Urgent need to integrate mental health services into TB programs

World TB Day is marked every 24th day of March through sharing of success stories and challenges faced in the elimination of TB. This year’s theme, “Yes! We can end TB!” draws attention to the disease and our collective power to eliminate it by 2030, a target set by the Sustainable Development Goals (SDGs).

As we mark World TB Day 2023, we at United for Global Mental Health wish to highlight the urgent need to address the intersection between TB and mental health. TB does not only cause physical disease, but there is also an elevated risk of depression, anxiety and psychosis among people with TB, including MDR-TB. Globally, depression among individuals with any form of TB could reach as high as 50% due to biological, social and behavioural factors. Depression is associated with delays in TB diagnosis, treatment, and poor treatment outcomes such as disability, poor quality of life, treatment failure and death. Evidence supports providing integrated mental health interventions within TB services to boost the rates of treatment completion. .

According to the World Health Organization (WHO), Mental Health Atlas 2020, levels of public expenditure on mental health are low with a global median of 2.1% of government health expenditure particularly in low- and middle-income countries.

According to UnitedGMH’s “Bending the Curve Report”, integrating mental health into TB care would have the following positive outcomes:

• Avoidance of as many as 14 million TB cases – more than the predicted number of cases for any year between now and 2030.

• Delivery of Faster progress towards global targets set against HIV and TB.

• Improvement of the quality of life for vulnerable groups.

• Better adherence to drugs and consequently better treatment outcomes.

• Addressing the long-term effects of the COVID-19 pandemic on those affected by TB and HIV.

These findings demonstrate why mental health services are a critical aspect of TB programs and the need to invest in addressing the mental health needs of people affected by TB.

Therefore on this World TB Day, we urge governments, health organisations, and other key stakeholders to prioritise the integration of mental health services into TB programs and to invest more in mental health services and resources. We also urge stakeholders to ensure that political declarations at the United Nations High Level Meeting on TB which will be held in September 2023 have strong messages which support integration of mental health into TB programs.

Together, we can work towards a world where no one is left behind in the fight against TB and mental illness.