On the ground in Moldova: how the country fights tuberculosis. The country continues to grapple with high tuberculosis rates, but joining the EU could help fight the disease, reports Julia Kaiser from Moldova, where she travelled with The Global Fund
Olga with three of her five children in her home. Photo by Vincent Becker
By Julia Kaiser
Julia is a journalist at The Parliament Magazine in Brussels
07 Dec 2023
If Olga had waited just a little longer before seeking help, she would probably not be alive. Battling tuberculosis (TB) was a traumatising experience, she recalls, something she does not wish on anyone.
The 41-year-old is standing in the living room of her house in Bălți, Moldova’s second largest city. A music programme is playing on the tube TV, and her children are gathering around her, including her eldest daughter and granddaughter who have come to visit. Here, the family sleeps – there is a crib for the toddler, a bed for Olga and her younger daughter, and padded chairs for the two boys.
When she got sick about three years ago, her youngest was only four months old. Her greatest concern at the time: that the treatment wouldn’t work and her children, now aged between three and 21 years, would be alone, the single mother recalls. Back then, Olga was employed at a car wash – a job that requires working outside. Now she has recovered, she doesn’t want to return, too great is the fear of a relapse caused by the harsh working conditions.
Other employers, she says, don’t want to hire her – due to the stigma that comes with TB. “When people know about your disease, they keep their distance, or they ask you to put a mask on your face,” she says. The kindergarten teachers have told her that they don’t want to see her there – even if she has a certificate confirming her recovery.
Olga’s experience is unlikely to be unique. In 2021, Moldova recorded the highest TB incidence in Europe. According to data from the World Health Organisation (WHO), the country counted 84 cases per 100,000 in 2021. In the European Union/European Economic Area, there were 8.4 cases per 100,000 in comparison, with most cases (45) occurring in Romania, and the fewest (2.8) in Slovakia. The situation in Moldova, however, improved in 2022, when the incidence fell to 74.
To this day, TB is one of the leading causes of deaths by an infectious disease worldwide. Globally, about seven and a half million people were newly diagnosed in 2022 – the highest number since the WHO began global TB monitoring in 1995. “It’s the pandemic we don’t talk about,” says Peter Sands, executive director of The Global Fund.
The infectious disease mostly affects the poor and the marginalised, such as people living in slums, refugees, prisoners or sex workers. The reasons are, according to Sands, reduced access to healthcare services, living in close proximity to other people, and malnutrition. Plus, the Covid-19 pandemic has worsened the situation as it led to fewer people being diagnosed and treated. country fights tuberculosis
TB is transmitted through the air when those who are ill with the disease cough, sneeze or spit. But infection does not equal disease. When the immune system stops the bacteria from growing, TB can live for many years in the body without making the infected person sick. Those with a so-called latent TB infection cannot spread it and don’t have any symptoms.
Patients get TB disease when the body can’t fight the bacteria. Factors such as diabetes, malnourishment and a weakened immune system can increase a person’s risk. Therefore, those who are HIV-positive are about 16 times more likely to fall ill with TB disease; it is the leading cause of death among HIV patients.