Tuberculosis response recovering from pandemic but accelerated efforts needed to meet new targets – PAHO/WHO

November 7, 2023 (PAHO) – The World Health Organization (WHO) global tuberculosis (TB) report 2023 highlights a significant global recovery in scaling up tuberculosis diagnosis and treatment services in 2022. Sample an encouraging trend that is beginning to reverse the harmful effects. effects of COVID-19 disruptions on tuberculosis services.

The report, which includes data from 192 countries and areas, shows that 7.5 million people were diagnosed with tuberculosis in 2022, making it the highest number recorded since the WHO began global monitoring of tuberculosis in 1995. .

The increase is attributed to the good recovery in access and delivery of health services in many countries. India, Indonesia and the Philippines, which together accounted for more than 60% of the global reductions in the number of people newly diagnosed with tuberculosis in 2020 and 2021, have recovered to levels above those of 2019 in 2022.

“For millennia, our ancestors suffered and died from tuberculosis, without knowing what it was, what caused it or how to stop it,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “Today we have knowledge and tools that they could only have dreamed of. We have political commitment and we have an opportunity that no generation in the history of humanity has had: the opportunity to write the final chapter in the history of tuberculosis.”

Globally, an estimated 10.6 million people fell ill with tuberculosis in 2022, up from 10.3 million in 2021. Geographically, in 2022, the majority of people who developed tuberculosis were in the WHO regions of the Southeast Asia (46%), Africa (23%) and the Western Pacific (18%), with smaller proportions in the Eastern Mediterranean (8.1%), the Americas (3.1%) and Europe (2.2% ).

The total number of TB-related deaths (including those of people with HIV) was 1.3 million in 2022, up from 1.4 million in 2021. However, during the period 2020-2022, disruptions caused by COVID-19 caused almost half a million more deaths. of tuberculosis. Tuberculosis remains the leading cause of death among people with HIV.

Multidrug-resistant tuberculosis (MDR-TB) remains a public health crisis. While an estimated 410,000 people developed multidrug-resistant or rifampicin-resistant tuberculosis (MDR/RR-TB) in 2022, only two in five people accessed treatment.

There is some progress in the development of new diagnostics, drugs and vaccines against tuberculosis. However, this is limited by the overall level of investment in these areas.

Accelerate action and investment to achieve new goals

The WHO reports that global efforts to combat tuberculosis have saved more than 75 million lives since 2000. However, even greater efforts are needed as tuberculosis remained the second leading cause of infectious death in the world in 2022.

Despite a significant recovery in 2022, progress was insufficient to meet the global TB targets set in 2018, with disruptions caused by the pandemic and ongoing conflicts being the main contributing factors:

• the net decline in TB-related deaths between 2015 and 2022 was 19%, well below the WHO End TB Strategy target of a 75% reduction by 2025;
• the cumulative reduction in the tuberculosis incidence rate between 2015 and 2022 was 8.7%, far from the WHO End TB Strategy goal of a 50% reduction by 2025;
• About 50% of TB patients and their households face total costs that are catastrophic (direct medical expenses, non-medical expenses and indirect costs such as loss of income that represent more than 20% of total household income), far from the target of the WHO to end tuberculosis. Strategic goal of zero;
• Targets set for 2018-2022 in the political declaration of the first UN High-Level Meeting on Tuberculosis were not met, with only 84% of the 40 million people targeted for treatment reached of tuberculosis; and only 52% of the 30 million people who receive preventive treatment for tuberculosis access it; and
• Less than half of the funding was mobilized for TB service delivery and research.

The 2023 UN General Assembly High-Level Meeting on TB reinforced the 2018 commitments and targets, setting new targets for the period 2023-2027. The new goals include reaching 90% of people in need with tuberculosis prevention and care services; use a rapid test recommended by WHO as the first method to diagnose tuberculosis; provide a package of health and social benefits to all people with tuberculosis; ensure the availability of at least one new safe and effective tuberculosis vaccine; and close funding gaps for tuberculosis research and implementation by 2027.

«We have strong commitments to concrete targets formulated by world leaders in the political declaration of the second United Nations High-level Meeting on Tuberculosis, which provides a strong impetus to accelerate the response to tuberculosis,» said Dr. Tereza Kasaeva, Director of the WHO Global Tuberculosis Programme. . “This report provides key data and evidence on the state of the tuberculosis epidemic and a review of progress, which serves to inform the translation of these goals and commitments into action in countries. We need everyone to get to work to make the vision of ending tuberculosis a reality.”

The report further highlights the importance of concerted action across health and other sectors to address the social, environmental and economic determinants of tuberculosis and the consequences of inaction. WHO continues to support the participation of other sectors in the tuberculosis response, through its Multisectoral Accountability Framework. In 2022, outside the health sector, education was the sector most engaged in promoting and sharing information on tuberculosis, followed by the defense sector and the justice sector, for prevention and care services. tuberculosis, and the social development sector for patient support, including service delivery. of economic, social and nutritional benefits.

The report emphasizes that ending the global tuberculosis epidemic requires translating the commitments made at the 2023 UN high-level meeting on tuberculosis into real action, changing the lives and livelihoods of communities.

Note to the editor

The 2023 edition of the WHO World Tuberculosis Report is based primarily on data collected by WHO from national Ministries of Health in annual rounds of data collection. In 2023, 192 countries and areas (out of 215) with more than 99% of the world’s population and tuberculosis burden reported data. The report also draws on monthly or quarterly national TB case notification data, which has been collected since the start of the COVID-19 pandemic, and on databases maintained by other UN agencies and the World Bank.

The report has three main components. There is a brief main report that focuses on key findings and messages; web pages that provide more detailed and digitized information, including many interactive graphics; and an application containing national, regional and global profiles, as well as two slide decks. All components can be accessed from the WHO website and all data can be downloaded from the WHO online global tuberculosis database.