Tuberculosis risk increases due to fund cut

The Tuberculosis burden in the country remains significant as the health department is still unable to detect 17 per cent of tuberculosis cases.

The suspension of support from the United States donor agency USAID has impacted tuberculosis detection efforts.

However, government officials have stated that they intend to continue the tuberculosis control programme without relying on foreign aid.

According to the World Health Organisation (WHO), Bangladesh is among the seven countries with a high prevalence of both common and drug-resistant tuberculosis.

The other countries on this list include Angola, South Korea, Mongolia, Pakistan, Papua New Guinea and Vietnam. Despite the long-term implementation of the national tuberculosis control programme, the situation has not improved.

The WHO 2024 Global Report indicates that 3, 79,000 people contract tuberculosis in Bangladesh each year. According to data from the National Tuberculosis Control Programme, shared with Prothom Alo yesterday Sunday, 3, 13,624 tuberculosis cases were identified across the country last year.

This means that 65,376 suspected cases, equivalent to 17 per cent, remain undiagnosed. These individuals are neither receiving treatment nor taking measures to prevent the spread of the disease.

In this context, World Tuberculosis Day is being observed today, Monday. This year’s theme for World Tuberculosis Day is ‘With commitment, investment and service, a tuberculosis-free Bangladesh is Achievable.’ To mark the occasion, the National Tuberculosis Control Programme has organised two separate seminars this morning, one at the National Institute of Diseases of the Chest and Hospital in Mohakhali and another at the BRAC Centre Inn.

Both the government and the non-government sources indicate that, for nearly two and a half decades, several NGOs including BRAC have been assisting the government in tuberculosis control efforts. The International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) has also contributed to government programmes.

However, the United States government’s decision to scale down USAID operations globally, including in Bangladesh, has had a sudden and significant impact on tuberculosis control initiatives. As a result, icddr,b has discontinued its USAID funded tuberculosis control programme and has laid off approximately 1000 officers and staff members.

According to government and private sources, icddr,b previously supported the government in detecting tuberculosis cases at healthcare centres and within communities. It also played a crucial role in diagnosing tuberculosis in children.

Additionally, the organisation assisted in the management of drug-resistant tuberculosis patients at tuberculosis hospitals in Shyamoli, as well as at chest disease hospitals in Faujdarhat (Chattogram), Sylhet, Rajshahi and Khulna. Icddr,b had assigned one medical officer to each of these hospitals. However, these operations have now ceased.

Currently, 17 per cent of tuberculosis cases remain undiagnosed, while non-governmental support for detection has been withdrawn. This situation poses a significant risk of further deterioration in tuberculosis control efforts.

General Secretary of Bangladesh Lung Foundation, Professor Asif Mahmud Mujtafa told Prothom Alo, “The suspension of USAID funding will have a direct impact on the tuberculosis control prgramme. The health ministry must ensure the optimal utilisation of government infrastructure and human resources while also increasing budget allocations for tuberculosis management. If these measures are not taken to reaffirm the state’s commitment, the tuberculosis control programme will collapse.”

Since the World Health Organisation (WHO) declared tuberculosis a global public health emergency in 1993, the Bangladesh government has been working alongside non-governmental organisations to control the disease.

In Bangladesh, tuberculosis diagnosis, medication and treatment are provided free of charge to all citizens, with foreign aid playing a crucial role in sustaining these services. The withdrawal of USAID support has disrupted tuberculosis programmes in Bangladesh and several other countries.

Speaking to Porthom Alo yesterday, Sunday, the acting line director of the National Tuberculosis Control Programme, Zubaida Nasreen stated, “The discontinuation of support from non-governmental organisations initially posed some challenges. However, we have swiftly managed the situation by training government physicians to handle drug-resistant tuberculosis cases.”