The World Health Organization (WHO), in its latest report, revealed a troubling surge in tuberculosis (TB) cases, with approximately 8.2 million new diagnoses in 2023—the highest number recorded since global monitoring began in 1995.
This marks a significant increase from the 7.5 million cases reported in 2022, making TB the leading infectious disease killer worldwide, surpassing COVID-19.
According to the WHO’s Global Tuberculosis Report 2024, India accounted for 26% of TB cases in 2023, followed by Indonesia (10%), China (6.8%), the Philippines (6.8%), and Pakistan (6.3%).
The report further indicated that 55% of new cases were men, 33% were women, and 12% were children and adolescents.
The resurgence of tuberculosis as the leading cause of infectious disease-related deaths demands urgent action, the WHO said.
The report also highlighted that the disease disproportionately affected populations in 30 countries with the highest burden of TB cases.
These countries include Angola, Bangladesh, Brazil, Cambodia, the Central African Republic, China, Congo, North Korea, DR Congo, Ethiopia, India, Indonesia, Kenya, Lesotho, Liberia, Mozambique, Myanmar, Namibia, Nigeria, Pakistan, Papua New Guinea, the Philippines, Russia, Sierra Leone, South Africa, Thailand, Tanzania, Vietnam, Zambia, and Zimbabwe.
The WHO report also presented a mixed picture of progress in combating TB, as persistent challenges like underfunding continue to hinder global efforts. While TB-related deaths slightly decreased from 1.32 million in 2022 to 1.25 million in 2023, the estimated number of individuals falling ill with TB rose to 10.8 million.
WHO Director-General Tedros Adhanom Ghebreyesus expressed outrage over the continued toll of TB, stating: “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.” He called on countries to fulfill their commitments to expand the use of available tools to combat TB.
Multidrug-resistant tuberculosis—a critical threat
One of the most pressing issues in the fight against TB is the rise of multidrug-resistant tuberculosis (MDR-TB). This variant poses a significant threat to public health and raises major concerns for health systems globally. In 2023, only about 40% of individuals with drug-resistant TB accessed treatment, highlighting a substantial gap in care and access.
MDR-TB occurs when TB bacteria develop resistance to primary antibiotics used in treatment, such as isoniazid and rifampicin. This resistance often results from improper treatment regimens, poor-quality medications, or premature discontinuation of treatment. The WHO warns that the emergence of drug-resistant strains complicates treatment protocols and hinders global efforts to control TB.
The implications of MDR-TB are profound. It leads to longer treatment durations and necessitates the use of more expensive and toxic medications, straining healthcare resources and limiting access for affected populations.
Global disparities and funding challenges
The burden of TB is not evenly distributed; low- and middle-income countries bear the brunt of the disease. In 2023, India reported nearly 2.55 million new TB cases, the highest since its TB control program began in the 1960s. This significant rise reflects national efforts to identify and treat affected individuals but also underscores the vast challenges that remain.
Despite advancements, funding for TB prevention, diagnosis, and treatment remains severely underfunded. The WHO estimates that approximately $22 billion is needed annually to meet global TB targets established for 2027 during the 2023 UN high-level meeting on TB. This shortfall poses a significant barrier to progress in combating the disease.
The report indicates that most financial support for TB services comes from domestic sources, but international donor funding remains crucial, particularly for high-burden countries. Unfortunately, domestic funding trends have declined in several high-burden nations, including Brazil, India, and South Africa.
Progress and achievements in TB control
Despite the daunting challenges, the global fight against TB has yielded notable successes, the WHO said, adding that efforts to combat TB have saved an estimated 79 million lives since 2000.
The narrowing gap between estimated new TB cases and reported cases—approximately 2.7 million—suggests that national and global efforts to restore TB services disrupted by the COVID-19 pandemic are beginning to show results.
The WHO emphasized the importance of collaborative strategies and strong policy reforms to effectively combat TB. Enhanced awareness and the implementation of mandatory notifications for TB cases have led to a notable increase in case notifications. Such initiatives are critical in fostering early diagnosis and timely treatment, ultimately breaking the transmission cycle, it said.
Impact of TB-HIV co-infection
The WHO highlighted that the intersection of TB and HIV continues to present significant challenges, adding that individuals living with HIV are 16 times more likely to develop TB than those without the virus. In 2023, approximately 161,000 people died from HIV-associated TB.
The WHO recommended a comprehensive approach to TB-HIV collaborative activities to reduce mortality and improve treatment outcomes for those affected by both diseases.
Integrating TB and HIV services is essential for addressing the dual burden faced by these populations. Improved screening, treatment protocols, and support systems can enhance overall health outcomes for individuals living with HIV and TB, WHO said in its report.
Ending TB epidemic
The WHO said ending the TB epidemic by 2030 is among the health targets of the UN’s Sustainable Development Goals (SDGs), highlighting the need for sustained commitment and action from all nations.
To achieve this ambitious goal, the global health community must prioritize funding, innovative treatment options, and collaborative strategies that address both social determinants of health and structural barriers to care, WHO said in its report.
Enhancing public awareness, improving healthcare infrastructure, and fostering partnerships across sectors will be crucial in the fight against TB, it added.
With strategic investments, enhanced collaboration, and innovative approaches to treatment and prevention, there is hope for a future where TB is effectively managed and ultimately eradicated.
The challenges are formidable, but the global response must be equally robust. By rallying around the goal of ending the TB epidemic, we can work towards a healthier, more equitable future for all.
