Tuberculosis (TB), an infectious disease that spreads primarily through airborne transmission, has resurged as the world’s leading infectious killer.
A report released by the World Health Organization (WHO) on Wednesday shows that TB claimed more lives in 2023 than any other single infectious disease, overtaking Covid-19, which was the deadliest.
The estimated death toll reached 1.25 million last year, including 1.09 million among HIV-negative individuals and an additional 161,000 among people with HIV.
The Global 2024 Tuberculosis Report further indicates that at least 8 million people, 500, 000 more than the number in 2022, were newly diagnosed with TB in 2023- the highest number WHO has recorded since it began TB monitoring in 1995.
Though diagnostic and treatment efforts have rebounded post the pandemic, the disease continues to spread alarmingly, with the global incidence rate still well off track from the 50 per cent reduction milestone set for 2025.
According to WHO, countries in the Asia region accounted for the most TB cases with India (26 per cent), Indonesia (10 per cent), China (6.8 per cent), the Phillippines (6.8 per cent and Pakistan at 6.3 per cent.
The report highlights that the disease disproportionately affected individuals in 30 countries with the highest burden of TB cases.
These countries are Angola, Bangladesh, Brazil, Cambodia, the Central African Republic, China, Congo, North Korea, DR Congo, Ethiopia, India, Indonesia and Kenya.
Others are Lesotho, Liberia, Mozambique, Myanmar, Namibia, Nigeria, Pakistan, Papua New Guinea, the Philippines, Russia, Sierra Leone, South Africa, Thailand, Tanzania, Vietnam, Zambia, and Zimbabwe.
The proportion of TB among people living with HIV has been on the decline over the years resulting in 6.1 per cent of the 10.8 million TB incident cases in 2023, with the majority of cases being diagnosed in Africa.
Of the new cases diagnosed last year, 55 per cent were men, 33 per cent were women while children and adolescents accounted for 12 per cent of the 8 million cases.
WHO said that the “higher share of TB cases among men is consistent with evidence from national TB prevalence surveys, show that TB disease affects men more than women and that gaps in case detection and reporting are higher among men.”
“TB is a disease of deprivation,” said Tedros Ghebreyesus, Director-General of WHO. “It disproportionately affects those who are already marginalised — the poor, malnourished, and people who can least afford to bear the cost of treatment. For too many, the journey with TB leads to financial hardship or even deeper poverty.”
As one of the oldest diseases known to humankind, TB continues to take a toll on sub-Saharan Africa, which carries nearly a quarter of global TB cases.
The Democratic Republic of Congo, for instance, is one of the World’s top 10 TB hotspots, accounting for roughly 3.1 per cent of all global cases. DRC is also on WHO’s list for high-burden TB and multi-drug resistant TB (MDR-TB).
MDR-TB refers to a form of tuberculosis caused by strains of Mycobacterium tuberculosis that are resistant to at least two of the most potent first-line anti-TB drugs- isoniazid and rifampicin, remains a public health crisis, WHO notes.
While treatment success rates for multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB) have reached 68 per cent, the report posits that of the 400,000 people estimated to have developed MDR/RR-TB, only 44 per cent were diagnosed and treated in 2023.
Kenya is also among countries considered as TB high burden countries with the Kenya Medical Research Institute stating last month that more than 128,000 new TB cases are reported every year.
According to the WHO report, a significant number of new TB cases are driven by five major risk factors: undernutrition, HIV infection, alcohol use disorders, smoking and diabetes.
While the race to end the TB epidemic remains a world’s world-distant goal due to persistent challenges like underfunding, WHO says in its report that there are many positive trends.
“The global rise in the number of people falling ill with TB each year has slowed and started to stabilise and the WHO African and European regions have made progress towards the 2025 milestones reductions in the TB incidence rate and the number of deaths caused by TB,” read part of the report.
To meet WHO’s ambitious goals, countries worldwide need substantial funding and investment. The 2023 UN High-Level Meeting on TB set targets to reach 90 percent treatment coverage and ensure all new TB diagnoses involve rapid testing by 2027.
But in 2023, only $5.7 billion was available globally for TB prevention, diagnosis, and care, far below the annual $22 billion needed.
Research funding remains critically low, with only $1 billion allocated in 2022, while WHO estimates that $5 billion is necessary to develop new tools and treatments by 2027.
“The fact that TB still kills and sickens so many people is an outrage when we have the tools to prevent it, detect it and treat it,” offers Dr Tedros Ghebreyesus in a press release. “WHO urges all countries to make good on the concrete commitments they have made to expand the use of those tools and to end TB.”
To meet WHO’s ambitious goals of ending TB by 2035, countries worldwide need substantial funding and investment. The 2023 UN High-Level Meeting on TB set targets to reach 90 per cent treatment coverage and ensure all new TB diagnoses involve rapid testing by 2027.
But in 2023, only 5.7 billion US dollars was available globally for TB prevention, diagnosis, and care, far below the annual 22 billion US dollars needed.
Research funding remains critically low, with only 1 billion US dollars allocated in 2022, while WHO estimates that more than five US billion dollars is necessary to develop new tools and treatments by 2027.
