A team from the University of Ottawa (uOttawa) is leading a collaborative study about the “catastrophic costs” of tuberculosis (TB) care, citing U.S. government cuts for foreign aid to prevent the disease. The international study “is a systematic review to help inform decisions on patient burden and cost-effective care of tuberculosis,” the university said in a news release Wednesday. The university’s Faculty of Medicine team says evidence suggests that costs to treat the illness can be high, though many countries offer free treatment. “These are uniquely challenging times in the fight against the enduring and accelerating scourge of tuberculosis,” reads the release. “The COVID-19 pandemic caused a serious setback in TB progress as health resources were diverted. The slashing of foreign aid by the U.S. government, which had largely propped up international TB prevention and treatment efforts, threatens to hobble access to care for this chronic disease and provide new chances for TB to propagate and spread drug resistance.” Sixty-seven studies were conducted in low or middle-income countries as part of the collaboration. The results suggest that the average total cost of TB care is a mean of $3,617 for drug-resistant tuberculosis patients, and a mean of $1,083 for drug-sensitive tuberculosis patients. The study suggests that the world’s most vulnerable are more at risk, noting that the average total cost to treat the illness is around 80 per cent of the household’s monthly income in many parts of the world. Improving access to drug resistance testing and implementing more active case finding approaches could significantly reduce the catastrophic costs across the world, according to the leader of the study, Dr. Alice Zwerling, senior author and associate professor at the School of Epidemiology and Public Health at uOttawa. “As services are further withdrawn due to funding challenges in the current political climate, these pathways will only become more lengthy, convoluted and costly for TB patients seeking care, likely leading to more delayed diagnosis and treatment, ongoing community transmission and negative societal economic impacts,” she said. Historically, TB was known as a disease of poverty, reads the release. It is transferred by air, and caused by bacterium, mycobacterium tuberculosis, that affects the lungs. It is transferred when people sneeze or cough. In Canada, the rate of active tuberculosis is among the lowest in the world. Canada experienced a steady decrease in the rate of TB between the 1940s and 1980s. The annual rates have remained about the same since then. The rate of active TB cases in Canada was 5.1 per 100,000 population in 2022. The rates were highest among Inuit (136.7 per 100,000), First Nations (21.4 per 100,000) and people born outside of Canada (14.4 per 100,000).
