Protecting Global Gains: Innovation pays dividends against COVID-19 & TB in Karachi

February 11, 2021

The latest edition of Protecting Global Gains profiles how Karachi, the Pakistani mega-city of over 20 million people, took on the dual-threat of COVID-19 and tuberculosis (TB) by fitting mobile radiology vans with chest X-ray machines capable of screening for both infections, and adapting programs to support safer outreach.

Numerous predictive models quantify the devastating impact of COVID-19 on TB programming, including one that estimates TB-related mortality will increase by 20 percent in the next five years. Innovation pays dividends against COVID-19 and TB. This update from Karachi explores how public health leaders in the city are deploying infrastructure and expertise—honed from decades of TB programming—to tackle COVID-19 and safeguard valuable declines in TB incidence.

When Pakistan braced for a wave of COVID-19 infections in March 2020, the government shut down 12 mobile radiology vans that were offering TB screening in Karachi as part of the Zero TB Initiative-Karachi (ZTBI-Karachi), led by the Indus Health Network (IHN). But the shutdown contributed to a staggering 80 percent drop in TB detection. IHN sprang into action, developing methods and technology so the vans could get back on the roads and into the communities. The COVID-ready program offered simultaneous screening for TB and COVID-19 while following all infection-control protocols to minimize the risk of transmission. The innovation and adaptability reversed dangerous declines in TB case notification, almost bringing numbers back to pre-COVID levels, and continued connecting people at risk of TB or COVID-19 to prevention and treatment across the city.

This story from Karachi demonstrates one case where policymakers refused to choose between safeguarding global health gains or keeping down cases of COVID-19; with the right innovation and approach, both can be done. Other case studies, highlighted on the PGG website, show how health services rooted in community-centered, client-focused strategies are especially resilient, quickly solving problems, sustaining effective care, minimizing disruptions from the impact of COVID-19 and protecting lives.

Follow the Protecting Global Gains series on social media at @hivpxresearch, @theglobalfight, @Amref_Worldwide and #ProtectingGlobalGains, and consider amplifying these stories on your own social media. Advocates can call for national and international action to support the Global Fund’s COVID-19 response and for continued investment to end the TB epidemic. Visit to learn more about how to take action.