WHO: TB deaths, disease, treatment resistance continued to increase in 2021
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Disruptions to care caused by the COVID-19 pandemic continued to negatively impact the fight against tuberculosis as cases and deaths have increased for the second year in a row after decades of declines, according to WHO’s 2022 Global TB Report.
“The TB situation is urgent. TB is again the biggest single killer globally of any infectious disease, including COVID-19,” Mel Spigelman, MD, president and CEO, TB Alliance, said in a statement. “For too long, TB has been a low-priority disease, a phenomenon we have seen clearly during the COVID-19 pandemic. We lost more than a decade of progress in 2020, and 2021 saw increases in both incidence and mortality. Despite gains in areas like preventative therapy, we are still behind in just about every pledge and goal regarding TB.”
According to the WHO report, in 2021 an estimated 10.6 million people were diagnosed with TB, an increase of 4.5% from 2020. Among these cases, men accounted for 56.5%, women 32.5% and children 11%. Additionally, 1.6 million people died from TB — approximately 100,000 more than in 2020. According to the report, 187,000 of these deaths were among people with HIV.
Additionally, the report showed that the burden of drug-resistant TB also increased by 3% between 2020 and 2021, with approximately 450,000 new cases of rifampicin-resistant TB reported in 2021. WHO says this is the first time in many years that an increase has been reported in the number of people diagnosed with TB and drug-resistant TB.
“This is a pivotal moment for the global fight to end tuberculosis,” Tereza Kasaeva, MD, PhD, director of the WHO Global TB Programme, said during a press briefing on Thursday. “While 74 million lives were saved due to TB prevention and care since the year 2000, the COVID-19 pandemic, coupled with an ongoing crisis such as armed conflict, increasing food insecurity, political and economic instability, has reversed the years of progress made in the fight against TB.”
According to the report, these disruptions have led to people with TB missing diagnoses and treatment. WHO found that the number of people newly diagnosed with TB fell from 7.1 million in 2019 to 5.8 million in 2020. Kasaeva added that there was a partial recovery to 6.4 million in 2021 but that this was still well below pre-pandemic levels.
She added that prevention efforts are “lagging,” with a reduction in provision of TB preventive treatment. According to the report, in 2021, TB preventive treatment was provided to 3.5 million people, slightly below the level of 3.6 million of 2019 but still a good recovery from 3.2 million in 2020, Kasaeva said.
Spigelman said, however, there is “great potential” when looking at the future of TB in terms of treatment options.
“There is great potential right now, with shorter and more effective treatments available for drug-sensitive and drug-resistant TB, shorter and more effective TB prevention treatments, better detection technologies and many promising TB vaccine candidates in the pipeline,” he said. “These new technologies need to be embraced and distributed in addition to pursuing further innovations.”
He added, however, that there is still no broadly effective vaccine, although political will bolstered by this year’s report could be a catalyst to strengthen the fight. According to the report, one way to do so is through funding.
According to the WHO report, global spending on essential TB services decreased 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. This funding was primarily from domestic sources (79%). The U.S. government is the largest contributor of funding to the Global Fund and is also the largest bilateral donor overall, contributing close to 50% of international donor funding for TB.
The report also said that funding goals for the development of new diagnostics, drugs and vaccines falls short of the global target of $2 billion per year by remaining at around $900 million.
“It's time to put a stop to this a long-time killer. Working together, we can end TB,” Kasaeva said. “Colleagues, we cannot falter in our commitments to reach and save every man, woman and child, family and community impacted by this deadly disease. No more excuses and delays in prioritizing and investing to end one of the top infectious killers.”
References:
- Tuberculosis deaths and disease increase during the COVID-19 pandemic. https://www.who.int/news/item/27-10-2022-tuberculosis-deaths-and-disease-increase-during-the-covid-19-pandemic#:~:text=An%20estimated%2010.6%20million%20people,Organization's%202022%20Global%20TB%20report. Posted Oct. 27, 2022. Accessed Oct. 27, 2022.
- WHO. Global tuberculosis report 2022. https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022. Accessed Oct. 27, 2022.
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