How Plausible Is Ending TB Scourge?

Despite countries making bold commitments to end TB by 2030, in the Sustainable Development Goals, the WHO End TB Strategy and the 2018 political declaration on the fight against TB, the epidemic shows no sign of slowing down.

In 2021, approximately 10.6 million people fell sick with TB, and 1.6 million died. Drugresistance continues to be a major problem with close to half a million people developing drug-resistant TB every year.

The burden of drug-resistant TB (DR-TB) also increased by 3 per cent between 2020 and 2021, with 450 000 new cases of rifampicin-resistant TB (RRTB) in 2021.This is the first time in many years an increase has been reported in the number of people falling ill with TB and drug resistant TB.

According to Global TB Report 2022, the reported number of people newly diagnosed with TB fell from 7.1 million in 2019 to 5.8 million in 2020. There was a partial recovery to 6.4 million in 2021, but this was still well below pre-pandemic levels.

Reductions in the reported number of people diagnosed with TB suggest that the number of people with undiagnosed and untreated TB has grown, resulting first in an increased number of TB deaths and more community transmission of infection and then, with some lag-time, increased numbers of people developing TB.

The report notes a decline in global spending on essential TB services from $6 billion in 2019 to $5.4 billion in 2021, which is less than half of the global target of $13 billion annually by 2022. As in the previous 10 years, most of the funding used in 2021 (79 per cent) was from domestic sources.

The WHO report reiterates its call for countries to put in place urgent measures to restore access to essential TB services. It further calls for increased investments, multisectoral action to address the broader determinants that influence TB epidemics and their socioeconomic impact as well as the need for new diagnostics, drugs and vaccines.