Operational Considerations for Maintaining Essential Services and Providing Tuberculosis (TB) Prevention, Care, and Treatment in Non-U.S. Low-Resource Settings During the COVID-19 Pandemic


Although preventable and curable, tuberculosis (TB) remains the world’s deadliest infectious disease, killing 1.5 million people each year. A quarter of the world’s population, nearly 2 billion people, is infected with tuberculosis. In 2018, 10 million people, including 1.1 million children, contracted tuberculosis (1). The global community has made substantial progress in the fight to end TB, and it is essential that the progress made in TB prevention, care and treatment is not undone by the COVID-19 pandemic.

Modeling highlights the potentially devastating effects of the COVID-19 pandemic on global TB programs, which could result in 6.3 million additional TB cases and 1.4 million TB deaths d by 2025 (2). Additionally, an overall 25% reduction in TB detection over 3 months could lead to a 13% increase in TB deaths, bringing TB mortality levels back to where they were 5 years ago. (3).

The increased demand for health services due to COVID-19 can strain health facilities and health systems. Previous global and regional health emergencies, such as Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS) and Ebola virus disease, have negatively impacted TB care (4-6) . These challenges have often led to disruption of TB care services, delayed diagnosis and treatment, and increased illness and death among TB patients. It is therefore imperative to maintain the continuity of essential TB care services during the COVID-19 pandemic.

This document summarizes operational considerations to help TB programs, health service managers, and health personnel maintain continuity of essential TB services in low-resource and non-US settings during the COVID-19 pandemic. 19 (7-9).

Michelle J. Kelley