Russian invasion undermines Ukraine's progress against tuberculosis

With the Russian invasion of Ukraine, the country's efforts to combat tuberculosis could be undermined by the war, experts warn.

For a long time, Ukraine has been fighting tuberculosis, which was the most lethal infectious disease in the world until the onset of covid-19.

This disease kills 1.5 million people worldwide every year and infects more than 10 million people, although it can be diagnosed and treated, according to the World Health Organization. In Ukraine, about 30,000 cases are detected each year.

The country has one of the highest rates of drug-resistant tuberculosis, which 29% of Ukrainian patients suffered from in 2018, according to WHO. Against this type of disease, which is due to a bacillus that does not react to the two most potent drugs, Ukraine was the first country to try a new treatment.

Olya Klymenko, who overcame tuberculosis in 2016 and who is the founder of TB People Ukraine, said that “Before the war, Ukraine had done a lot (...) we had a more or less stable situation. But it all stopped in one day.”

“When the war is over, we will start everything again, not to mention from scratch, because of the years caused to our health system, to our medical infrastructures,” he said during a press conference on Tuesday, two days before World Tuberculosis Day.

Ukraine was “one of the pioneering countries in the response to tuberculosis” in the region, explained Askar Yedilbayev, head of WHO Europe's tuberculosis unit. But, with the Russian invasion, “Ukrainian health services have been razed,” he recalled to the press.

- “Major health crisis” -

For Michel Kazatchkine, former UN Special Envoy on AIDS for Eastern Europe and Central Asia, the most urgent thing is to ensure that patients have access to treatment. A tuberculosis center was bombed in Nizhyn, northwest of Kiev, he said.

“There will be a major health crisis. Ukraine will encounter a collapsed health system (...) diseases such as tuberculosis and drug-resistant tuberculosis will skyrocket,” he told AFP.

Kate White, emergency officer at Doctors Without Borders, stressed that due to the war, resources provided for patients with turbeculosis and AIDS will have to be allocated to care for the wounded.

In addition to the difficulties of the war are those caused by the covid-19 pandemic, since “in just two years, [the epidemic] pushed global progress in the fight against tuberculosis back ten years,” said José Luis Castro, president of the Renegé Vital Strategies, which calls the situation “catastrophic.”

Worldwide, for the first time in more than ten years, the number of deaths attributable to tuberculosis increased in 2020, according to WHO, which this week called for massive investments to curb this trend.

Many voices call for more efforts to find a vaccine.

The existing vaccine, BCG, is now centuries-old and “completely ineffective in adults,” said Lucica Ditiu, director of the Geneva-based Stop TB alliance. “Covid gave rise to research and funding to obtain a new vaccine in 10 months. We should not expect anything less for tuberculosis,” he said.

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