GLOBAL TUBERCULOSIS SITUATION- A Reflection On Global TB Burden

 

Tuberculosis

GLOBAL TUBERCULOSIS SITUATION:

·      1.5 million people worldwide died from TB in 2020. (including 214 000 people with HIV). TB is the second infectious killer in the world, after COVID-19 (behind HIV/AIDS), and the 13th leading cause of death worldwide.

·      The year 2020 is projected to see ten million new cases of tuberculosis (TB) worldwide. 3.3 million women, 5.6 million men, and 1.1 million children live in the country. All countries and age groups are affected by TB. TB can be treated and prevented, though.

·      In 2020, there were 1.1 million new cases of TB in children worldwide. Because it can be difficult to diagnose and treat, paediatric and adolescent TB is commonly disregarded by healthcare providers.

·      86% of new TB cases in 2020 were found in the 30 countries with the highest TB burden. Eight nations, led by India, are responsible for two thirds of the total, with China, Indonesia, the Philippines, Pakistan, Nigeria, Bangladesh, and South Africa following.

Global TB Situation

·      The public health dilemma and security threat posed by multidrug-resistant tuberculosis (MDR-TB) persist. In 2020, just around one in three individuals with drug-resistant TB received therapy.

·      Globally, the incidence of TB is decreasing at a rate of roughly 2% year, and between 2015 and 2020, this reduction totaled 11%. The End TB Strategy milestone of a 20% reduction between 2015 and 2020 was more than halfway reached.

·      Between 2000 and 2020, TB detection and treatment are expected to save 66 million lives.

·      According to the most recent national TB patient cost survey statistics, about one in two TB-affected households worldwide incur costs that exceed 20% of their household income. By 2020, the global goal of having no TB patients or their households incur catastrophic costs as a result of the disease was not met.

·      To reach the global goal set at the UN high level summit on TB in 2018, US$ 13 billion is required per year for TB prevention, diagnosis, treatment, and care. This figure will be reached by 2022.

·      The 98% of reported TB cases that are located in Low and middle income countries (LMICs ) are covered by significantly less funding than is required. The amount spent in 2020 was US$ 5.3 billion less than the overall goal (41%).

·      Spending decreased by 8.7% between 2019 and 2020 (from US$ 5.8 billion to US$ 5.3 billion), returning TB funding to 2016 levels in 2020.

·      One of the health objectives of the United Nations Sustainable Development Goals is to end the TB epidemic by 2030. (SDGs).

Key facts about TB

WHO IS MOST IN DANGER?

The majority of persons with tuberculosis are in their prime working years. All age groups, though, are in danger. Developing nations account for more than 95% of cases and fatalities.

Active TB is 18 times more likely to develop in HIV-positive people (see TB and HIV section below). Additionally, people with other immune-system compromising illnesses are more likely to have active TB. Undernourished individuals are three times as vulnerable. In 2020, there were 1.9 million new TB cases worldwide that were linked to malnutrition.

The risk of TB disease is multiplied by 3.3 for alcohol use disorder and 1.6 for cigarette use. The causes of 0.74 million new cases of TB worldwide in 2020 were related to alcohol use disorders, and 0.73 million were related to smoking.

 HIGH DISEASE BURDEN COUNTRIES RANKING: 

Eight countries accounted for two thirds of the global total:

1.      India (26%),

2.     Indonesia (8.5%),

3.     China (8.4%),

4.     the Philippines (6.0%),

5.     Pakistan (5.7%),

6.     Nigeria (4.4%),

7.      Bangladesh (3.6%) and

8.      South Africa (3.6%).

 TB SYMPTOMS:

Chest pains, weakness, weight loss, fever, and night sweats are all common signs of active lung TB, as do coughs that occasionally produce sputum and blood. Rapid molecular diagnostic assays, which have a high diagnostic accuracy and will significantly enhance the early diagnosis of TB and drug-resistant TB, are advised by the WHO to be used as the initial diagnostic test in all patients exhibiting signs and symptoms of TB. WHO advises using the Xpert MTB/RIF Ultra and Truenat assays as rapid tests.

It can be difficult and expensive to diagnose HIV-associated TB, multidrug-resistant TB, and other resistant forms of TB (see the section below on multidrug-resistant TB).

The diagnosis of tuberculosis in Children is extremely challenging.

TB SYMPTOMS

TB & HIV

Active TB disease is 18 times more likely to strike HIV-positive individuals than HIV-negative individuals.

Together, HIV and TB are a deadly combo that hastens the spread of each disease. About 215 000 persons would pass away from TB caused by HIV in 2020. Only 73% of reported TB patients in 2020 had a recorded HIV test result, up from 70% in 2019. 85% of TB patients in the WHO African Region, where the prevalence of HIV-associated TB is highest, had a recordable HIV test result. In total, 88% of TB patients who were known to be HIV-positive in 2020 were taking ART.

To decrease mortality, the WHO suggests a 12-component approach of cooperative TB-HIV activities, including steps for infection and disease prevention and treatment.

TB & HIV 

GLOBAL COMMITMENT TO END TB

Moving from halting TB to ending TB by 2030 

Global TB Commitment 

SDG-2030 & END TB 2035 TARGETS

END TB 2035 TARGETS

UPDATE ON GLOBAL TB TARGETS

Even while there has been some progress, it has been very sluggish, and it is projected that the End TB Strategy's goal of eliminating TB as a hazard to public health globally by 2035 will not be achieved.

Global TB Targets Update

When it comes to stepping up the TB response, WHO works together with nations, partners, and civil society. In order to help achieve the goals of the UN high-level meeting political declaration, SDGs, End TB Strategy, and WHO strategic priorities, WHO is pursuing six primary functions:

• Assuming a leading role in the formulation of global strategies to eradicate tuberculosis (TB) through political and multisectoral engagement, enhancing review and accountability, advocating for change, and alliances, including with civil society;
• Setting the direction for TB research and innovation while fostering knowledge creation, translation, and dissemination;
• Establishing guidelines and standards for TB treatment and prevention, as well as supporting and enabling their implementation; 

• Creating and promoting moral and fact-based TB preventive and treatment policy solutions;
• Ensuring the delivery of specialized technical assistance to Member States and partners in collaboration with WHO regional and country offices, sparking change, and creating sustainable capacity

• Monitoring and reporting on the status of the TB epidemic and the advancement of funding and response implementation at the global, regional, and national levels.