Tuberculosis deaths rise for first time in more than a decade as spending falls, COVID surges

The World Health Organization (WHO) reported last week that tuberculosis (TB) deaths rose for the first time in more than a decade as COVID-19 continues to impact the world.

According to WHO, approximately 1.5 million people died as a result of TB in 2020. The organization noted that fewer people were diagnosed and treated for TB or given TB preventative treatments compared to the previous year. Exacerbating issues included the fact that overall spending on TB services fell and continued to fall.

The WHO’s 2021 Global TB report attributed much of this to the new world under COVID-19. TB services have been disrupted in many countries, resources reallocated to deal with the new threat, and many afflicted now struggle to seek care amidst lockdowns. Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, said the report confirmed many fears and could signal the unraveling of much progress on TB.

“This is alarming news that must serve as a global wake-up call to the urgent need for investments and innovation to close the gaps in diagnosis, treatment, and care for the millions of people affected by this ancient but preventable and treatable disease,” Tedros said.

The bulk of TB-related deaths were felt in 30 countries that already bear the highest burden of TB, and WHO projects that still higher numbers of people could develop and die from TB through 2022. Last year, TB diagnoses tumbled from 7.1 million to 5.8 million when compared to 2019 figures. Treatment fell 21 percent over the year to 2.8 million people. Worse, only about one in three people needing treatment for drug-resistant TB were treated in 2020, according to WHO.

Low and middle-income countries account for 98 percent of reported TB cases. Of total funding available for TB in 2020, 81 percent came from domestic sources. Global spending on affiliated diagnostics, treatment, and prevention services fell overall by approximately $500 million, leaving total investment at $5.3 billion — or less than half the global target for a fully funded annual TB response. WHO estimated that around 4.1 million people currently suffer from TB but have not yet been diagnosed or reported, up from 2.9 million in 2019.

While some progress was noted in the development of new countermeasures, even R&D is running short. Despite $2 billion sought for annual investment, as of 2019, investment only reached about $900 million per year.

“We have just one year left to reach the historic 2022 TB targets committed by Heads of State at the first UN High Level Meeting on TB. The report provides important information and a strong reminder to countries to urgently fast-track their TB responses and save lives,” said Dr. Tereza Kasaeva, director of WHO’s Global TB Programme. “This will be crucial as preparations begin for the 2nd UN High Level Meeting on TB mandated for 2023.”