The World Health Organization (WHO) has released a report on the latest status of treatment of tuberculosis worldwide. The report shows that around the world more people are getting adequate care for tuberculosis in 2018 than ever before but some vulnerable populations are still left out.
The WHO’s latest Global TB Report release from Geneva I Washington DC reveals that worldwide there have been 7 million diagnoses of TB who were treated successfully in 2018. These numbers were 6.4 million in 2017. United Nations had declared earlier that TB would be the next target and these numbers are encouraging says WHO. The report added that in 2018 there have been 1.5 million deaths due to TB which came down from 1.6 million in 2017.
Although low-income nations are still at risk, the report states, there has been a steady decline in the number of new TB cases. In 2018 the number of new cases of TB was 10 million say experts. This means that if 7 million were treated adequately in 2018, 3 million remain undertreated.
WHO health worked undertaking TB screening in Cambodia. Image Credit: WHO
Eight nations struggling with TB burden at present include “Bangladesh, China, India, Indonesia, Nigeria, Pakistan, the Philippines, and South Africa” says the press release from WHO. Some other nations which have high incidence of TB but have achieved over 80 percent treatment coverage include “Brazil, China, the Russian Federation and Zimbabwe,” says the WHO.
Dr Tedros Adhanom Ghebreyesus, WHO Director-General, in his statement to the press said, “Today we mark the passing of the first milestone in the effort to reach people who’ve been missing out on services to prevent and treat TB. This is proof that we can reach global targets if we join forces together, as we have done through the ‘Find.Treat.All.EndTB’ joint initiative of WHO, Stop TB Partnership and the Global Fund to Fight AIDS, TB and Malaria”.
The report emphasizes upon the fact that in order to reach the Sustainable Development Goal of ending TB by 2030, there should be a faster progress towards providing treatment for TB to all individuals with the diagnosis and also reduce the number of new cases further. The experts behind the report state that 3 million people still need the care for TB.
The WHO report highlights some of the problems that make the task look daunting. These include poor health infrastructure and shortages of healthcare workforce as the main problems. The authors of the report add that there is much more to be done for the reporting systems which are inadequate in many regions. Many cases being treated successfully may go unreported, the researchers write. The expenditure on the disease among 80 percent of the patients in nations where the disease is more prevalent is 20 percent or more of their annual household income.
According to Dr Tedros, “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.” To achieve this, last month heads of the state met and Universal Health Coverage was agreed upon at the United Nations in New York. This could help treat public health problems including TB, HIV and malaria, says WHO.
Children with TB
Children with TB are being increasingly left out of the healthcare umbrella says the report with half of the children with TB getting adequate treatment and one in four of those under the age of five years living in households with TB receiving preventive care.
TB and HIV
TB and HIV have been focus of attention says the WHO report. The two need to be integrated as many who are positive for HIV are at risk of TB. Amalgamating the two programmes has helped two thirds of the patients with TB know their HIV status and get treatment for both conditions.
Drug resistant TB
Another major issue with TB is ending drug resistant organisms causing TB. There is an emergence of drug resistant TB that makes treatment difficult and more long standing say experts. There have been half a million new cases of drug resistant TB in 2018 and of these only one third received adequate medication and care, says the report. The WHO protocol says those with multi-drug resistant TB or MDR TB need to be treated fully and completely with oral regimens that are safer and more effective. The WHO guidance on this was released on the 24th of March this year on World TB day.
The path ahead
Dr Tereza Kasaeva, Director of WHO’s Global TB Programme, said in a statement, “WHO is working closely with countries, partners and civil society to accelerate the TB response. Working across different sectors is key if we are to finally get the better of this terrible disease and save lives.”
The WHO Global TB strategy has set goals of a 90 percent decline in TB related deaths and a 80 percent decline in TB incidence by 2030 compared to the levels in 2015. According to this strategy, the 2020 goals are 35 percent decline in TB deaths and 20 percent reduction in TB incidence compared to 2015 numbers. The UN targets are treatment of 40 million people with TB between 2018 and 2022, provide preventive care to 30 million persons with latent TB between 2018 and 2022, bring in at least US$13 billion a year and at least US$2 billion a year for TB diagnosis/treatment/care and research respectively by 2022.
The WHO report says that there is a shortage of funds in TB prevention and healthcare. In 2019 the funds for TB are to the tune of US$3.3 billion with a shortage of US$1.2 billion. International funding is vital for nations that are low and middle-income says the report. This is at US$0.9 billion in 2019.
Further 73 percent of this fund comes from the Global Fund. US government provides 50 percent of the total international donor funding for TB channelled via the Global Fund. Funds are needed for preventive drug treatment, vaccines, diagnostic tests, shorter drug regimens for TB etc.
Kasaeva said, “To accelerate TB research and innovation, WHO is developing a global strategy. We are collaborating with academia, research networks such as the BRICS TB Research network, and partners including the Bill & Melinda Gates Foundation, UNITAID and others in a quest to bring innovations into practice to break the trajectory of the TB epidemic”.