Routine immunization for children in the Philippines

WHO Reports Alarming Rise In Tuberculosis Cases In 2023

The World Health Organization (WHO) today published a new report on tuberculosis revealing that approximately 8.2 million people were newly diagnosed with TB in 2023 – the highest number recorded since WHO began global TB monitoring in 1995. This represents a notable increase from 7.5 million reported in 2022, placing TB again as the leading infectious disease killer in 2023, surpassing COVID-19.

WHO's Global Tuberculosis Report 2024 highlights mixed progress in the global fight against TB, with persistent 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 falling ill with TB rose 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 accounted for 56% of the 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 TB still kills and sickens so many people is an outrage, when we have the tools to prevent it, detect it and treat it. 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."

Dr. Tedros Adhanom Ghebreyesus, WHO Director-General

In 2023, the gap between the estimated number of new TB cases and those reported narrowed to about 2.7 million, down from COVID-19 pandemic levels of around 4 million in 2020 and 2021. This follows substantial national and global efforts to recover from COVID-related disruptions to TB services. The coverage of TB preventive treatment has been sustained for people living with HIV and continues to improve for household contacts of people diagnosed with TB.

However, multidrug-resistant TB remains a public health crisis. Treatment success rates for multidrug-resistant or rifampicin-resistant TB (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.

Funding gaps and challenges

Global funding for TB prevention and care decreased further in 2023 and remains far below target. Low- and middle-income countries (LMICs), which bear 98% of the TB burden, faced significant funding shortages. Only US$ 5.7 billion of the US$ 22 billion annual funding target was available in 2023, equivalent to only 26% of the global target.

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

Globally, TB research remains severely underfunded with only one-fifth of the US$ 5 billion annual target reached in 2022. This impedes the development of new TB diagnostics, drugs, and vaccines. WHO continues leading efforts to advance the TB vaccine agenda, including with the support of the TB Vaccine Accelerator Council launched by the WHO Director-General.

Complex drivers of the epidemic

For the first time, the report provides estimates on the percentage of TB-affected households that face catastrophic costs (exceeding 20% of annual household income) to access TB diagnosis and treatment in all LMICs. These indicate that half of TB-affected households face such catastrophic costs.

A significant number of new TB cases are driven by 5 major risk factors: undernutrition, HIV infection, alcohol use disorders, smoking (especially among men), and diabetes. Tackling these issues, along with critical determinants like poverty and GDP per capita, requires coordinated multisectoral action.

"We are confronted with a multitude of formidable challenges: funding shortfalls and catastrophic financial burden on those affected, climate change, conflict, migration and displacement, pandemics, and drug-resistant tuberculosis, a significant driver of antimicrobial resistance," said Dr Tereza Kasaeva, Director of WHO's Global Tuberculosis Programme. "It is imperative that we unite across all sectors and stakeholders, to confront these pressing issues and ramp up our efforts."

Global milestones and targets for reducing the TB disease burden are off-track, and considerable progress is needed to reach other targets set for 2027 ahead of the second UN High-Level Meeting. WHO calls on governments, global partners, and donors to urgently translate the commitments made during the 2023 UN High-Level Meeting on TB into tangible actions. Increased funding for research, particularly for new TB vaccines, is essential to accelerate progress and achieve the global targets set for 2027.

Many Concerned After Hundreds Tested For Possible Tuberculosis Exposure At Walton High School

COBB COUNTY, Ga. — Around 300 students and staff members at Walton High School were tested for tuberculosis on Tuesday after a possible exposure.

One student, who did not get tested, told Channel 2′s Tom Regan that other students required to get tested were informed at the beginning of the school day.

"Some kids got slips in their homeroom. I didn't know there was that many." said the student.

The Cobb & Douglas County Public Health Department confirmed to Channel 2 Action News that it, along with Cobb County Schools, has identified those who may have been exposed to the infection.

Per HIPAA guidelines, the department and district are not allowed to release the names of those who have been possibly infected.

Parents told Channel 2 Action News they are glad to hear of efforts by the health department and school district to contain the spread of infection and prevent a tuberculosis outbreak.

"I'm all for the testing, definitely do that. But it concerns me that it is in existence. That's a worry." said parent John Cullom.

Officials say students and staff who don't get tested on Tuesday will need to go to their physician to get tested and bring back a written report confirming the test.

On Thursday, the health department will return to the school to read and measure the reactions to the tests.

The health department says a positive test would mean the person tested has been exposed to someone with active tuberculosis. Then, the positive tests will take a chest X-ray to rule out having the active disease.

Health officials say that if the test X-ray is negative, they will be offered preventative medication, while if the X-ray is positive, they will be treated for the disease. Though tuberculosis can be deadly if untreated, most people infected with the bacteria fully recover.

"I do love the school system is proactive and is taking preventative care for the students." said parent Kristina Moreno.

The Atlanta-based Centers for Disease Control and Prevention says tuberculosis germs can get into the air "when a person with active TB disease of the lungs or throat coughs, speaks, or sings."

Tuberculosis germs are not spread by shaking someone's hand, sharing food or drink, touching bed linens or toilet seats, sharing toothbrushes, or kissing, according to the CDC.

"It is important to know that a person who is exposed to TB germs is not able to spread the germs to other people right away. Only persons with active TB disease can spread TB germs to others," the CDC says.

Click here for more information information to know from the CDC if you or your child has been exposed to tuberculosis.

COVID-19 Resulted In Nearly Half A Million Excess Deaths, WHO's Global TB Report States

A doctor examines a X-ray picture of a tuberculosis patient in a district TB centerPhoto Credit: AP

India, Indonesia, and the Philippines, which collectively accounted for a large share of the global reductions in the number of people newly diagnosed with tuberculosis (TB) in 2020 and 2021, all recovered to above 2019 levels in 2022, notes the latest World Health Organization TB report, 2024, released on Tuesday (October 29, 2024).

It added that COVID-19 related disruptions are estimated to have resulted in almost half a million excess deaths from TB in the three years 2020–2022, compared with the number that would have occurred if pre-pandemic trends had been maintained.

Also read: 7.5 million new cases of TB in 2022: WHO report

Thirty high TB burden countries accounted for 87% of the world's TB cases in 2022 and two-thirds of the global total was in eight countries including India (27%), Indonesia (10%), China (7.1%), the Philippines (7.0%), and Pakistan (5.7%) among others.

In 2022, 55% of people who developed TB were men, 33% were women and 12% were children (aged 0–14 years). 

The Ministry of Health and Family Welfare, India, released its TB Report 2024, which highlighted that the mortality rate due to the infection declined from 28 per lakh population in 2015 to 23 per lakh population in 2022. The estimated incidence of TB in 2023 increased slightly to 27.8 lakh from the previous year's estimate of 27.4 lakh.

Meanwhile, the WHO report, which provides a comprehensive assessment of the TB epidemic at global, regional and country level, states that globally in 2022, TB caused an estimated 1.30 million deaths. This was down from best estimates of 1.4 million in both 2020 and 2021 and almost back to the level of 2019. In 2022, TB was the world's second leading cause of death from a single infectious agent, after coronavirus disease (COVID-19), and caused almost twice as many deaths as HIV/AIDS, notes the report.

TB is caused by the bacillus Mycobacterium tuberculosis, which is spread when people who are sick with TB expel bacteria into the air (e.G. by coughing). About a quarter of the global population is estimated to have been infected with TB. Following infection, the risk of developing TB disease is highest in the first two years (approximately 5%), after which it is much lower. Of the total number of people who develop TB disease each year, about 90% are adults, with more cases among men than women. The disease typically affects the lungs (pulmonary TB) but can affect other sites as well.

"There was a major global recovery in the number of people diagnosed with TB and treated in 2022, after two years of COVID-related disruptions. This has started to reverse or moderate the damaging impact of the pandemic on the number of people dying from or falling ill with TB,'' the report states. 

It adds that the global number of people newly diagnosed with TB was 7.5 million in 2022. This is the highest number since WHO began global TB monitoring in 1995, above the pre-COVID baseline (and previous historical peak) of 7.1 million in 2019, and up from 5.8 million in 2020 and 6.4 million in 2021. 

It highlights that the number in 2022 probably includes a sizable backlog of people who developed TB in previous years, but whose diagnosis and treatment was delayed by COVID-related disruptions that affected access to and provision of health services. 

Additionally, the net reduction in the global number of deaths caused by TB from 2015 to 2022 was 19%, which it noted is far from the WHO End TB Strategy milestone of a 75% reduction by 2025. 

The global gap between the estimated number of people developing TB (incident cases) and the reported number of people newly diagnosed with TB (notified cases) narrowed to a best estimate of 3.1 million in 2022, down from around four million in both 2020 and 2021 and back to the pre-pandemic level of 2019, the report said.

Published - October 29, 2024 10:45 pm IST

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