Reporting of tuberculosis (TB) cases in India went down by 41 per cent between 2019 and 2020 due to the Covid-19 pandemic, according to the World Health Organization’s 2021 Global TB report released on Thursday.

India, followed by Indonesia (14 per cent), the Philippines (12 per cent) and China (8 per cent) were the top four countries that contributed most to the global reduction in TB notifications between 2019 and 2020.

About 16 countries, including these four, together accounted for 93 per cent of the total global drop in notifications.

The report revealed that the number of people newly diagnosed with TB and those reported to national governments fell to 5.8 million in 2020 from 7.1 million in 2019.

WHO estimates that some 4.1 million people currently suffer from TB but have not been diagnosed with the disease or have not officially reported to national authorities. This figure is up from 2.9 million in 2019.

In March 2021, an analysis by the Ministry of Health and Family Welfare revealed that notification of TB cases in India reduced by 25 per cent between January and December 2020 because of the lockdown and diversion of resources for Covid-19 control measures.

In 2019, the number of cases reported was 24.04 lakh, a rise of 12 per cent from previous years. It reduced by 25 per cent to 18.02 lakh cases in 2020.

The 2021 WHO Global TB report features data on disease trends and the response to the epidemic from 197 countries and areas, including 182 of the 194 World Health Organization (WHO) Member States.

It showed that the Covid-19 pandemic reversed years of global progress in tackling TB.

Nearly 1.5 million people died from TB in 2020 (including 214,000 among the HIV positive). The increase in TB deaths, the first in more than a decade, occurred mainly in the 30 countries with the highest burden of TB, including India, and also in 2020 than in 2019.

The major reasons were due to disruption in access to TB services and a reduction in resources and people struggling to seek care in the context of lockdowns, as in many countries, human, financial and other resources were reallocated from tackling TB to the Covid-19 response, the report said.

The WHO models and projections suggest that the number of people developing TB and dying from the disease could be much higher in 2021 and 2022.

“This report confirms our fears that the disruption of essential health services due to the pandemic could start to unravel years of progress against tuberculosis,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General, in a statement.

“This is alarming news that must serve as a global wake-up call to the urgent need for investments and innovation to close the gaps in diagnosis, treatment and care for the millions of people affected by this ancient but preventable and treatable disease,” he added.

There was also a reduction in provision of TB preventive treatment. Some 2.8 million people accessed this in 2020, a 21 per cent reduction since 2019. In addition, the number of people treated for drug-resistant TB fell by 15 per cent, from 177 000 in 2019 to 150 000 in 2020, equivalent to only about 1 in 3 of those in need, the report said.

Moreover, 2020 also saw a drop in global investment for TB diagnostic, treatment and prevention services, from $5.8 billion to $5.3 billion — less than half of the global target of $13 billion annually by 2022.

Funding in the low and middle-income countries that account for 98 per cent of reported TB cases remains a challenge. Of the total funding available in 2020, 81 per cent came from domestic sources, with the BRICS countries (Brazil, Russian Federation, India, China and South Africa) accounting for 65 per cent of total domestic funding.

However the report also noted some successes. Globally, the reduction in the number of TB deaths between 2015 and 2020 was only 9.2 per cent — about one quarter of the way to the 2020 milestone of 35 per cent.

Globally, the number of people falling ill with TB each year (relative to population) dropped 11 per cent from 2015 to 2020, just over half-way to the 2020 milestone of 20 per cent.

“We have just one year left to reach the historic 2022 TB targets committed by Heads of State at the first UN High Level Meeting on TB. The report provides important information and a strong reminder to countries to urgently fast-track their TB responses and save lives,” said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme.

The report calls on countries to put in place urgent measures to restore access to essential TB services, double investments in TB research and innovation.