of people officially reported as diagnosed with TB was about 3 million. The pandemic has greatly exacerbated the situation.

One way to address this is through restored and improved TB screening to rapidly identify people with TB infection or TB disease.  New guidance issued by WHO on World TB Day aims to help countries identify the specific needs of communities, the populations at highest risk of TB, and the locations most affected to ensure people can access the most appropriate prevention and care services. This can be achieved through the more systematic use of screening approaches that employ novel tools.

These include the use of molecular rapid diagnostic tests, the use of computer-aided detection to interpret chest radiography, and the use of a wider range of approaches for screening people living with HIV for TB. The recommendations are accompanied by an operational guide to facilitate roll-out.

But this will not be enough alone. In 2020, in his report to the United Nations General Assembly,  the UN Secretary-General issued a set of 10 priority recommendations that countries need to follow. These include activating high-level leadership and action across multiple sectors to urgently reduce TB deaths; increasing funding; advancing universal health coverage for TB prevention and care; addressing drug resistance, promoting human rights, and intensifying TB research.

And critically, it will be vital to reducing health inequities.

“For centuries, people with TB have been among the most marginalized and vulnerable. COVID-19 has intensified the disparities in living conditions and ability to access services both within and between countries,” says Dr. Tereza Kasaeva, Director of WHO’s Global TB Programme. “We must now make a renewed effort to work together to ensure that TB programs are strong enough to deliver during any future emergency – and look for innovative ways to do this.”

Source: www.who.int

As of 17 March 2021, more than 120 million cases of COVID-19 infections, with more than 2 million deaths, had been reported globally.  Vaccination remains a critical tool to help prevent further illness and death and to control the pandemic.

So far, more than 20 million doses of the AstraZeneca vaccine have been administered in Europe and more than 27 million doses of the Covishield vaccine (AstraZeneca vaccine by Serum Institute of India) have been administered in India.

The GACVS COVID-19 subcommittee met virtually on 16 and 19 March 2021 to review available information and data on thromboembolic events (blood clots) and thrombocytopenia (low platelets) after vaccination with the AstraZeneca COVID-19 vaccine.

The subcommittee reviewed clinical trial data and reports based on safety data from Europe, the United Kingdom, India, and Vigibase, the WHO global database of individual case safety reports.

Based on a careful scientific review of the available information, the subcommittee came to the following conclusions and recommendations:

• The AstraZeneca COVID-19 vaccine (including Covishield) continues to have a positive benefit-risk profile, with tremendous potential to prevent infections and reduce deaths across the world.
• The available data do not suggest an overall increase in clotting conditions such as deep venous thrombosis or pulmonary embolism following administration of COVID-19 vaccines. Reported rates of thromboembolic events after COVID-19 vaccines are in line with the expected number of diagnoses of these conditions. Both conditions occur naturally and are not uncommon. They also occur as a result of COVID-19.  The observed rates have been fewer than expected for such events.
• While very rare and unique thromboembolic events in combination with thrombocytopenia, such as cerebral venous sinus thrombosis (CVST), have also been reported following vaccination with the AstraZeneca COVID-19 vaccine in Europe, it is not certain that they have been caused by vaccination. The European Medicines Agency’s Pharmacovigilance and Risk Assessment Committee has reviewed 18 cases of CVST out of a total of more than 20 million vaccinations with the AstraZeneca COVID-19 vaccine in Europe. A causal relationship between these rare events has not been established at this time (1).
• Adequate education should be provided to health-care professionals and persons being vaccinated to recognize the signs and symptoms of all serious adverse events after vaccinations with all COVID-19 vaccines, so that people may seek and receive prompt and relevant medical care and treatment.
• The GACVS subcommittee recommends that countries continue to monitor the safety of all COVID-19 vaccines and promote reporting of suspected adverse events.
• The GACVS subcommittee also agrees with the European Medicines Agency’s plans to further investigate and monitor for these events.

The GACVS COVID-19 subcommittee will continue to review the safety data from all COVID-19 vaccines and update any advice as necessary. The WHO COVID-19 vaccine safety surveillance manual provides guidance to countries on the safety monitoring and adverse events data sharing for the new COVID-19 vaccines and can be accessed here.

Source: www.who.int