Global TB Report 2023

Context

Recently, the World Health Organization (WHO) has released the Global Tuberculosis (TB) report 2023.

Key Findings

• Reports highlighting the high burden of TB worldwide in 2022.
• Featuring data from 192 countries and areas, the report reveals that 7.5 million people were diagnosed with TB in 2022, marking the highest figure recorded since WHO began global TB monitoring in 1995.

1. Burden of TB:

1. It was the world's second leading cause of death from a single infectious agent in 2022, following Covid-19.
2. TB caused almost twice as many deaths as Human Immunodeficiency Virus (HIV)/acquired immunodeficiency syndrome stage (AIDS).

• More than 10 million people continue to fall ill with TB every year.

3. 30 High burden TB countries collectively accounted for 87% of the world's TB cases in 2022.

• Among the top eight high burden countries, in addition to India, are Indonesia, China, the Philippines, Pakistan, Nigeria, Bangladesh, and the Democratic Republic of Congo.

2. Increase in TB Diagnosis:

1. In 2022, 7.5 million people were diagnosed with TB, marking the highest figure recorded since WHO began global TB monitoring in 1995.

3. High Mortality Without Treatment:

1. Without treatment, the death rate from TB disease is high, at about 50%.
2. However, with treatments currently recommended by WHO (a 4–6 months course of anti-TB drugs), about 85% of people with TB can be cured.

4. Global Recovery in TB Diagnosis and Treatment:

1. There is a positive global recovery in the number of people diagnosed with TB and treated in 2022, following two years of Covid-19-related disruptions.
2. Countries like India, Indonesia, and the Philippines, accounted for over 60% of the global reductions.

5. TB Incidence Rate:

1. The TB incidence rate, which measures new cases per 100,000 population per year, increased by 3.9% between 2020 and 2022.
2. This increase reversed the declining trend of about 2% per year that had been observed for most of the past two decades.

Findings Related to India

• India accounted for the highest number of tuberculosis (TB) cases in the world in 2022, representing a staggering 27% of the global burden.

TB Case Fatality Ratio in India	India reported a case fatality ratio of 12%, indicating that 12% of TB cases in the country resulted in death. The report estimates that 3,42,000 TB-related deaths occurred in India in 2022, with 3,31,000 among HIV-negative individuals and 11,000 among those with HIV.
Multidrug-Resistant TB (MDR-TB)	India recorded 1.1 lakh cases of multidrug-resistant TB (MDR-TB) in 2022, highlighting the continued challenge of MDR-TB as a public health crisis.

Areas where India made Tremendous Progress:

1. Improving case detection and reversed the impact of COVID-19 on the TB programme.
2. The case detection strategies have resulted in the highest ever notification of cases in 2022 - over 24.22 lakh TB cases were notified, surpassing the pre-COVID levels.
3. The treatment coverage has improved to 80% of the estimated TB cases, an increase of 19% over the previous year.
4. In reduction of TB incidence by 16% in 2022 (from 2015) almost double the pace at which global TB incidence is declining (which is 8.7%).
5. The mortality of TB has also reduced by 18% during the same period in India and globally.

Initiatives to Combat TB

Global Efforts

The WHO has launched a joint initiative “Find. Treat. All. #EndTB” with the Global Fund and Stop TB Partnership. WHO also releases the Global Tuberculosis Report.

India’s Efforts

National Strategic Plan (NSP) for Tuberculosis Elimination (2017-2025), The Nikshay Ecosystem (National TB information system), Nikshay Poshan Yojana (NPY- financial support), TB Harega Desh Jeetega Campaign. Currently, two vaccines VPM (Vaccine Project Management) 1002 and MIP (Mycobacterium Indicus Pranii) have been developed and identified for TB, and are under Phase-3 clinical trial. In 2018 Nikshay Poshan Yojna was launched, which aimed to support every Tuberculosis (TB) Patient by providing a Direct Benefit Transfer (DBT) of Rs 500 per month for nutritional needs.

 

Way Ahead Recommended in the Global TB Report 2023:

1. TB preventive treatment: For people living with HIV, household contacts of those with bacteriologically confirmed pulmonary TB, and clinical risk groups (e.g., those receiving dialysis).
2. Addressing the co-epidemics of TB and HIV: Among all incident cases of TB in 2022, 6.3% were people living with HIV; this proportion has been steadily declining for several years.
3. Increasing access to early and accurate diagnosis: Using a molecular WHO-recommended rapid diagnostic test is one of the main components of TB laboratory-strengthening efforts under the End TB Strategy.
4. Research and innovation: The diagnostic pipeline has expanded considerably in terms of the number of tests, products or methods in development.
5. Progress towards universal health coverage (UHC): UHC along with better levels of social protection and multisectoral action on broader TB determinants are all essential to reduce the burden of TB disease.
6. Augmenting TB Finance: There was a decline in global funding available on essential TB services from US$ 6.5 billion in 2019 to US$ 5.8 billion in 2022, which is less than half of the global target.

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