Each year, World Tuberculosis (TB) Day is commemorated on March 24. This is done to raise awareness with an emphasis on health and the social and economic consequences of TB. The main goal is to end the TB epidemic. According to the World Health Organisation (WHO), over 4,100 people lose their lives to TB, and close to 28,000 people fall ill with this preventable and curable disease each day.
The COVID-19 pandemic has reversed the progress made over the years in the fight to end TB. TB-related deaths have been on the rise since 2020. The theme for World TB Day 2022 is, Invest to End TB. Save Lives. The theme emphasises the urgent need to invest resources to fast track the fight against TB and achieve the commitments made by global leaders to end TB.
In 2010, at the initiation of the TB community, a partnership was formed between the World Health Organization Stop TB Program, the Worldwide Hospice Palliative Care Alliance (WHPCA), and the Open Society Foundation’s International Palliative Care Initiative to explore how to improve the ability of TB professionals to deliver palliative care (PC) to their patients. Palliative care is critical when drug-resistant TB treatment has failed. When all treatment options have been exhausted, it can be particularly challenging to the people infected and their families.
The three important considerations in suspending and changing anti-TB therapy to palliative care are the patient’s quality of life, the public health interest, and the model of care available to provide end-of-life care and proper TB infection control to patients who have no effective treatment alternatives. Patients with drug-resistant TB have a high prevalence of symptoms; hence, staff caring for these patients should have some familiarity with palliative care, so that general palliative care principles are available to all patients.
Palliative care aims to relieve suffering in all stages of the disease. WHO has identified drug-resistant TB as one of the most common conditions requiring palliative care for adults. Breathlessness, pain, and worry, as well as the need for psychological advice and social support, are some of the most burdensome palliative care problems experienced by patients with drug-resistant TB. The timely identification, and addressing, of adverse events occurring during the treatment course, is considered as general palliative care for those receiving curative treatment. Any patient for whom the decision is taken to discontinue treatment should be eligible to receive specialized palliative care services.
Some challenges lead to non-adherence to TB medication and these challenges are common in low and middle-income countries. Some of the challenges are quality of health services, financial constraints, lacking social support and difficulty in accessing health facilities. They are complex and dynamic because they are affected by multiple factors. Some steps have been taken to improve the situation such advocating for free TB treatment in some of the most affected regions in the world. There is still more that needs to be done to be done to win the fight against TB.
The TB and palliative care communities can benefit from each other’s expertise to improve care. There are resources available to advance palliative care for TB patients until all patients are cured of TB. Patients should be more compliant with treatment because TB has been proven to be curable if patients adhere to effective anti-tuberculosis therapy and treatment. The spread of Tb can also be prevented in the communities by good general hygiene and also respiratory and cough etiquette.