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World TB Day: Investing to end TB saves lives and can even help defeat meningitis

It is World Tuberculosis (TB) Day and we want to jump on the campaign to raise awareness about the devastating impacts that diseases like TB and meningitis have on our health, our communities and our economy.

As much as they are different, TB and meningitis are also relatively similar in terms of how they can affect you. For example, they can both be fatal. WHO estimates that in 2020, 1,500,000 people died from TB and, in the same year, meningitis estimates indicate that it killed more than 460,000 people. Yet, despite the high disease burden, they are both largely vaccine preventable. TB is an infection caused by bacteria (mycobacterium tuberculosis) and most commonly affects the lungs. In some cases, however, the bacteria can invade the membranes and fluid surrounding the brain and spinal cord, leading to TB meningitis. TB meningitis is a type of bacterial meningitis, which is a very serious disease that can be potentially fatal if not treated in time.

The theme of World TB Day 2022 is ‘Invest to End TB. Save Lives.’ At CoMO, we are already committed to defeating meningitis by 2030, but that doesn’t mean to say we don’t have a common goal here. While we have different objectives and methods, it’s obvious that meningitis and TB advocates share one major objective: we want to save lives.

So, how do we save lives?

Well, firstly, we can raise awareness about and advocate for vaccination against these diseases. Vaccines are a sure-fire way to reduce the impact of diseases like meningitis and TB. The most common causes of bacterial meningitis are predominantly vaccine preventable. We recently posted about the work of Dr. Sara Branham, whose research was fundamental in developing treatment for meningococcal meningitis. It points out how bacterial meningitis was essentially considered a death sentence; the ‘incurable disease.’ Nearly 100 years later we have developed ways to treat and vaccinate against a variety of strains of bacterial meningitis, including TB meningitis. For example, the BCG vaccine offers 75% protection in a UK setting. As this isn’t 100%, it remains absolutely necessary to know the signs and symptoms of diseases like TB and meningitis; both are treatable and survival rates are much higher when these diseases are caught early. So, although bacterial meningitis remains the cause of more than approximately 300,000 deaths around the world per year, it is no longer thought of as the ‘incurable disease’ that it once was. Not only is this thanks to ongoing research into treating and vaccinating against the disease, it is also thanks to advocacy for and implementation of routine vaccination.

It can take a lot to get a new vaccine added to immunisation calendars. One of our members in Spain has only just recently managed to advocate for the inclusion of the MenB vaccine in Catalonia’s vaccination calendar, citing how children born in different regions should all be protected from meningitis. While this certainly calls for a huge congratulations to Asociación Española contra la Meningitis (AEM) and to the Catalonian regional government for implementing the vaccine, it also highlights that the autonomous regions in Spain offering routine MenB vaccines form part of a minority. This evidences the continuing need for vaccination advocacy in Europe, let alone in the communities that are more likely to experience meningitis epidemics, such as those lying on the meningitis belt in Africa. It shouldn’t matter where you’re born, we all deserve to be protected against meningitis regardless.

Even if we aren’t patient advocates or organisations campaigning for vaccination against meningitis, we can still work to prevent the preventable. Thanks to the pandemic, many routine immunisations were put on hold. As society gradually opens up again and we go back to hugging and kissing our relatives and loved ones, making sure we’ve all had our necessary shots is crucial to reducing the spread of infectious diseases like meningitis. This is particularly relevant when considering that:

‘The UKHSA (UK Health Security Agency) data begins to confirm the dangers of a post-lockdown infectious disease rebound, something leading charities, led by the Meningitis Research Foundation, warned of in December 2021, following reports of cases in universities, including the University of Exeter.’

It is important to highlight that this is in the UK but we have unfortunately seen an increase in meningitis cases following lockdown, predicted by local meningitis charities and now confirmed by the UKHSA. With that in mind, it’s all well and good that advocates succeed in implementing routine vaccines against meningitis, but we all have a role to play to ensure that our communities are protected against meningitis.

How else can we save lives?

It takes time to create the change we want to see on a policy level, so, in the meantime, we can raise awareness within our communities about signs, symptoms, prevention and treatment of diseases like meningitis and TB. Knowing the signs and symptoms of these diseases is, in many cases, the difference between life and death. Although catching the signs of meningitis early might not always mean that you come out of it entirely unaffected, it can help save a life. This is pretty significant when we think about how 10-20% of people affected by bacterial meningitis die within 24-48 hours. What would the statistics be if we all knew more about the signs of meningitis? Raising awareness about the disease itself is a definite way to save lives.

What else?

Offering support to individuals and families affected by meningitis can mean the difference between struggling to adapt to life after meningitis and establishing a new way of life within a supportive community. Losing a limb, losing a loved one, losing a way of life; these are hard things to deal with, alone or not, so having a supportive community of people who can empathise, saves lives. You can find a CoMO member in your country to join such a community.

The necessity of a supportive network is similarly evident when considering the recovery process for TB meningitis:

‘Treatment generally lasts for about a year, involving intensive treatment with three or four antibiotics at first and continually with two antibiotics for about 10 more months. TB meningitis tends to be more severe than other forms of meningitis. Although 70 - 85% of those affected will survive, up to one quarter of those may have long-term after effects.

And this doesn’t even take into consideration the need for any psychological, emotional or social support, this simply refers to the practical requirements of overcoming TB meningitis.

We want to live in a world where there are neither, 300,000 deaths or more per year globally because of bacterial meningitis, nor months upon months of recovery and multiple courses of antibiotics because of TB meningitis. The ways to save lives mentioned in this blog post are not mutually exclusive and the list certainly isn’t exhaustive, but they are significant; according to WHO, since 2000, 66,000,000 lives were saved by global efforts to end TB. This is an incredible feat, but they go on to note the pandemic’s negative impact on their progress:

"[…] the COVID-19 pandemic has reversed years of progress made in the fight to end TB. For the first time in over a decade, TB deaths increased in 2020."

The pandemic has blocked progress in a variety of sectors, but the reversal of saving lives means people are dying. This isn’t just the case for TB, efforts to combat meningitis have likewise been hampered in some regards; negatively impacting our ability to defeat it. You can help us save lives from infectious diseases like meningitis by becoming part of our community, following our social media or signing up to become a CoMO member. Together, we can #DefeatMeningitis by 2030.

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