Bangladesh faces TB risks amid USAID funding cuts

Infographic: TBS

Bangladesh's fight against tuberculosis faces significant challenges following funding cuts by USAID, impacting crucial research and treatment programmes.

Under USAID funding, the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) had been running approximately eight projects under which active tuberculosis or TB cases were identified and screened.

Currently, all of these projects have been halted, and the staff working on them have been laid off. 

With the support of USAID, the private development organisation BRAC had also been running a TB research project. However, the project was halted in January. 

Dr Farhana Nishat Seheli, lead, technical, Communicable Disease of the BRAC Health Programme, told TBS that since January, the research project funded by USAID has been closed. 

"Although no significant impact has been observed in the first two months," she said.

In 2021, with the support of USAID, the country's first one-stop tuberculosis (TB) service centre was inaugurated at Shyamoli in Dhaka. At this One-Stop TB Centre, funded by USAID, a doctor was providing treatment, particularly for patients suffering from MDR-TB (Multi-Drug Resistant Tuberculosis). 

However, with the cessation of funding, the doctor has to be removed, as confirmed by Dr Ayesha Akter, deputy director of Shyamoli 250-bed TB Hospital.

Dr Ayesha said, "At our hospital, the One-Stop TB Service Centre continues to provide care for TB patients. To ensure uninterrupted service, we have trained our doctors to enhance their skills, and they are now delivering comprehensive care. Currently, we have 21 patients admitted to our hospital, of whom 5 are suffering from drug-resistant tuberculosis (MDR-TB)."

In 2010, the estimated death rate from tuberculosis in Bangladesh was 54 per one lakh people, but by 2022, the figure had decreased to 25 per one lakh. 

Experts believe that to achieve the target of eliminating tuberculosis by 2035, it is crucial to identify and bring into treatment those patients who are currently untreated or undiagnosed. 

In light of these circumstances, today (March 24) World Tuberculosis Day is being observed. This year, its theme is "Yes! We Can End TB: Commit, Invest, Deliver."

In 2024, Bangladesh's National Tuberculosis Control Programme identified 3,13,624 tuberculosis patients. However, only 83% of these have received treatment, leaving approximately 17% untreated. 

The patients who remain untreated are spreading the tuberculosis bacteria, creating a risk of further increasing the number of cases, experts say.

The World Health Organization (WHO) said abrupt funding cuts of USAID threaten the achievements of tuberculosis control programmes around the world, putting millions – especially the most vulnerable – at grave risk.

"Any disruption to TB services — whether financial, political or operational — can have devastating and often fatal consequences for millions worldwide," said Dr Tereza Kasaeva, director of WHO's Global Programme on TB and Lung Health.

In 2024, Bangladesh received $500 million in foreign assistance. This year, that amount has cratered to $71 million. To put that number into context, in the three years from 2021-2023, USAID committed an average of $83 million annually in Bangladesh for health initiatives alone, including combating TB, reports BBC. 

Dr Ahmed Parvez Zabeen, divisional TB expert of the National Tuberculosis Control Programme, DGHS, however, said, "Since Bangladesh's infrastructure is strong, the withdrawal of USAID funds will not have as much of an impact as it has had in African countries. Our disease diagnosis and treatment will not be significantly affected. We will continue to receive around 3 lakh patients annually." 

He further said, "Since the Global Fund is a major donor for treatment, there should not be a major problem. While it would have been better if their assistance continued, they did play a role in raising awareness. 

"In this area, there will be a shortfall, and the government will need to step up its efforts to engage people more effectively."

 Prof Dr Muzaherul Huq, former regional adviser (South-East Asia Region) at the WHO and member of the Health Sector Reform Commission, said, "We have achieved success in the TB control programme. USAID's funding primarily focused on providing services to MDR-TB patients. The government has the capability to keep this under control. 

"However, if any issues arise, the government will need to address them. As long as the supply of medicine is ensured, we shouldn't face significant problems."