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Is Global Tuberculosis Progression at Risk according to WHO?

 

WHO: Global tuberculosis progression is at risk

Before the COVID-19 pandemic, many countries made steady progress in tackling tuberculosis. The incidence rate dropped by 9% between 2015 and 2019, and the mortality rate dropped by 14% during the same period. Global and national high-level political commitments are also being implemented. 

However, a new WHO report shows that access to tuberculosis services is still a challenge. If urgent action and investment are not taken, the global tuberculosis control target may not be achieved.

 

How many people dies from tuberculosis in the year 2019?

In 2019, approximately 1.4 million people died from tuberculosis-related diseases. 

It is estimated that 10 million people will suffer from tuberculosis in 2019, of which about 3 million have not been diagnosed or formally reported to the national health department.

 

The situation of patients with drug-resistant tuberculosis is even more serious

 In 2019, approximately 465,000 people were newly diagnosed with drug-resistant tuberculosis, and less than 40% of them received treatment. 

There is also limited progress in expanding tuberculosis prevention and treatment services.

 

Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, pointed out on Tuberculosis:

 “equal access to high-quality and timely diagnosis, prevention, treatment and care is still a challenge. To realize our goals in 2022, there is an urgent need to accelerate action around the world.”

 

According to the report, approximately 14 million people received tuberculosis treatment during 2018-2019, which is just over one-third of the five-year target (40 million people) for 2018-2022. 

From 2018 to 2019, about 6.3 million people started receiving tuberculosis prevention and treatment, which is only about one-fifth of the 5-year target (30 million people).

 

Is Funding a big issue in Tuberculosis Treatment?

In 2020, the amount of funding provided for tuberculosis prevention, diagnosis, treatment and care is US$6.5 billion, which is only half of the US$13 billion target agreed by world leaders in the "United Nations Political Declaration on Tuberculosis."

 

The COVID-19 pandemic disrupted services and further frustrated tuberculosis control efforts

Many countries have transferred human, financial and other resources in the field of tuberculosis to COVID-19 response measures. Data collection and reporting systems are also affected.

 

COVID-19 pandemic and tuberculosis

According to the new report, data collected from more than 200 countries show that the number of notified cases of tuberculosis has decreased significantly.

 From January to June 2020, the number of cases reported by the three high-burden countries (India, Indonesia, and the Philippines) decreased by 25%-30% compared to the same period in 2019. 

According to WHO simulation estimates, as the number of reported cases decreases, the actual number of deaths from tuberculosis may increase significantly.

 

Do all Countries take measures to Lower the Impact of COVID19 on Tuberculosis?

Under the guidance of WHO, countries have taken measures to reduce the impact of COVID-19 on basic tuberculosis services by strengthening infection control measures. 

A total of 108 countries (including 21 countries with a high burden of tuberculosis) further use digital technology to provide remote consultation and support.

 In order to reduce the need for people to visit medical facilities, many countries encourage patients to treat at home, provide oral treatment for patients with drug-resistant tuberculosis, carry out tuberculosis prevention and treatment, and ensure that tuberculosis patients receive adequate drug supplies.

 

Dr. Tereza Kaseva, Director of WHO’s Global Tuberculosis Programme, said:

 “In the face of this pandemic, the state, civil society and other partners have joined forces to ensure the continued provision of basic tuberculosis and COVID-19 services to those in need. 

These Efforts are essential to strengthen the health system, ensure the health of everyone and save lives."

 

Tuberculosis infection and Treatment infographics
TB Infection in Lungs

A recent progress report prepared by the Secretary-General of the United Nations pointed out that Member States and other stakeholders need to take 10 priority actions to close the gaps in tuberculosis care, funding and research, combined with the COVID-19 pandemic and other Situation, advancing multi-sectoral actions and accountability.

 

Latest Development regarding Tuberculosis Worldwide

In 2014 and 2015, WHO and member states of the United Nations adopted the United Nations Sustainable Development Goals and the WHO’s End Tuberculosis Strategy. 

The Sustainable Development Goals and the "End Tuberculosis Strategy" set out targets and indicators to substantially reduce the incidence of tuberculosis, tuberculosis mortality, and medical expenses faced by tuberculosis patients and families.

 

Target 3.3 under Sustainable Development Goal 3 lists a tuberculosis indicator that determines "to eliminate epidemics such as AIDS, tuberculosis, malaria and neglected tropical diseases by 2030".

 

The WHO’s "End Tuberculosis Strategy" aims to reduce tuberculosis deaths by 90% and tuberculosis incidence by 80% by 2030, with 2015 as the baseline. 

The target set by the strategy for 2020 is to reduce the incidence of tuberculosis by 20% and the number of deaths from tuberculosis by 35%.

 

In 2017 and 2018, the political commitment to fight tuberculosis was increased, and the first high-level meeting of the UN General Assembly on tuberculosis was held in September 2018.

 The high-level meeting adopted a political declaration reaffirming its commitment to the Sustainable Development Goals and the End Tuberculosis Strategy. The United Nations Political Declaration on Tuberculosis sets forth 4 new goals for 2018-2022:

  • Treat 40 million tuberculosis patients
  • Provide tuberculosis prevention and treatment for at least 30 million people with latent tuberculosis infection
  • Raise at least US$13 billion annually for universal tuberculosis diagnosis, treatment and care
  • Raise at least US$2 billion each year for tuberculosis research.
  • Progress in advancing global goals

According to this new report, the WHO European region is expected to achieve the main 2020 targets set in the WHO’s End Tuberculosis Strategy, with morbidity and mortality reduced by 19% and 31% respectively in the past five years. 

Infection of TB - Tuberculosis
TB Infographics


Significant progress has also been made in the African region, with morbidity and mortality rates reduced by 16% and 19% respectively over the past five years. 

However, the global progress is lagging behind. Therefore, the world will not be able to achieve the main 2020 targets set in the End TB Strategy.

 

Fundraising for TB

As in previous years, most funding for TB in 2020 (85%) will come from domestic funding. Brazil, the Russian Federation, India, China and South Africa account for 57% of total global funding.

 In 2019, international donations amounted to US$900 million, which will increase to US$1 billion in 2020. 

The Global Fund to Fight AIDS, Tuberculosis and Malaria is the largest international tuberculosis contributor in 2020, and the United States remains the largest bilateral funder for the end of tuberculosis.

 

Research and innovation regarding TB

To achieve the 2030 global tuberculosis target, technological breakthroughs need to be achieved before the end of 2025.

 The world needs to provide fast, easy and affordable point-of-care testing, and it needs to provide new, safer and more effective treatment tools and vaccines.

 In response to these challenges, Member States in 2018 called on WHO to formulate a global strategy for tuberculosis research and innovation, identifying important measures that governments and non-state actors can take. The World Health Assembly adopted this strategy in August 2020.

 

Multisectoral actions and accountability Regarding TB

To make further progress in ending tuberculosis, cross-sectoral actions must be taken and focus on implementing the WHO multisectoral accountability framework for tuberculosis.

 During 2019 and 2020, WHO worked with countries with a high burden of tuberculosis to ensure that accountability mechanisms were incorporated into national budget plans. 

We sent high-level missions to conduct assessments and carried out tuberculosis planning reviews with civil society representatives.

 

What are some Tuberculosis facts?

Tuberculosis is caused by bacteria (Mycobacterium tuberculosis) that often infect the lungs. It is the deadliest infectious disease killer in the world. 

Tuberculosis patients discharge bacteria into the air through coughing, etc., causing tuberculosis to spread.

 

About 90% of TB patients come from 30 countries each year. 

Most patients are adults, and there are more cases in men than women.

 

Tuberculosis is preventable and curable. Approximately 85% of tuberculosis patients can be cured by receiving 6 months of drug treatment; another benefit of treatment is that it can inhibit secondary transmission.

 

Since 2000, tuberculosis treatment has saved more than 60 million lives. However, due to the lack of universal health coverage, millions of people are still unable to receive diagnosis and treatment.



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