About 85% of people who develop TB can be cured using a 4- to 6-month regimen. However, economic and financial barriers can affect access to health care to accurately diagnose TB and complete treatment. As a result, about half of people with TB and their households suffer catastrophic costs from TB disease. Although TB occurs worldwide, 30 countries bear the brunt. Therefore, progress on universal health coverage (UHC), multisectoral action on broader TB determinants, and better levels of social protection are essential to reduce the global burden of TB disease. Global tuberculosis report 2022. Image Credit: Kateryna Kon / Shutterstock
Tuberculosis and the COVID-19 pandemic
According to the World Health Organization, an estimated 10.6 million people contracted TB in 2021, a 4.5% increase from 2020, and 1.6 million people died from TB. In addition, the burden of drug-resistant tuberculosis (DR-TB) was observed to increase by 3% between 2020 and 2021. However, this is reportedly the first time that the number of people infected with drug-resistant TB has tuberculosis is increasing. Along with many healthcare services, TB services have also been disrupted due to the COVID-19 pandemic with serious consequences. In addition, ongoing conflicts in the Middle East, Africa and Eastern Europe have further worsened the situation for vulnerable populations. This resulted in a decrease in the number of people diagnosed with TB and an increase in the number of people who were not treated for TB. The number of people diagnosed with TB was seen to decline from 7.1 million in 2019 to 5.8 million in 2020. Although a partial recovery was seen in 2021, they were still significantly below pre-pandemic levels. This has led to an increase in the number of people developing TB, greater transmission in the community and an increase in TB deaths. In addition, the number of people treated for rifampicin-resistant tuberculosis (RR-TB) and multidrug-resistant tuberculosis (MDR-TB) was also observed to decrease between 2019 and 2020. The number of people reported to have started treatment for RR-TB in 2021 there were 161,746, about a third of the people in need of treatment. A new report published by the World Health Organization indicated a reduction in global spending on essential TB services from US$6 billion in 2019 to US$5.4 billion in 2021. Most of the funding used in 2021 came from domestic sources. However, in middle- and low-income countries, international financing remains essential. The main source of global funds is the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund), to which the United States government is the largest contributor. “If the pandemic has taught us anything, it’s that with solidarity, determination, innovation and judicious use of tools, we can overcome serious health threats. Let’s apply these lessons to TB. It’s time to stop this long-running killer. Working together , we can end tuberculosis.” Dr. Tedros Adhanom Ghebreyesus Director-General of the World Health Organization
Estimated tuberculosis incidence rates, 2021
Small achievements
Amid slow progress, there are few successes. About 26.3 million people were reported to have been treated for TB between 2018 and 2021 at the UN High-Level Summit on TB. Of the 30 countries with the highest burden, Bangladesh, Zambia, China, Brazil and Uganda were reported as the countries with the highest levels of treatment coverage in 2021. In addition, the number of people receiving preventive treatment for TB it was also reported to have rebounded in 2021, close to 2019 levels.
WHO End Tuberculosis Strategy: Milestones to 2025 In addition, more than 10 million people living with HIV were reported to have received preventive treatment for TB in the past 4 years. Kenya, Namibia, the United Republic of Tanzania, Lesotho, Zambia, South Africa and Ethiopia are reported to have surpassed the 2020 milestone with a 20% reduction in TB incidence compared to 2015. “The report provides important new evidence and makes a strong case for the need to join forces and urgently redouble efforts to get the TB response back on track to meet TB targets and save lives. It will be an essential resource for countries, partners and civil society in view of the second UN high-level meeting on TB to be held in 2023.” Dr Tereza Kasaeva Director of the WHO Global Tuberculosis Program Many countries have also increased uptake of new WHO guidelines and tools leading to early access to TB prevention and better outcomes. As a result, a 5% increase in the number of TB diagnoses has been observed in 2021 compared to 2020. One hundred and nine countries used oral longer regimens and 92 shorter regimens for the treatment of MDR/RR-TB in 2021. In addition, it has increase access to shorter rifamycin-based regimens for TB preventive treatment. This report therefore points to the urgent need for countries to restore access to essential TB services, increase investment, take multisectoral action to address determinants of TB epidemics and their socio-economic impact, and to improve new diagnostics, drugs and vaccines to prevent severe TB cases and deaths.
