Climate change poses an unprecedented and solely biggest threat to human health. It is adding to the emergence of new diseases and exacerbating existing ones. Tuberculosis (TB), for example, has been considered one of the climate-sensitive diseases, and climate change affects the pattern and burden of TB.

The evidence indicates that the links between climate change and TB are not direct, like 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. Therefore, this article attempted to explore the nature of the relationship between climate change and TB, focusing on Bangladesh and the potential actions 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.

In general, climate change can create a favorable environment where TB is more likely to be transmitted, develop, and disrupt TB diagnosis and treatment services. Climatic variables like temperature, precipitation, and humidity are associated with TB transmission by altering host factors. For example, rising temperatures might increase bacterial growth, making TB more likely to grow and spreading many possibilities happening in the Bangladesh context.

It is also found that changes in temperature and humidity may also 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 the TB burden.

One indirect but obvious factor is displacement due to climate change. It hinders healthcare for the displaced, which can negatively affect the management of treatment for those with TB because patients need to take treatment daily. 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.

Besides, 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 case increase, the country’s health system capacity, including access, equity, and cost, will also be threatened. The vulnerable people will suffer to get proper treatment to deal with the unavoidable consequences of TB.

It is evident that 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 fixed the target to eliminate the TB by 2035. Therefore, it is essential to understand the indirect but multidimensional relationship of climate change that has a significant effect on TB management to achieve the TB goal.

World Health Organization (WHO) reminds us that 10.6 million people fell ill with TB, whereas 1.3 million people died from TB in 2022. It is anticipated that the cost of climate change will worsen the scenario of TB happening in 2022 if we cannot take proper public health steps.

Every year, World TB Day is observed on March 24th and is targeted at raising public and political awareness of TB, a 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 created to deal with this complex issue. Only then can we believe and shout, “Yes! We can End TB”.

 

Monaemul Islam Sizear
Technical Advisor,
Health System for Tuberculosis, Open Development
And
Organizing Secretary, Public Health Foundation Bangladesh
Email: sizear.monaemul@gmail.com