WeeklySA_AdminBURDEN: World health body sounds alarm as the latest figures show steep increase over 2022 cases, surpassing Covid-19…
By Monk Nkomo
Tuberculosis remains a deadly infectious disease with nearly 8,2 million people newly diagnosed in 30 countries in 2023 and South Africa recording 56 000 deaths and 270 000 cases the same year.
This is according to the World Health Organization’s Global Tuberculosis Report released on Tuesday and which classified the 2023 figures as the highest recorded since global monitoring of the disease began in 1995. In addition, these figures starkly contrast the 2022 cases when 7,5 million people were diagnosed with TB that year, placing the disease as the leading infectious disease killer in 2023, surpassing COVID-19.
According to WHO, a total 56 000 people died of TB in South Africa in 2023 and 31 000 of the victims were living with HIV while 25 000 were not. A total 270 000 fell ill with TB and 13 000 of the patients fell ill with drug-resistant forms of TB. These figures however were now steadily declining. The latest WHO report revealed that the disease was disproportionately affecting people in 30 high-burden countries including India ( 26%), Indonesia (10%), China (6,8%), the Philippines (6,8%) and Pakistan (6,3%) who together accounted for 56 percent of the global burden. A total 55 percent of people who developed TB were mostly men, 33 percent were women and 12 percent were children and young adolescents.
Dr. Tedros Adhanom Ghebreyesus, WHO Director -General, was greatly concerned about the surge in TB cases when there was actually proper medication to treat the deadly disease.
‘’The fact that TB still kills and sicken 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.’’
The latest WHO report highlighted that a significant number of new TB cases were driven by five major risk factors that included undernutrition, HIV infection, alcohol use disorders, smoking ( especially amongst men) and diabetes. Tackling these issues, along with critical determinants like poverty and GDP per capita, required coordinated multisectoral action.
Global milestones and targets for reducing the TB disease burden, according to the report, were off-track and considerable progress was needed to reach other targets set for the year 2027 ahead of the second United Nations High-Level Meeting.
The WHO said there had been 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.
‘’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’’.
The WHO lamented that the multidrug-resistant TB remained a public health crisis. Treatment success rates for multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB) had now reached 68%. But, of the 400 000 people estimated to have developed MDR/RR-TB, only 44% were diagnosed and treated in 2023.
Global funding for TB prevention and care decreased further in 2023 and remained far below target. Low- and middle-income countries (LMICs), which bore 98% of the TB burden, faced significant funding shortages. Only 5.7 billion US dollars of the 22 US billion dollars annual funding target was available in 2023, equivalent to only 26% of the global target.
The total amount of international donor funding in LMICs had remained at around 1.1 – 1.2 billion US dollars per year for several years. The United States government remained 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 remained insufficient to cover essential TB service needs. The report emphasized that sustained financial investment was crucial for the success of TB prevention, diagnosis and treatment efforts.
‘’Globally, TB research remains severely underfunded with only one-fifth of the five billion US dollars 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’’.
For the first time, the report provided estimates on the percentage of TB-affected households that faced catastrophic costs (exceeding 20% of annual household income) to access TB diagnosis and treatment in all LMICs. These indicated that half of TB-affected households faced such catastrophic costs.
Director of WHO’s Global Tuberculosis Programme, Dr. Tereza Kasaeva, said : “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.
It is imperative that we unite across all sectors and stakeholders, to confront these pressing issues and ramp up our efforts.”
KEY FACTS
• A total of 1.25 million people died from TB in 2023 (including 161 000 people with HIV). Worldwide, TB has probably returned to being the world’s leading cause of death from a single infectious agent, following three years in which it was replaced by coronavirus disease (COVID-19). It was also the leading killer of people with HIV and a major cause of deaths related to antimicrobial resistance.
• In 2023, an estimated 10.8 million people fell ill with TB worldwide, including 6.0 million men, 3.6 million women and 1.3 million children. TB is present in all countries and age groups. TB is curable and preventable.
• Multidrug-resistant TB (MDR-TB) remains a public health crisis and a health security threat. Only about 2 in 5 people with drug resistant TB accessed treatment in 2023.
• Global efforts to combat TB have saved an estimated 79 million lives since the year 2000.
• US$ 22 billion is needed annually for TB prevention, diagnosis, treatment and care to achieve the global target by 2027 agreed at the 2023 UN high level-meeting on TB.
• Ending the TB epidemic by 2030 is among the health targets of the United Nations Sustainable Development Goals (SDGs).
