Recently, the World Health Organization (WHO) has released the Global Tuberculosis (TB) Report, 2024.In the year 2024, 193 countries and territories, covering more than 99% of the world’s population and TB cases, have reported data.This decline, exceeding the global average of 8.3%, underscores India’s unwavering commitment to eliminating TB by 2025, under the National Tuberculosis Elimination Programme (NTEP).
Key Findings of the Global Tuberculosis Report 2024
- Global TB Incidence Trends: 8.2 million new TB cases were reported in 2023, up from 7.5 million in 2022, marking the highest figure recorded by WHO since 1995.
- An estimated 1.25 million TB deaths were recorded in 2023, slightly lower than 1.32 million in 2022.
- Demographics of TB Cases: 30 low- and middle-income countries (LMICs) account for 87% of the global TB burden.
- Five countries alone—India (26%), Indonesia (10%), China (6.8%), the Philippines (6.8%), and Pakistan (6.3%) contribute 56% of the global TB burden.
- 55% of TB cases occurred in men, 33% in women, and 12% in children and young adolescents.
- India’s TB Scenario: India recorded an estimated 27 lakh TB cases in 2023, of which 25.1 lakh individuals were diagnosed and began treatment.
- TB incidence in India dropped from 237 cases per lakh population in 2015 to 195 per lakh in 2023, reflecting a 17.7% decline over the period.
- Treatment coverage increased to 89% in 2023, up from 72% in 2015, significantly reducing the gap of undiagnosed or untreated cases.
- End TB Strategy Goals (Post-2015): WHO Global TB Report 2024 indicates, India is unlikely to eliminate TB by 2025 as it is falling short of the WHO’s End TB Strategy milestones, which require reducing TB deaths by 75% and incidence by 50% from 2015 levels.
- Progress so far suggests India will not achieve the target of reducing TB deaths to 7 per 1,00,000 and incidence to 118.5 per 1,00,000 by 2025
Tuberculosis (TB)
- TB is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs.
- Transmission: TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air.
- Symptoms: Cough with sputum and blood at times, chest pains, weakness, weight loss, fever and night sweats.
- Treatment: TB is a treatable and curable disease.
- It is treated with a standard 6 month course of 4 antimicrobial drugs that are provided with information, supervision and support to the patient by a health worker or trained volunteer.
- Anti-TB medicines have been used for decades and strains that are resistant to 1 or more of the medicines have been documented in every country surveyed.
- Multidrug-resistant tuberculosis (MDR-TB) is a form of TB caused by bacteria that do not respond to isoniazid and rifampicin, the 2 most powerful, first-line anti-TB drugs. MDR-TB is treatable and curable by using second-line drugs. India holds 27% of the global burden of multi-drug resistant TB (MDR-TB)
- Extensively drug-resistant TB (XDR-TB) is a more serious form of MDR-TB caused by bacteria that do not respond to the most effective second-line anti-TB drugs, often leaving patients without any further treatment options.
India’s Commitment to Eliminate TB
- SDG Target 3.3: As part of the Sustainable Development Goals (SDGs), India is committed to eliminating TB by 2025, five years ahead of the global deadline of 2030.
Goals
- 80% reduction in TB incidence from 2015 levels.
- 90% reduction in TB mortality from 2015 levels.
- Elimination of catastrophic health costs for TB-affected households.
- High-Level Initiatives: The commitment was reiterated at events like the “End TB Summit” (2018) and the “One World TB Summit” (2023) and through India’s signing of the Gandhinagar Declaration (adopted at the end of the two-day meeting held in Gandhinagar, Gujarat, to follow up on the progress made to end TB by the countries of South-East Asia Region)
Challenges Encountered in Eradicating TB
- Insufficient Global Funding: In 2023, the total funding available in low- and middle-income countries (LMICs) was USD 5.7 billion, equivalent to only 26% of the target of reaching USD 22 billion by 2027.
- Catastrophic TB Costs: Nearly 20% of Indian households with TB face catastrophic health expenses, well above the WHO target of zero.
- Limited Donor Support in LMICs: International donor funding in LMICs remains stagnant at around USD 1.1–1.2 billion annually.
- Although the U.S. and the Global Fund are major contributors, their support is insufficient to meet essential TB service needs.
- Underfunded TB Research: With only one-fifth of the USD 5 billion research target met in 2022, critical advancements in TB diagnostics, drugs, and vaccines are hindered.
- Complex and Interlinked Epidemic Drivers: The epidemic is driven by multiple risk factors, including undernutrition, HIV, alcohol use, smoking, and diabetes.