Scale up public health funding to win TB fight


Community Health Advocate Anne Nyambura, a Tuberculosis Champion at the Tudor Sub-county Hospital in this photo taken on 16th August 2021. PHOTO | KEVIN ODIT | NMG

We commemorate the fight against tuberculosis on the anniversary of Dr Robert Koch’s discovery in 1882 of the bacterium that is the largest cause of death in humans from a single infectious disease in current times.

This deadly but curable disease each day claims the lives of 4,100 people globally. Recent survey data estimates tuberculosis to be prevalent in more than 420 people amongst every 100,000 Kenyans, and that we fail to diagnose about 40 percent of these cases.

Further, only about 52 percent of Kenyans suffering from tuberculosis eventually receive complete and successful treatment.

The World Health Organization (WHO) has led health entities all over the world in the fight against this scourge with steady gains in reduction of deaths and infection rates year-on-year. We have recently come through a devastating Covid-19 pandemic that cost us in excess of six million lives globally and more than 5,600 Kenyan lives.

The pandemic disrupted lifestyles and livelihoods of many but also had a major impact on health-seeking behaviour and delivery of healthcare not only in Kenya but all over the world. It is estimated that 21 percent or 1.4 million fewer people received the care they needed for tuberculosis in 2020 compared to the preceding year primarily because of the Covid-19 pandemic.

This could result in half a million more tuberculosis deaths, according to analysis of preliminary data from 84 countries by the WHO.

Clearly, to win the war against tuberculosis, we need to suppress disease transmission through similar public health interventions that worked for Covid-19, detect and successfully treat all cases, have an effective contact tracing programme, and protect those amongst us who are vulnerable to infection like children, the elderly and people living with HIV and other chronic diseases, not excluding cancer, diabetes and different organ failures.

To improve early detection, the Kenyan government key stakeholders in healthcare should continue to conduct and support health awareness promotion campaigns which employ easy-to-understand but high-impact advertisements within social and mainstream media and similar methods.

The universal health coverage (UHC) programme of necessity aspires to increase and improve access for all Kenyans to good quality healthcare wherever they are.

Tuberculosis does not yield to socio-economic or political boundaries and it is thus imperative that we all have access to proximal and affordable healthcare that is fit for the purpose of diagnosis, effective treatment and monitoring of this avoidable but life-threatening disease.

The Ministry of Health recently launched updated national guidelines that have improved the robustness of screening procedures for more effective case detection at every level of care, and that offer crucial guidance for all cadres of healthcare providers for appropriate management and contact tracing of tuberculosis, leprosy and other lung diseases.

Kenyans have had for several years, free proximal access to effective treatment for tuberculosis in key government and non-government-funded healthcare facilities.

This way, we have continually improved the ante in the fight against tuberculosis much as we are yet to achieve desirable targets.

The recent Covid-19 pandemic setbacks notwithstanding, our biggest challenges in this fight in Kenya and globally remain inequitable access to healthcare, stigmatisation and discrimination, insufficient local research data to inform more precise interventions, and less devoted leadership in healthcare across the divide.

It is for these reasons that the theme for this year’s fight against tuberculosis urges us all to invest in the fight to end tuberculosis.

We need investment in UHC, education and training of our healthcare providers, funding useful research in tuberculosis and HIV, healthcare leadership, and diagnostic and treatment resources to improve our ability to fight the disease.

Dr Bwika is a Consultant Physician and Head of Pulmonology, Department of Medicine, Aga Khan University Medical College, East Africa