During the COVID-19 epidemic, tuberculosis mortality and illness increase
According to the World Health Organization's 2022 Global TB report, 10.6 million people were predicted to have had tuberculosis (TB) in 2021, an increase of 4.5% from 2020, and 1.6 million people died from TB (including 187 000 HIV positive individuals). This is the first time in many years that an increase in the number of persons getting sick with TB and drug resistant TB has been documented. The burden of drug-resistant TB (DR-TB) also increased by 3% between 2020 and 2021, with 450 000 new cases of rifampicin-resistant TB (RR-TB) in 2021. The COVID-19 pandemic in 2021 will disrupt numerous services, including TB services, but it will have a particularly negative effect on the TB response.
Small gains
While progress is stagnating, some achievements have been made. Between 2018 and 2021, 26.3 million persons received TB treatment, well short of the 40 million targets established for 2018–2022, at the UN High-Level Meeting on TB. Bangladesh, Brazil, China, Uganda, and Zambia had the highest rates of treatment coverage in 2021 among the 30 countries with a high TB burden. The amount of individuals receiving TB preventive treatment increased again in 2021 to levels that were nearly identical to those of 2019, but the cumulative total of 12.5 million between 2018 and 2021 was still far behind the goal of 30 million by the end of 2022.
Positively, more than 10 million people have received TB preventative therapy for people living with HIV in just 4 years, considerably surpassing the global objective of 6 million for the period of 2018–2022. Together, the seven nations of Zimbabwe, Zambia, India, Nigeria, South Africa, Uganda, and the United Republic of Tanzania accounted for 82% of individuals who began preventative treatment in 2021.
Ethiopia, Kenya, Lesotho, Namibia, South Africa, the United Republic of Tanzania, and Zambia are seven high-TB burden nations in the area that have met or surpassed the 2020 benchmark of a 20% decrease in the TB incidence rate compared to 2015.
Countries are also adopting more of the new tools and recommendations made by the WHO, which leads to earlier access to TB prevention and care as well as improved outcomes. Rapid diagnostic testing was used to make the first diagnosis in 33% more cases of TB in 2020 than it was in 2021. For the treatment of MDR/RR-TB, 109 nations used longer all-oral regimens (up from 92 in 2020), and 92 used shorter regimens (up from 65 in 2020).
Shorter (1-3 month) rifamycin-based regimens for TB prevention have become more widely available. Rifapentine-containing regimens were reported to have been used to treat 185 350 patients in 52 countries in 2021, up from 25 657 patients in 37 countries in 2020.
The study reiterates its demand that nations take immediate action to reestablish access to crucial TB services. In addition, it urges additional spending and cross-sectoral engagement to address the broader factors that drive TB epidemics and their socioeconomic effects, as well as the requirement for improved diagnostics, medications, and vaccinations. WHO will host a high-level summit in the early part of 2023 to accelerate vaccine research while drawing on the lessons learned from the epidemic.
The 2022 report includes information on epidemic trends and responses from 215 nations and regions, including all 194 WHO Member States.
Global TB targets
All WHO and UN Member States endorsed the End TB Strategy and UN Sustainable Development Goals (SDGs) in 2014 and 2015, respectively. Targets and benchmarks for significant reductions in TB incidence, TB fatalities, and costs experienced by TB patients and their households are included in both the SDGs and the End TB Strategy.
At the United Nations (UN) high-level meeting on TB in 2018, participating nations made a commitment to accelerating efforts toward ambitious goals to treat an extra 40 million TB patients and treat at least 30 million people at risk of the illness by 2022.
TB facts
The microorganisms that cause tuberculosis (Mycobacterium tuberculosis), which is the second-deadliest infectious killer (after COVID-19), most frequently damage the lungs. It can spread when TB patients release bacteria into the air, such as when they cough.
The majority of those who contract the illness are adults; in 2021, men made up 56.5% of those affected with TB, adult women made up 32.5%, and children made up 11%. Five risk factors, including undernourishment, HIV infection, alcohol use disorders, smoking, and diabetes, are responsible for a large number of new cases of TB.
TB can be avoided and treated. A four to six-month drug regimen can effectively treat 85% of people who get TB disease; the treatment also lessens the spread of the virus to others.
Access to healthcare for TB diagnosis and completion of TB treatment can be hampered by economic and financial hurdles; around half of TB patients and their households incur catastrophic total expenses as a result of the disease. To lessen the burden of TB disease, it is crucial to make progress toward universal health coverage (UHC), improve social protection levels, and take multisectoral action on broader TB determinants.
Although TB exists in every country, the biggest burden is concentrated in 30 of them. Among them are Angola, Bangladesh, Brazil, China, Congo, Democratic People's Republic of Korea, Democratic Republic of Congo, Ethiopia, Gabon, India, Indonesia, Kenya, Lesotho, Liberia, Mongolia, Mozambique, Myanmar, Namibia, Nigeria, Pakistan, Papua New Guinea, Philippines, Sierra Leone, South Africa, Thailand, Uganda, United Republic of Tanzania, Viet Nam, and Zambia.