Responding to COVID-19: adjusting TB services in a low-burden setting

Efforts to eliminate tuberculosis as a public health problem require reductions in mortality, incidence, and the eradication of associated catastrophic costs; however, the question of catastrophic costs is often neglected, particularly in the context of low-incidence settings like Australia. This study reviews the financial support provided to those identified as in need, and in receipt, of economic aid from the Victorian Tuberculosis Program. The study design used Epstein’s clinical data mining framework to produce descriptive statistics which were supplemented by clinical collaboration. A consistent one-third of those receiving care from the Program due to a notification of active tuberculosis received emergency financial relief over the study period. Overwhelmingly, funds were used to relieve financial distress, and each year approximately one-third of the expenditure was used to support 2% of those people notified as affected by tuberculosis (or 7–9% of those in receipt of funds). Many of this 2% experienced income loss and expenditure that may be considered catastrophic. Further investigation is needed to better define and understand the nature of catastrophic costs in the context of universal health care and existing low tuberculosis incidence.

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