Climate change means more tuberculosis in Bangladesh

Climate change poses an unprecedented threat to human health. Not only does it contribute to the emergence of new diseases but it also exacerbates existing ones. Tuberculosis (TB), for example, is considered a climate-sensitive disease, and climate change affects the pattern and burden of TB.

The evidence indicates that the links between climate change and TB are not direct, similar to malaria and dengue. There is a less established causal relationship between these two. Still, the impact of climate change on issues such as malnutrition, poverty, displacement and overcrowding can have a serious effect on increasing TB cases in densely populated countries like Bangladesh.

This article will attempt to explore the nature of the relationship between climate change and TB, focusing on Bangladesh and the potential actions we can take to deal with the emerging threat.

The latest report from the Intergovernmental Panel on Climate Change (IPCC) warned of the health impacts of global warming, particularly an increase in the incidence of infectious diseases like TB. The impact of extreme weather on TB is already being seen in some parts of the world, and Bangladesh is no exception.

Climate change is happening faster with more complex and intersecting impacts than we are prepared for. It is the defining crisis of our times. Strong public health systems and healthcare infrastructure are needed to mitigate the risks and impacts of climate change-related TB.

Tuberculosis Observation Day – 2024 (Sticker)

In general, climate change can create a favourable environment where TB is more likely to be transmitted, develop and disrupt TB diagnosis and treatment services. Climatic variables like temperature, precipitation and humidity can alter host factors. For example, rising temperatures might increase bacterial growth, making TB more likely to grow and spread further.

It was also found that changes in temperature and humidity may affect bacterial survival rates, ultimately leading to new strains that are more resistant to treatment for TB. Furthermore, climate change is expected to affect the pattern and distribution of TB.

One indirect but obvious factor is climate change-induced displacement. It hinders healthcare for the displaced which can negatively affect the management of daily treatment for those with TB. Most importantly, interruption of treatment can leave them infectious for longer and at risk of developing drug-resistant TB, which in turn is much more difficult and expensive to treat.

Both extreme droughts and flooding can impact food security, devastating crops and killing livestock and leading to malnutrition and undernutrition—known risk factors for TB. In Bangladesh, malnutrition remains the leading risk factor for TB, which might worsen the scenario.

Apart from these associations between climate change and TB cases, the country's health system capacity, including access, equity and cost, will also be threatened. Vulnerable people will struggle to get proper treatment and deal with the unavoidable consequences of TB.

Climate change is happening faster with more complex and intersecting impacts than we are prepared for. It is the defining crisis of our times. Strong public health systems and healthcare infrastructure are needed to mitigate the risks and impacts of climate change-related TB. Moreover, prevention efforts, early diagnosis and effective treatment are also crucial.

It is noted that ending the TB epidemic by 2030 is among the health targets of the United Nations Sustainable Development Goals (SDGs). Bangladesh is no exception and has also targeted to eliminate TB by 2035. Therefore, it is essential to understand the indirect but multidimensional relationship between climate change and its effect on TB management.

According to the World Health Organization (WHO), in 2022, 10.6 million people contracted TB and 1.3 million people died. It is anticipated that the cost of climate change will worsen the scenario of TB in the future unless we can take proper public health steps.

Every year, World TB Day is observed on 24 March to raise public and political awareness of this preventable and treatable disease. The theme "Yes! We can End TB" has been fixed this year. To turn the slogan into a reality, proper awareness regarding the association between climate change and TB among policymakers and TB professionals needs to be spread. Only then can we believe and shout, "Yes! We can End TB"

Monaemul Islam Sizear is a Technical Advisor at the Health System for TB. He is also the Organising Secretary at the Public Health Foundation Bangladesh. Email: sizear.monaemul@gmail.com

Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the opinions and views of The Business Standard.