Getting back on the road towards tuberculosis elimination: lessons learnt from the COVID-19 pandemic

Since early 2020, the world’s attention has shifted to the COVID-19 pandemic, and the medical and scientific community has joined forces to fight it. However, although necessary, this diversion of attention has had an impact in all areas of health. The effect of COVID-19 on tuberculosis services is estimated to be global and dramatic. All over the world, we witnessed the reallocation of health care workers to fight the COVID-19 pandemic; the closure of many tuberculosis outpatient clinics and laboratories; the shortage of laboratory reagents for the diagnosis of tuberculosis and even the shortage of anti-tuberculosis drugs. These shortages in resources may be due to the economic impact of the pandemic and stretched national budgets, which are likely to affect routine public health programmes. In China, all of these changes led to a significant reduction in tuberculosis reports in comparison with the previous three years. In a study including 37 tuberculosis centres worldwide, the Global Tuberculosis Network compared the first quarters of 2019 with those of 2020 and concluded that there were reductions in newly diagnosed cases of active tuberculosis and of latent tuberculosis, as well as in the number of visits of outpatients with active or latent tuberculosis. The exact significance of this decrease has yet to be determined. Has there been a real decrease in the number of tuberculosis cases? Or is it a result of the disruption of and lack of access to tuberculosis services?