Women Indian Community health volunteers line up to deliver samples for tuberculosis screening

Community-health volunteers in India prepare to take tuberculosis samples to microscopy centres. Worldwide, an additional 500,000 people may have died from the disease in 2020.Credit: Sanjay Baid/EPA-EFE/Shutterstock

This month, the world passed a devastating milestone, with three million deaths attributed to COVID-19. As the World Health Organization (WHO) has reported, globally, the pandemic remains on a steep upward curve.

Although vaccines have been developed in record time, more than 10,000 people are dying each day — around one-third of whom are in Brazil or India. And, as we report in a Feature this week, deaths from other infectious diseases are likely to rise, because diagnosis and treatment of these diseases has suffered as COVID-19 has been prioritized.

The greatest impact seems to have been on tuberculosis (TB), with the number of people having treatment down by more than one million. Partly as a result, an extra 500,000 people might have died from TB last year, in addition to the 1.4 million who die from it annually. Scientists say that this has set back TB treatment efforts by at least a decade.

Measles cases worldwide were already on the rise before the pandemic, with some 210,000 people, mostly young children, dying annually. A year ago, many countries suspended measles immunization campaigns in response to guidance from the WHO to prioritize COVID-19 — and in 24 countries, these have still not resumed.

It is hard to predict when non-COVID immunization might return to pre-pandemic levels. Companies in India normally produce around 60% of the world’s vaccines, according to the Centre for Science and Environment in New Delhi, but supplies are being interrupted as India concentrates on producing vaccines against COVID-19.

At present, recorded measles cases worldwide are low — in 2020, there were just 89,000, compared with 870,000 in 2019. Researchers say this is down to a combination of factors, including reduced surveillance and the effects of lockdowns, which have limited the disease’s spread. But they are concerned that cases will surge among unvaccinated children once restrictions are eased.

Many lives could have been saved had national leaders taken earlier action on the three essential tools for managing a pandemic: competence in testing, tracing and isolating infected people and their contacts; limiting gatherings and enforcing social distancing; and, when necessary, mandating lockdowns. Many leaders rejected some or all of these measures. Some doubted the dangers of the virus.

There needs to be renewed urgency in ending the pandemic, but we must not lose sight of other diseases. That means continuing with all essential public-health interventions, and it also means vaccine equity — getting vaccines out, especially to the most vulnerable, as fast as possible.

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