India, Indonesia and the Philippines account for over 60% drop in tuberculosis reporting in 2020 and 2021

WHO report finds TB still world’s second leading cause of death from a single infectious agent

By Seema Prasad
Published: Tuesday 07 November 2023
Photo: iStock__

India, Indonesia and the Philippines together accounted for more than 60 per cent of reductions in tuberculosis (TB) case notifications in 2020 and 2021 during the COVID-19 pandemic, followed by a rebound to 2019 levels or beyond in 2022, according to a new report released by the World Health Organization (WHO). 

TB remained the world’s second leading cause of death from a single infectious agent in 2022, after COVID-19 and caused almost twice as many deaths as human immunodeficiency virus (HIV) / acquired immunodeficiency syndrome (AIDS), being the leading cause of death among people with HIV. 

The Global Tuberculosis Report was released on November 7, 2023. 

Read more: COVID-19 reverses decades of progress in TB elimination, India worst-hit: WHO

As a result of the major global recovery in case reporting in 2022, 7.5 million people were newly diagnosed with TB. “This was a rebound to above the pre-COVID level (7.1 million in 2019), 16 per cent above the level of 2021, 28 per cent above the level of 2020 and the highest number for a single year since WHO started global TB monitoring in the mid-1990s,” the report said.

Following large increases between 2017 and 2019, there was a reduction of 18 per cent between 2019 and 2020, from 7.1 million to 5.8 million, with a partial recovery to 6.4 million in 2021, the report added.

There were an estimated 1.3 million TB-related deaths in 2022, down from 1.4 million in both 2020 and 2021 and back to the 2019 levels. However, almost half a million excess deaths from TB were recorded in the three years 2020–2022.

About 10.6 million people had tuberculosis in 2022 worldwide, recording an increase from 2021 and 2020 estimates of 10.3 million and 10 million, respectively. 

Based on the underlying factors, an estimated 2.2 million incident cases of TB were attributable to undernourishment, 0.89 million to HIV infection, 0.73 million to alcohol use disorders, 0.70 million to smoking, and 0.37 million to diabetes.

Read more: WHO launches ‘The Big Catch-Up’ to restore immunisation progress lost during pandemic

Thirty countries with a high TB-burden contributed to 87 per cent of the 2022 estimate, with two-thirds found in eight countries. India alone accounted for 27 per cent of this proportion. 

The WHO African and Southeast Asia regions also accounted for 81 per cent of the combined total number of deaths caused by TB among people with and without HIV; India was responsible for 26 per cent of such deaths.

People living with HIV accounted for 6.3 per cent of the total number of people living with tuberculosis, though this incidence has been steadily declining.  

In 2022, 81 per cent of the global number of deaths caused by TB among HIV-negative people occurred in the WHO African and Southeast Asia regions. India accounted for 29 per cent of such deaths. 

At the first United Nations high-level meeting on tuberculosis held in September 2018, member countries set a target to provide preventive treatment to 30 million people between 2018 and 2022. The latest update said 15 million people were given TB prevention treatment, meeting only 52 per cent of the target. 

Read more: India launches community support scheme for ‘adopting’ TB patients, providing nutritional assistance

As most of the people treated had HIV, member states will meet the targets of providing TB preventive treatment for six million people living with HIV between 2018 and 2022. A total of 34 million people were treated for TB between 2018 and 2022, representing 84 per cent of the cumulative five-year target of 40 million. 

For the provision of TB diagnosis, treatment, and prevention services in 2022, about $5.8 billion was available, below pre-COVID levels and less than half of the target of at least $13 billion per year by 2022. 

Similarly, investment in TB research averaged just under $1 billion per year, less than half of the $2 billion target, the report said.

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