SWITZERLAND – The World Health Organization (WHO) has announced a resurgence in global tuberculosis (TB) cases, now exceeding COVID-19 as the leading cause of death among infectious diseases.
The Global Tuberculosis Report 2024, released today, highlights the ongoing challenge of TB worldwide, with 8.2 million new diagnoses in 2023, marking the highest number since WHO’s TB tracking began in 1995.
This number reflects a sharp increase from 7.5 million new cases in 2022, indicating that COVID-related disruptions in healthcare services may have compounded TB’s global burden.
Beyond confirmed diagnoses, the total number of TB cases, including those not officially diagnosed, is estimated to have reached 10.8 million in 2023—an increase from 10.7 million in 2022.
WHO officials note that the gap between estimated new cases and confirmed notifications has narrowed to 2.7 million, a positive sign of improved diagnostic access.
“While we’ve seen progress in closing the gap between reported and estimated cases, there is still much work ahead,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus.
Reduction in TB mortality, yet challenges remain
The report highlights that TB-related deaths decreased from 1.32 million in 2022 to 1.25 million in 2023, showing signs of recovery from the pandemic’s peak disruption.
However, TB deaths significantly outnumbered COVID-19 fatalities, estimated at 320,000 last year, underscoring TB’s continued impact on global health.
According to Dr. Tedros, “It is unacceptable that TB continues to claim so many lives when we have the tools to prevent, detect, and treat it.”
High Incidence in LMICs and risk factor correlations
The burden of TB remains disproportionately high in low- and middle-income countries (LMICs), with 30 such nations carrying 87% of global cases.
India, Indonesia, China, the Philippines, and Pakistan alone accounted for 56% of the global TB burden.
Data also points to the influence of five primary risk factors—undernutrition, HIV, alcohol use disorders, smoking, and diabetes—on new TB cases, reinforcing the need for a multisectoral approach to tackle TB effectively.
“Addressing TB requires more than medical intervention; it demands a coordinated response to social determinants like poverty and health system access,” WHO emphasized.
Financial barriers and catastrophic costs for TB patients
For the first time, the WHO report included an analysis of the financial impact of TB on patients, revealing that 50% of TB-affected individuals experience “catastrophic costs”—defined as expenditures exceeding 20% of household income.
TB advocate Shaka Brown shared his experience with the disease, emphasizing, “Half of those affected by TB face crushing financial burdens. When I was hospitalized, it took months before I could go home; many are not as fortunate.”
Funding shortfalls threaten TB elimination goals
The WHO also raised concerns over declining funding for TB services. At the 2023 United Nations High-Level Meeting on TB, countries pledged to mobilize US $22 billion per year to support TB prevention and treatment in LMICs by 2027.
However, funding in 2023 was only $5.7 billion—just 26% of the target. WHO’s Global TB Program Director Dr. Tereza Kasaeva stressed that this shortfall hampers global progress.
She said, “Sustained financial investment is crucial to TB elimination. With only 26% of required funding, universal access to care remains elusive.”
The report also cites underinvestment in TB research, with only US $1 billion dedicated to innovation in 2023, far short of the US $5 billion annual target.
This funding gap risks stalling advances in TB diagnostics, treatments, and vaccines, which are vital for improving global outcomes.
Advances in TB treatment and vaccine development offer hope
Despite these challenges, WHO remains optimistic about ongoing research and innovation.
The treatment success rate for drug-susceptible TB stands at 88%, while newer, shorter treatment regimens have increased success rates for multidrug-resistant TB to 68%.
Currently, 15 TB vaccine candidates are in development, with six in phase 3 trials in high-burden countries.
The UN has set a goal of developing at least one new, effective TB vaccine by 2028, a milestone Dr. Kasaeva hopes will be surpassed.
“There is a real possibility we may see not just one, but multiple new vaccines by 2028,” she noted.
