The World Health Organisation (WHO) on September 18, 2018 released the 2018 Global TB Report in New York. The report calls for an exceptional mobilisation of national and international commitments enough to end Tuberculosis (TB) by 2030.
As per the report, although global efforts have prevented an estimated 54 million TB deaths since 2000, TB remains the world’s deadliest infectious disease.
The United Nations General Assembly High-level Meeting on the fight against tuberculosis is about to take place on September 26, 2018 to deliberate on the same issue.
Tuberculosis: Status of the epidemic
• Overall, TB deaths have decreased over the past year. In 2017, there were 1.6 million deaths including 300000 HIV-positive people. Since 2000, a 44 percent reduction in TB deaths has been witnessed among people infected with HIV.
• An estimated 10 million people developed TB in 2017. The number of new cases is falling by 2 percent every year, although faster reductions have occurred in Europe and Africa between 2013 and 2017.
• Few countries are moving faster than others as evidenced in countries such as Lesotho, Eswatini, Namibia, South Africa, Zambia, and Zimbabwe which witnessed annual declines of 4-8 percent.
• In the Russian Federation, high level political commitment and intensified TB efforts have led to more rapid 5 percent decline in cases and 13 percent decline in deaths.
• Despite all these efforts, drug-resistant TB remains a global public health crisis. In 2017, 558000 people developed disease resistant to rifampicin, the most effective first-line TB drug.
• The vast majority of people had multidrug-resistant TB (MDR-TB), the combined resistance to rifampicin and isoniazid medicines.
TB Response: Challenges
• Underreporting and under-diagnosis of TB cases remains a major challenge. Of the 10 million people who fell ill with TB in 2017, only 6.4 million were officially recorded, leaving 3.6 million people undiagnosed, or detected but not reported.
• Ten countries accounted for 80 percent of the gap of underreporting and under-diagnosis, with India, Indonesia and Nigeria topping the list.
• Treatment coverage lags behind at 64 percent and must increase to at least 90 percent by 2025 to meet the TB targets.
• To improve detection, diagnosis and treatment rates, WHO along with the Stop TB Partnership and the Global Fund launched the new initiative ‘Find. Treat. All. #EndTB’ in 2018, providing quality care to 40 million people with TB from 2018 to 2022.
• Only around half of the estimated 920000 people with HIV-associated TB were reported in 2017, of these, 84 percent were on antiretroviral therapy.
• Only one in four people with MDR-TB were reported to have received treatment with a second-line regimen.
• China and India alone were home to 40 percent of patients requiring treatment for MDR-TB, but not reported to be receiving it.
• Globally, MDR-TB treatment success remains low at 55 percent, often due to drug toxicity making it impossible for patients to stay on treatment.
• The report predicts that at least 30 million people should be able to access TB preventive treatment between 2018 and 2022, based on new WHO guidance.
• One of the most urgent challenges is to scale up funding. In 2018, investments in TB prevention and care in low- and middle-income countries fell short of USD 3.5 billion. Without an increase in funding, the annual gap will widen to USD 5.4 billion in 2020.
• A further USD 1.3 billion per year is required to accelerate the development of new vaccines, diagnostics and medicines.
To meet the global target of ending TB by 2030, countries urgently need to step up their response by increasing domestic and international funding to fight the disease. WHO strongly recommends preventive treatment for people living with HIV, and children under 5 years living in households with TB.
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