Global spending on essential tuberculosis services decreased from $6 billion in 2019 to $5.4 billion in 2021.
The COVID-19 pandemic has set back years of progress made on nearly every indicator on tuberculosis (TB) front. New cases in 2021 — an estimated 10.6 million people — increased by 4.5 per cent from 2020 while the burden of drug-resistant TB (DR-TB) increased by three per cent in the same duration.
These figures have increased for the first time in many years, the World Health Organization’s (WHO) 2022 Global TB report released on 27 October noted.
“If the COVID-19 pandemic has taught us anything, it’s that with solidarity, determination, innovation and the equitable use of tools, we can overcome severe health threats. Let’s apply those lessons to tuberculosis. Working together, we can end TB,” said Tedros Adhanom Ghebreyesus, WHO director-general.
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Several other key indices typically used to measure progress in eradicating TB have witnessed a decline. Global spending on essential TB services decreased from $6 billion (Rs 49,542 crore) in 2019 to $5.4 billion in 2021.
The decline is worrying because even the 2019 figure was less than half of the global target of $13 billion annually by 2022. For the past decade, nearly 80 per cent of funding for essential TB services has come from domestic sources, but for low- and middle-income countries, international donors are crucial.
The number of newly diagnosed cases fell from 7.1 million in 2019 to 5.8 million in 2020, followed by a marginal improvement to 6.4 million in 2021. This is not an indication of successfully controlling TB but insufficient testing, tracing and diagnosis.
“Reductions in the reported number of people diagnosed with TB suggest that the number of people with undiagnosed and untreated TB has grown,” the report noted.
This has resulted in an increased number of TB deaths and more community transmission of infection and then, with some lag-time, increased numbers of people developing TB.
A similar trend is seen in the treatment of rifampicin-resistant TB patients, with 161,746 receiving medical attention — about one in three of those in need. Between 2018 and 2021, some 26.3 million people were treated for TB, a figure still far from the goal set at the United Nations high-level meeting on treating 40 million people in the same duration.
“The report provides important new evidence and makes a strong case on the need to join forces and urgently redouble efforts to get the TB response back-on-track to reach TB targets and save lives,” Tereza Kasaeva, director of WHO’s global TB programme said in a WHO statement.
Read more: India reports sharp decline in tuberculosis registration after COVID-19 lockdown
“This will be an essential tool for countries, partners and civil society as they review progress and prepare for the 2nd UN high-level meeting on TB mandated for 2023,” Kasaeva added.
However, some progress has been made. Bangladesh, Brazil, China, Uganda and Zambia had the highest treatment coverage among the high TB-burden countries. Between 2018 and 2020, more than 10 million HIV-positive patients were given preventative TB treatment, surpassing the global target of 6 million in the same period.
More than 80 per cent of those who started preventive therapy in 2021 were from India, Nigeria, South Africa, Uganda, the United Republic of Tanzania, Zambia and Zimbabwe.
The use of rapid diagnosis has also increased from 33 per cent in 2020 to 38 per cent in 2021. All-oral longer treatment regimens for multidrug-resistant TB are in use in 109 countries in 2021, up from 92 in 2020; while shorter regimens are in use in 92 countries in 2021, up from 65 in 2020.
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