Tuberculosis (TB) is the world’s leading infectious cause of death, apart from COVID-19. TB has claimed more lives than any other infectious disease in the last decade: according to TBAlliance.org,10 million people contracted TB and 1.4 million people died in 2020 alone.
With research, time, and efforts spent on stopping the spread of COVID-19, TB has continued to take its toll in underserved countries across the globe. TB Workplace programs may yield a solution to curb the spread.
Despite numerous scientific advances made to diagnose and treat TB, its devastating impact still remains, straining economies and increasing global inequity.
While the world has been focusing on combating the COVID-19 pandemic, other crises continue to surge. With research, time, and efforts spent on stopping the spread of COVID-19, TB has continued to take its toll in underserved countries across the globe.
World TB Day on March 24 commemorates the discovery of the bacteria that causes TB. Now is the time to renew our commitment to combatting TB. As part of World TB day, PRA, along with multiple industry partners, is promoting TB education initiatives in the workplace. Read on for information about TB’s disproportionate prevalence worldwide and ways we can all implement awareness regimens in our workplaces and communities.
What is TB?
TB is an airborne disease caused by the Mycobacterium tuberculosis bacteria. It’s preventable, curable, and treatable. While not as prevalent in the United States or Europe, it’s extremely prevalent in other countries.
Adding to the challenge is drug-resistant TB and the widespread latency of TB. Drug-resistant TB occurs when bacteria are able to withstand typical TB treatments, meaning that TB drugs cannot kill the TB bacteria. Twenty-three percent of the world’s population—billions of people—are latently infected with TB, which means they carry the TB bacteria but do not become sick. This presents a dangerous amount of potential reactivation TB, making it easier to spread to other people. These different forms of TB are contributing to a growing health crisis.
TB needs a combination of drugs to treat. Different combinations of drugs are required for different variations of TB, so it's hard to single out a particular drug for specific reference. TB is most effectively treated using the Bacille Calmette Guérin (BCG) vaccine, but even that existing vaccine is not sufficient enough to ensure widespread immunity.
“The TB vaccine is just one of those vaccines that’s complicated to address. The good news is that right now, there are clinical trials that aim to improve the overall efficacy of the vaccine,” says Darin Seehafer, Director of Therapeutic Expertise at PRA.
The demand is growing for new technologies and research to jumpstart the global TB vaccine pipeline in years to come. Thankfully, a multitude of treatments are on the horizon, such as Johnson & Johnson’s medicine for pulmonary MDR-TB, which was granted accelerated approval by the US FDA. This medicine was the first targeted TB drug with a novel mechanism of action to be approved in more than 40 years.
TB’s Disproportionate Prevalence
Anyone can get TB, but it disproportionately occurs in certain populations more than others. According to the Center for Disease Control, the adverse effects of TB are historically the most serious for racial and ethnic groups who already experience health obstacles based on their race or ethnicity alone. This is why there are such high case numbers of TB in Hispanic, Latino, Black, and Asian populations.
Many other factors contribute to the disparities in TB infection rates, including pre-existing medical conditions, geographic location, age, housing, and incarceration.
People in high-burden areas are most at risk during peak productivity period of 15-54 years of age. Without proper treatment, employees with TB may lose three to four months of productivity, while effective diagnosis and treatment can decrease this to two to three weeks.
Data courtesy of Ending Workplace TB (EWTB) shows examples of places that have a high incidence of TB and PRA employees: China, India, the Philippines, and Thailand. Each of these countries are on the World Health Organization’s (WHO) list of “High TB Burden Countries.” For reference, PRA has 566 employees in China, 264 in India, 69 in the Philippines, and 62 in Thailand.
- Total number of TB cases: 833,000 (3rd)
- Rates of TB: 58 per 100,000 (89th)
- Total deaths from TB: 33,000 (8th)
- Estimated number of cases not formally diagnosed and treated by official health centers: 13% (108,000) (joint 112th)
- Total number of TB cases: 2.64m (1st)
- Rates of TB: 193 per 100,000 (39th)
- Total deaths from TB: 445,000 (1st)
- Estimated number of cases not formally diagnosed and treated by official health centers: 18% (475,000) (joint 106th)
- Total number of TB cases: 599,000 (4th)
- Rates of TB: 554 per 100,000 (3rd)
- Total deaths from TB: 28,000 (11th)
- Estimated number of cases not formally diagnosed and treated by official health centers: 32% (192,000) (joint 33rd)
- Total number of TB cases: 105,000 (18th)
- Rates of TB: 150 per 100,000 (50th)
- Total deaths from TB: 11,500 (23rd)
- Estimated number of cases not formally diagnosed and treated by official health centers: 16% (16,800) (109th)
Organizations worldwide, like PRA and Johnson & Johnson, are working to address health disparities in TB through a number of important initiatives. EWTB is one such initiative that provides partner companies with resources and technical support to help them strengthen their workplace health offerings.
What are TB Workplace Programs and Why Do We Need Them?
Employees, companies, and communities alike can all benefit from workplace TB programs. A workplace TB program is an initiative enacted in the workplace to encourage measures to stop the spread of TB.
Organizations like EWTB provide partner companies with resources and technical support to help them strengthen their workplace health offerings, focusing on measures that will increase resilience and productivity. Implementing a workplace TB program can protect workers and their families, as well as safeguard against other respiratory diseases.
The elements for a successful workplace TB program are simple to implement. These include:
- Providing a healthy working environment: protects workers from dust and overcrowding, as well as gives them access to fresh air and light.
- Checking new hires for TB: prevents the disease from being introduced to the workplace.
- Offering sick leave and medical coverage: supports employees when they are treated for any illness.
- Offering information about TB in wellness programs: spreading information about TB can help raise awareness of TB and how to prevent it.
PRA is working hard to raise awareness about the prevalence of diseases like TB in the workplace by implementing the elements above.
“People always come first at PRA,” says Nicole Duffey, SVP, Strategic Solutions Division and PRA’s champion of the Ending Workplace TB initiative. “We were thrilled to accept Johnson & Johnson’s invitation to be one of the first members of the EWTB initiative. PRA’s chief consideration is ensuring that all of us feel safe and secure in our working environment. Our commitment to stopping the spread of TB is a paramount, human-centric commitment.”
People always come first at PRA. We were thrilled to accept Johnson & Johnson’s invitation to be one of the first members of the EWTB initiative. PRA’s chief consideration is ensuring that all of us feel safe and secure in our working environment. Our commitment to stopping the spread of TB is a paramount, human-centric commitment.
Nicole Duffey, SVP, Strategic Solutions Division
As a recent example of this commitment, following a reported TB case with one of our colleagues in China last year, PRA took a positive and proactive approach in customizing our health checks within our local health benefits offering. We added an onboarding health checkup to all new hires in PRA China from August 2020. This was in addition to the established annual health checkups that those colleagues in China already receive.
Speaking about the case, Quanje Wei, Executive Director and Head, China – Strategic Solutions Division said, “This is a clear demonstration of PRA’s dedication to the health, safety, and well-being of our employees and our sponsor’s employees."
From our office in Bangalore, Nagalakshmi Shetty, Vice President, India Operations echoed those thoughts: “At PRA, we foster a culture of open communication between managers and employees. We ensure that every employee can freely share health concerns related to TB and indeed other diseases.”
Thankfully, we also have expertise in-house at PRA’s Center for Vaccine Research, which can help guide us and provide further insight on TB. In a recent interview with PRA experts from the Center for Vaccine Research and physicians from the University of Siena’s Master’s in Virology Program, experts listed several methods they are studying to increase TB awareness.
The experts, led by Lynlee Burton, stressed the importance of spreading information about certain immunization programs and testing for TB that can yield accurate results. They also highly emphasized using proper precautions—including similar precautions to preventing COVID-19—in order to stop the spread of TB.
These precautions can be as complex as immunization programs and testing, but the TB spread can be halted on an individual level. Simple methods like covering your mouth when you sneeze or cough and washing your hands thoroughly can make all the difference.
Nicole Duffey, Senior Vice President and General Manager – Strategic Solutions speaks about ending workplace TB and reducing stigma associated with the disease. Video curtesy of J&J.
Through a multitude of efforts, workplaces and communities can do their part to stop the transmission of TB. PRA Health Sciences is committed to improving health for our people and communities. We’re joining the fight to end TB.
This article is part of a joint alliance initiative with the following partners:
- Ending Workplace TB
- Johnson & Johnson
- The World Economic Forum
- The Global Fund to Fight AIDS, Tuberculosis, and Malaria
- The Stop TB Partnership
- Fullerton Health
- Royal Philips
- The Confederation of Indian Industry
- The US Agency for International Development
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