The evolution of tuberculosis in Spain. Ten innovations in Barcelona and the great impact of COVID-19. Lecture, 26 January 2023

On a global scale, tuberculosis has been and continues to be a pandemic that in 2021 has still caused more than 10 million cases and more than 1.6 million deaths. In Spain in the first half of the 20th century, it was causing more than 50,000 deaths per year. With the new anti-tuberculosis treatments and other prevention and control measures and the socio-economic improvements, the situation improved only to worsen in the 80s of the last century due to the epidemic of heroin addicts and those infected with HIV. This situation prompted the development of the Barcelona tuberculosis Prevention and Control Program, which has been maintained until the arrival of the COVID-19 pandemic. In these years, innovations have been developed in terms of the epidemiological surveillance, research with relevant clinical trials, improvements in contact studies and adherence to long-term anti-tuberculosis treatments. Unfortunately, the COVID-19 pandemic had a great impact on the epidemiology of tuberculosis as well as other infectious and chronic diseases. In general, there has been under-detection and under-reporting of cases due to the avalanche of the cases generated in each epidemic wave and overwhelming the health system, which was detecting the most advanced cases above all. It is proposed to establish strong synergies between all the actors involved in the control of both infections to improve the current epidemiological situation.