What is needed to end tuberculosis in Latin America and the Caribbean?

What is needed to end tuberculosis in Latin America and the Caribbean?

Tuberculosis (TB) continues to be a major public health problem in the Latin American and Caribbean region. According to the Pan American Health Organization (PAHO), the region is home to 2 of the 20 countries (Brazil and Peru) with the most cases and deaths from TB in the world.

In 2020, there were an estimated 283,000 new TB cases in the region, with an incidence rate of 24 cases per 100,000 inhabitants. The countries with the highest incidence in the region are Brazil, Peru, Mexico and Haiti. Brazil alone accounts for about a third of all new TB cases in the region, with a rate of 32 cases per 100,000 people.

One of the main challenges in the fight against TB in the region is the high prevalence of TB/HIV coinfection, with approximately 15% of TB patients also living with HIV. Other factors contributing to the high burden of TB in the region are poor living conditions, limited access to health care, and insufficient funding for TB control programs.

Among the conditions for the high impact of TB in the region are poverty, malnutrition and lack of access to quality health services. According to the Pan American Health Organization (PAHO), by 2021, approximately 30% of the population in Latin America lacks access to basic health services, which prevents information campaigns and diagnosis of the disease from reaching communities more vulnerable.

Another challenge in the fight against TB in the region is the emergence of drug-resistant strains of the disease. Poor adherence to treatment generates drug resistance, which complicates treatment and generates higher costs for public health.

In Latin America, about 2 out of every 100 reported TB cases are resistant to first-line drugs such as Rifampicin. The case of Peru stands out, where 4 out of every 100 patients present drug resistance or multidrug resistance (PAHO).

According to the World Health Organization (WHO) in 2020 there were an estimated 28,000 deaths from tuberculosis (TB) in the Latin American and Caribbean region in 2020, that is, together with AIDS, one of the infectious diseases that cause more deaths in Latin America.

According to estimates by the Global Fund for the Response to AIDS, Tuberculosis and Malaria, US$13 billion a year is needed for the prevention, diagnosis, treatment and care of tuberculosis, in order to reach the global target agreed in the United Nations high-level meeting on tuberculosis in 2018. Let us remember that the eradication of TB is part of the Sustainable Development Goals for 2030.

All in all, funding in low- and middle-income countries, where 98% of reported TB cases occur, is far less than is needed. Spending in 2020 amounted to US$5.3 billion, less than half (41%) of the global target.

Despite these numbers, tuberculosis is a curable and preventable disease, but it remains a major public health problem in Latin America and requires sustained efforts to control and eradicate it.

AHF, as the world public health organization, works in 45 countries together with civil society, donors and government agencies towards the latest effort to end TB through a 10-point plan:

  1. That a package of USD$5 billion in global funds be guaranteed for prevention, epidemiology, testing, treatment, training and research to conquer TB worldwide with a focus on the countries with the highest incidence.
  2. Universal access to the best TB drugs, including those that shorten the treatment period.
  3. Dramatically reduce the number of undiagnosed TB patients through large-scale point-of-care testing programs and contact tracing.
  4. Intensifies NGO participation in planning, outreach and adherence programs at local, national and global levels
  5. Integration of TB services with HIV and primary care settings.
  6. Universal TB training of all health workers in high prevalence areas and production of high quality educational materials.
  7. Implementation of universal TB infection control policies and procedures to protect staff and patients in healthcare settings.
  8. Launch specialized testing programs to address late-onset TB to reduce unnecessary deaths and infections.
  9. Implement short-term TB prevention therapy for vulnerable populations.
  10. Involve cured and active patients as ambassadors in campaigns to improve adherence to treatment.