Around 10 million people from the low-income and marginalized populations developed TB in 2018, even though the number of new cases of TB have been declining steadily in recent years.
WHO’s latest Global TB Report highlights that the world must accelerate progress if it is to reach the Sustainable Development Goal of ending TB by 2030. The report also notes that an estimated 3 million of those with TB still are not getting the care they need.
Globally, 7 million people were diagnosed and treated for TB – up from 6.4 million in 2017, says the report.
The year 2018 also saw a reduction in the number of TB deaths: 1.5 million people died from TB in the year, down from 1.6 million in 2017.
Poor infra, weak reporting
In many countries today, fragile health infrastructure and workforce shortages make it difficult to provide timely diagnosis and the right treatments for TB. Weak reporting systems are another problem: health providers may treat people but fail to report cases to national authorities, leaving an incomplete picture of national epidemics and service needs. Further, up to 80 percent of TB patients in high burden countries spend more than 20 percent of their annual household income on treating the disease.
“Sustained progress on TB will require strong health systems and better access to services. That means a renewed investment in primary health care and a commitment to universal health coverage,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General in a statement.
In September, heads of state agreed on a political declaration on Universal Health Coverage at the United Nations in New York, highlighting the importance of expanding service coverage and committing specifically to strengthen efforts to address communicable diseases like HIV, TB, and malaria.
One way to improve coverage is to adopt more people-centred comprehensive approaches. Better integrated HIV and TB programmes already mean that two-thirds of people diagnosed with TB now know their HIV status. In addition, more people living with HIV are taking treatment.
But child health programmes still do not always focus adequately on TB: half of the children with TB do not access quality care and only a quarter of children under the age of 5 in TB-affected households currently receive preventive treatment.
Drug resistance: Major hurdle
Drug resistance remains another impediment to ending TB. In 2018, there were an estimated half a million new cases of drug-resistant TB. Only one in three of these people was enrolled in treatment.
New WHO guidance aims to improve the treatment of multidrug resistant TB, by shifting to fully oral regimens that are safer and more effective. The guidance is part of a larger package of steps released on 24 March 2019 — World TB Day — to help countries speed up efforts to end the disease.
The fight against TB remains chronically underfunded. WHO estimates the shortfall for TB prevention and care in 2019 at US$3.3 billion. International funding amounts to US$0.9 billion in 2019, with 73% coming through the Global Fund.