Economic Progress

Are we winning the war against tuberculosis?

This article is published in collaboration with The Bill & Melinda Gates Foundation.
Clinical lead Doctor Al Story points to an x-ray showing a pair of lungs infected with TB (tuberculosis) during an interview with Reuters  on board the mobile X-ray unit screening for TB in Ladbroke Grove in London January 27, 2014. The only mobile unit testing for TB in the country works with the most vulnerable to the disease including the homeless, drug and alcohol dependent.  REUTERS/Luke MacGregor  (BRITAIN - Tags: HEALTH SOCIETY) - RTX17X9Q

Clinical lead Doctor Al Story points to an x-ray showing a pair of lungs infected with TB. Image: REUTERS/Luke MacGregor

Melvin Sanicas
Regional Medical Expert, Sanofi Pasteur
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Economic Progress

The fight against tuberculosis (TB) is paying off, with this year’s death rate nearly half of what it was in 1990. From 2000 to 2014, about 43 million lives were saved because of better diagnosis and treatment. However, 1.5 million people died from TB in 2014. Most of these deaths could have been prevented, according to WHO’s Global TB Report. This is the 20th global report on tuberculosis (TB) published by WHO in a series that started in 1997. It provides a comprehensive and up-to-date assessment of the TB epidemic using data reported by over 200 countries that account for more than 99% of the world's TB cases.

Key themes from the report are as follows:

  • In 2014,TB for the first time surpassed HIV in total deaths per year with 1.5 million people dying from TB in 2014 (with 400,000 of those HIV positive) and 1.2 million per year dying from HIV.
  • New national prevalence data in Indonesia have resulted in an increase in their TB cases estimates from 460,000 to 1 million, which puts Indonesia above China as the country with the second most cases, after India. The increased estimates in Indonesia drove an increase in global estimates for new TB cases to 9.6 million per year. This is the second year in a row where improved national data (Nigeria in the previous year) lead to an increase in the overall estimate of cases.
  • Of the new TB cases in 2014, 58 percent were in the Southeast Asia and Western Pacific regions, with India having the largest percentage of cases at 23 percent. The African region had 28 percent of the world's cases in 2014, but the most severe burden relative to population: 281 cases for every 100,000 people – more than double the global average of 133. More than half of the world's TB cases (54%) are in China, India, Indonesia, Nigeria and Pakistan.
  • TB is not on the rise! The large number of cases is mainly due to improvements in recent years in the way many countries are conducting prevalence surveys which have unearthed more cases which were previously unaccounted for.
  • Continued slow progress on TB with global incidence falling 1.5% per year since 2000.

From 2016, the global goal will shift from controlling TB to ending the global TB epidemic. The End TB Strategy, adopted by all WHO Member States, serves as a blueprint for countries to reduce TB incidence by 80% and TB deaths by 90% and to eliminate catastrophic costs for TB-affected households by 2030. To be able to do so, better detection systems need to be in place and tools developed to better diagnose people, and a better vaccine should be developed.

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