TB was the leading cause of infectious disease-related deaths in 2023 – reclaiming its title which had been replaced by Covid-19 for three years – according to the 2024 Global Tuberculosis Report released this week.
Additionally, last year, 8.2m people were newly diagnosed, which is the highest number recorded since WHO began global TB monitoring in 1995, and which is up from the 7.5m reported in 2022.
One of them was Shaka Brown from the US, diagnosed with TB in November 2023 and who initially thought he had flu. However, after weeks of night sweats, fainting spells, and losing his hearing in one ear as well as nearly 25kg, he said he knew something was wrong.
Within hours of arriving at a hospital, ultrasounds, X-rays, and a battery of tests revealed that he had TB, reports Health Policy Watch.
The bacteria had spread from Brown’s lungs to nearly every organ in his body, including his bladder, brain, and spine. The infection had also compromised his lower spine, causing sharp pain down his leg.
“The hospital had a molecular diagnostic machine, which helped them quickly figure out that the standard treatment wouldn’t work for me,” he said.
He started life-saving antibiotics the next day of more than 15 pills daily – and the TB growth was halted within a week.
However, four months later, he was back in the hospital, this time with seizures and unable to speak.
“The TB in my brain wasn’t going away as quickly as they hoped,” Brown said. A week later, he underwent brain surgery to remove the infection. His doctors added anti-seizure medication to his TB regimen.
“They told me they’d stick with me every step of the way,” he added this week at the launch of the TB Report.
The 68-page document, which offers comprehensive data on TB trends and the global response, covering 215 countries and regions, and including all 193 WHO member states, shows that last year, TB caused almost twice as many deaths as HIV/Aids. Specifically, there were an estimated 1.25m deaths in 2023, including 161 000 among people with HIV.
The report reveals that 87% of cases in 2023 came from 30 high-burden countries, most new TB cases being in Southeast Asia (45%) and Africa (24%), with smaller percentages in the Western Pacific (17%), Eastern Mediterranean (8.6%), the Americas (3.2%), and Europe (2.1%).
Since 2000, says the report, TB prevention and treatment efforts have saved 79m lives. The global gap between estimated TB cases and reported new diagnoses narrowed to about 2.7m in 2023, down from around 4m in 2020 and 2021 and below the pre-pandemic level of 3.2m in 2019.
Resistant
Drug-resistant TB remains a serious public health threat, said Dr Tereza Kasaeva, WHO’s Global TB Programme director, noting that in 2023, 175 923 people were diagnosed and treated for multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB) – just 44% of the estimated 400 000 cases worldwide.
She said progress toward global TB milestones and targets was lagging, including those set for 2027. Global funding for TB prevention and care dropped in 2023. Of the $22bn target, only $5.7bn was received.
“With only 26% funding, it’s impossible to provide 100% access for everyone in need,” she added.
Domestic sources provided 80% of TB funding, while international funding for low- and middle-income countries has held steady at around $1.2bn per year. Funding for TB research also remains critically low at around $1bn per year, which is just a fifth of what’s needed.
The US is the largest bilateral donor to global TB efforts, thanks to bipartisan support from Congress, said Cheri Vincent, TB Division Chief at the US Agency for International Development (USAid).
Since 2000, USAid has invested $4.7bn in the fight against TB, its global TB strategy for 2023 to 2030 focusing on 24 priority countries.
The goal is to ensure that 90% of people with TB, including drug-resistant TB, are diagnosed and treated. It also seeks to provide preventive treatment for 30m people eligible for it.
See more from MedicalBrief archives:
TB diagnoses reached record high last year – WHO report
New TB framework for improved diagnosis and care
TB remains the world’s deadliest infectious disease — WHO report