The World Health Organisation on 31 October 2017 released Global TB Report 2017, according to which, India has topped the list of seven countries that account for almost 64 per cent of the 10.4 million new tuberculosis (TB) cases worldwide in 2016.
India was followed by Indonesia, China, Philippines, Pakistan, Nigeria and South Africa. The report stated that an estimated 1.7 million people died from TB in 2016, including nearly 400,000 people who were co-infected with HIV, recording a drop of 4 per cent in comparison to 2015.
• India along with China and Russia accounted for almost of half of the 490,000, multidrug-resistant TB (MDR-TB) cases registered in 2016. Multidrug-resistant TB (MDR-TB) remains a public health crisis and a health security threat.
• The WHO estimates that there were 600 000 new cases with resistance to rifampicin, the most effective first-line drug, of which 490 000 had MDR- TB.
• Despite global efforts to combat TB, which saved an estimated 53 million lives since 2000 and reduced TB mortality rate by 37 per cent, the disease still was the top infectious killer in 2016.
• TB has also been reported to be the main cause of deaths related to antimicrobial resistance and the leading killer of people with HIV.
• The biggest challenge has been underreporting and underdiagnosis of TB cases, especially in countries with weak health systems and large unregulated private sectors.
• Of the estimated 10.4 million new cases, only 6.3 million were detected and officially notified in 2016, leaving a gap of 4.1 million. According to the report, India, Indonesia and Nigeria accounted for almost half of this global gap.
• Further, the report states that of the almost half a million reported cases of HIV-associated TB, 15 per cent were not on antiretroviral therapy (ART) as recommended by WHO. Most of the gaps related to HIV-associated TB were in the WHO African Region.
• TB preventive treatment is expanding in two priority risk groups - people living with HIV and children under 5 years. However, most people eligible for TB preventive treatment are not accessing it.
• Further, investments in low- and middle-income countries for TB care and prevention fall almost US$ 2.3 billion short of the US$ 9.2 billion needed in 2017.
• In addition, at least an extra US$ 1.2 billion per year is required to accelerate the development of new vaccines, diagnostics and medicines.
Hence, more domestic funding is required in middle-income countries and more international donor support is needed to support low-income countries.
Further, putting a stop to the spread of TB epidemic requires action beyond the health sector to address the risk factors and determinants of the disease.