State rolls out ambitious plan to eradicate TB
By George.Kebaso, January 23, 2024The Ministry of Health yesterday rolled out an ambitious plan to eradicate Tuberculosis (TB) by 2030 in a new five-year strategy.
The roll-out follows disturbing statistics showing the disease killing more people than HIV/Aids and malaria combined.
If the 2022 data is anything to go by, then the country faces an uphill task to achieve these targets in the timeframe announced by Public Health and Professional Standards Principal Secretary, Mary Muthoni at Afya House.
An estimated 10.6 million people (9.9–11 million) fell ill with TB across the globe, including 5.8 million men, 3.5 million women and 1.3 million children according to the World Health Organisation two years ago.
In 2022, Kenya reported a total of 90,560 Drug-Sensitive Tuberculosis (DSTB) cases, where 8.3 percent were previously treated. This represented a 16.6 percent increase compared to 77,854 notified DSTB patients in 2021.
“Alarming as this figure is, it represents only 68 percent of the estimated 133,000 TB cases that were likely to emerge that year, leaving 32 percent undiagnosed and untreated,” the PS said before unveiling the National Strategic Plan for Tuberculosis, Leprosy and Lung Health (NSP), which she considers revolutionary in meeting the targets.
Drug-resistant TB
However, Muthoni regretted the emergence of drug-resistant TB cases, totalling 756 last year, highlights the urgent need for a comprehensive and coordinated response.
“The strategic plan does not only acknowledge the existing challenges in TB control but also proposes practical interventions to address the root causes of these barriers,” she said, identifying partnership and accountability as the key pillars towards a united front in this battle.
The PS was instrumental that the plan provides a clear enumeration of barriers, costed interventions, and activities, positioning itself as a comprehensive guide for tackling TB in Kenya.
“Notably, the plan has been developed using a people-centred approach, reflecting a bottom-up strategy championed by the government, ensuring all stakeholders, including affected communities, play a crucial role in policy design and implementation,” she pointed out. Kenya is one of the 30 high TB burden countries globally, with an estimated incidence of 133,000 cases in 2021.
However, despite these challenges, Muthoni noted Kenya has demonstrated commendable progress, achieving a 32 percent decline in TB incidence and a 42 percent reduction in mortality between 2015 and 2020.
“The country has successfully met the 2020 End TB strategy milestones, guided by the National Strategic Plan for Tuberculosis, Leprosy, and Lung Health 2019-2023,” achievements the PS said, have been realized through structured collaboration with all stakeholders in the country.
Strategy milestone
According to the WHO Global TB Report, 2021 Kenya was one of the high TB burden countries that achieved WHO’s End TB Strategy milestone for 2020 with a 32 percent reduction in TB incidence compared to 2015, against a target of 20 percent. Further, the country also achieved a 44 percent reduction in the number of TB deaths compared to 2015, against a target of 35 percent.
“Despite these significant achievements, the country’s treatment coverage gap remains wide at nearly 50 percent of unreached people with TB in 2021,” she said.
Notably, there has been a downward trend with the estimated TB treatment coverage declining from a peak of 63 percent in 2018 to 59 percent in 2021 according to the WHO Global Report 2022.
Similarly, TB notifications have shown a declining trend from 96,478 in 2018 to 77,854 in 2021.
The decline could be attributed to the Covid-19 pandemic though the country has shown recovery from services disruption during the Covid-19 period. The number and proportion of children with TB reported in the country has also seen a declining trend from 10.1 percent in 2018 to 9.6 percent in 2021. According to the WHO Global Report 2022, under-nutrition; HIV, alcohol use disorders, smoking, and diabetes mellitus as the key drivers and social determinants of tuberculosis in Kenya.
“In 2020, approximately 35,000 people fell ill with TB and HIV and 12,000 people succumbed to the co-infection in Kenya,” according to the WHO in 2020 findings.
An estimated 24.8 percent of Kenyans were undernourished in 2018, with the prevalence of those experiencing moderate or severe food insecurity estimated to be 68.5 percent in 2020. Similarly, the number of children with wasting and stunting was estimated to be at 4.2 percent and 19.4 percent respectively.