Tuberculosis is re-emerging as a major infectious disease killer

The World Health Organization (WHO) today published a new report on tuberculosis, revealing that an estimated 8.2 million people will be newly diagnosed with tuberculosis in 2023 – the highest number recorded since WHO began global monitoring of tuberculosis in 1995. This represents a significant increase from the reported 7, 5 million in 2022, making tuberculosis the leading infectious disease killer again in 2023, surpassing COVID-19.

WHO Global Tuberculosis Report 2024 highlights mixed progress in the global fight against tuberculosis, with ongoing challenges such as significant underfunding. While the number of TB-related deaths decreased from 1.32 million in 2022 to 1.25 million in 2023, the total number of people affected by TB increased slightly to an estimated 10.8 million in 2023.

With the disease disproportionately affecting people in 30 high-burden countries, India (26%), Indonesia (10%), China (6.8%), the Philippines (6.8%) and Pakistan (6.3%) together account for 56 % global TB burden. According to the report, 55% of people who developed TB were men, 33% were women, and 12% were children and young adolescents.

“The fact that tuberculosis still kills and sickens so many people is appalling, when we have the tools to prevent, detect and treat it,” said Dr. Tedros Adhanom Ghebreyesus, WHO director-general. “WHO calls on all countries to fulfill the concrete commitments they have made to expand the use of these tools and to end tuberculosis.”

In 2023, the gap between the estimated number of new TB cases and those reported narrowed to around 2.7 million, compared to pandemic COVID-19 levels of around 4 million in 2020 and 2021. This follows significant national and global efforts to recovery from COVID. associated barriers to TB services. TB preventive treatment coverage has been maintained for people living with HIV and continues to improve for household contacts of people diagnosed with TB.

However, multidrug-resistant tuberculosis remains a public health crisis. Treatment success rates for multidrug-resistant or rifampicin-resistant tuberculosis (MDR/RR-TB) have now reached 68%. But of the 400,000 people estimated to have developed MDR/RR-TB, only 44% were diagnosed and treated in 2023.

Shortcomings and challenges in financing

Global funding for TB prevention and care has further decreased in 2023 and remains well below the target. Low- and middle-income countries (LMICs), which bear 98% of the burden of tuberculosis, have faced significant resource shortfalls. Only USD 5.7 billion of the annual funding target of USD 22 billion was available in 2023, which equates to only 26% of the global target.

The total amount of international donor funding in LMIC countries has remained at around USD 1.1–1.2 billion per year for several years. The United States government remains the largest bilateral donor to tuberculosis. Although the contribution of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) to the international funding of the TB response, especially in LMICs, is important, it remains insufficient to cover the basic needs of TB services. The report emphasizes that sustainable financial investment is crucial for the success of tuberculosis prevention, diagnosis and treatment.

Globally, TB research remains severely underfunded with only one-fifth of the US$5 billion annual target reached by 2022. This prevents the development of new TB diagnostics, drugs and vaccines. WHO continues to lead efforts to improve the tuberculosis vaccine programme, including support from the Council for the Acceleration of Tuberculosis Vaccines launched by the Director-General of WHO.

Complex drivers of the epidemic