WHO report shows tuberculosis cases are on the rise globally

Tuberculosis (TB) is on the rise and has once again overtaken the coronavirus as the world's leading infectious disease killer, according to the latest report from the World Health Organization (WHO).

of World Tuberculosis Report 2024A report released today shows that 8.2 million people will be newly diagnosed with tuberculosis in 2023, the highest number since WHO began global tuberculosis monitoring in 1995. recorded the number of tuberculosis cases. This also represents a significant increase from 7.5 million new TB cases. Tuberculosis cases were reported in 2022.

Furthermore, the total number of people who contracted tuberculosis last year (including those who were not officially diagnosed) was estimated to be 10.8 million in 2023, up from 10.7 million in 2022 and 10.1 million in 2020. . The number of new and notified cases fell to 2.7 million, well below the 4 million during the first two years of the COVID-19 pandemic, when access to TB diagnosis and treatment was limited.

The estimated number of tuberculosis deaths in 2023 is 1.25 million, down from the 1.32 million recorded in 2022 and continuing a downward trend since the height of the COVID-19 pandemic, but the number remains This far exceeds the 320,000 deaths from the new coronavirus that was officially reported last year. year.

WHO officials say the decline in tuberculosis deaths and the narrowing gap between incident and notifiable tuberculosis cases suggest that tuberculosis prevention, diagnosis and treatment services have largely recovered from coronavirus-related disruptions. This is a positive trend. However, challenges remain and countries are far behind targets to reduce the global burden of tuberculosis.

“Despite the tools we have to prevent, detect and treat tuberculosis, too many people still die and get sick,” WHO Director-General Dr. Tedros Adhanom Ghebreyesus said in a press release. The facts are outrageous.” “WHO calls on all countries to scale up the use of these tools and deliver on the concrete commitments they have made to eliminate tuberculosis.”

Devastating costs for tuberculosis patients

The WHO says most of the global increase in tuberculosis cases from 2022 to 2023 is likely to reflect population growth. Still, the net reduction in TB incidence from 2015 to 2013 was only 8.3%, far short of the WHO's final TB strategy milestone of 50% reduction by 2025.

Similar to previous reports, the data shows that 30 countries, mainly low- and middle-income countries (LMICs), bear 87% of the global TB burden, with five countries – India, Indonesia, China, the Philippines and Pakistan. Together, they account for 56%. About burden. Of the 8.2 million people diagnosed with TB in 2023, 55% were men, 33% were women, and 12% were children and young people.

According to the report, a significant number of new TB cases are caused by five major risk factors: malnutrition, HIV infection, alcohol use disorder, smoking, and diabetes.

“Tackling these issues alongside key determinants such as poverty and GDP [gross domestic product] “As a proportion of the population, this will require coordinated multisectoral action,” the agency said.

Positive aspects of the report include that the treatment success rate for drug-susceptible tuberculosis remains high at 88%, and the treatment success rate for multidrug-resistant or rifampicin-resistant (MDR/RR) tuberculosis has increased to 68%. I can list it. This is primarily a result of shorter and less toxic treatment regimens for MDR/RR-TB currently recommended by the WHO.

It is outrageous that despite the tools we have to prevent, detect and treat tuberculosis, tuberculosis continues to kill and sicken so many people.

However, only 44% of the estimated 400,000 people who developed MDR/RR-TB in 2023 received diagnosis and treatment. Among drug-susceptible TB patients, 63% were diagnosed based on bacteriological confirmation and approximately 75% received treatment.

WHO says one of the barriers to closing the diagnosis and treatment gap is the economic cost faced by tuberculosis patients, analyzed for the first time in a new report. The analysis found that 50% of tuberculosis patients face total costs (including direct medical costs, non-medical expenditures, and lost income) that account for more than 20% of their income, and this amount WHO defines it as “catastrophic”.

Shaka Brown, a tuberculosis survivor and advocate who was diagnosed with tuberculosis in 2013 and almost died, addressed the issue at a WHO press conference today.

“Half of the people living with tuberculosis worldwide suffer from a significant economic burden,” Brown said. “I was lucky. I went to the hospital thinking I would be able to go to the hospital on the weekend and was discharged four months later. How many people can't go home for four months and still have a home?”

lack of funds

Another challenge highlighted in the report is further declines in global funding for TB services. in 2023 United Nations High Level Meeting on TuberculosisUnited Nations member states have agreed to a goal of mobilizing $22 billion a year for tuberculosis prevention, diagnosis and treatment services in small and medium-sized urban areas by 2027, but total funding available in 2023 is only $5.7 billion. , below the $6 billion available in each region. In the past three years, it was just 26% of the UN target.

Dr. Tereza Kasaeva, head of WHO's global tuberculosis program, said the amounts were insufficient to meet the needs of essential tuberculosis services.

“Sustained financial investment is essential to the success of tuberculosis prevention, diagnosis and treatment efforts,” she said. “With just 26% funding, it is impossible to provide 100% access to everyone in need.”

Kasaeva also pointed out that global investment in tuberculosis research in 2023 will be about $1 billion, just one-fifth of the annual target of $5 billion, and that the lack of funding for tuberculosis research will lead to new cases of tuberculosis. It added that it would hinder the development of diagnostics, therapeutics and vaccines.

Despite these challenges, Kasaeva expressed optimism about advances in shorter treatment regimens, rapid diagnostic tests and tuberculosis vaccine development. He listed 15 vaccine candidates in the development pipeline, six of which are being studied in phase 3 trials in the highest burden countries. In a political declaration adopted at the 2023 United Nations High-Level Meeting on Tuberculosis, member states called for the development of at least one new effective tuberculosis vaccine by 2028.

“I'm very optimistic that we can reach this goal, and hopefully not just with one vaccine, but probably with many more,” Kasaeva said.