Global Tuberculosis Report 2024

05-11-2024

In October 2024, the World Health Organization has published the Global Tuberculosis Report 2024 which is released annually.

Tuberculosis (TB) is a bacterial infection caused by an organism called mycobacterium tuberculosis, which mainly affects the lungs, but can also impact other parts of the body.
TB spreads through the air, particularly in close contact with an infected person in crowded or poorly ventilated spaces.
Symptoms: Symptoms of active TB in the lungs include - cough with sputum or blood, chest pain, weakness and weight loss, fever and night sweats
Treatment: TB is treated with a 6-month course of four antimicrobial drugs, administered with supervision and support from health workers or trained volunteers.
Drug Resistance: Resistance to TB drugs has been found globally.

Multidrug-Resistant TB (MDR-TB): Caused by bacteria resistant to the primary TB drugs, isoniazid and rifampicin. MDR-TB can be treated with 2^nd-line drugs like bedaquiline.
Extensively Drug-Resistant TB (XDR-TB): A severe form of MDR-TB where bacteria do not respond to most 2^nd-line drugs which limits the treatment options.

HIV and Antimicrobial Resistance: TB is the top cause of death among those with HIV and significantly contributes to antimicrobial resistance.

Key Highlights of the Global Tuberculosis Report 2024

Record High TB Diagnoses: In 2023, 8.2 million people were newly diagnosed with TB, marking the highest number recorded by WHO since 1995. This is a notable rise from the 7.5 million new cases in 2022.
TB Deaths: TB deaths in 2023 were estimated at 1.25 million which is a decrease from 1.32 million in 2022 and shows a steady decline since the COVID-19 pandemic peak.
TB Burden in Low-and Middle-Income Countries: 30 low-and middle-income countries account for 87% of global TB cases.

Top Five Contributors: India - 26%, Indonesia - 10%, China - 6.8%, Philippines - 6.8%, Pakistan - 6.3%.
These five countries collectively make up 56% of global TB cases.

Demographics of TB Patients: Gender and Age Distribution across the globe are-

Key Risk Factors for TB: Undernutrition, HIV infection, Alcohol use disorders, Smoking, Diabetes

Improvement in Diagnosis: The estimated number of tuberculosis cases in India slightly decreased in 2023 but the reported cases increased which is a positive sign that diagnosis gaps are closing.
India’s TB Cases and Deaths in 2023: India had around 28 lakh TB cases, representing 26% of global cases.

TB-Related Deaths: Estimated at 3.15 lakh which accounted for 29% of the global TB deaths.
Despite some reduction in cases and deaths, India still remains far from its TB elimination Target.

TB Incidence Rate: The incidence rate of TB per population also decreased in India, from 275 cases per 100,000 people in 2010 to 195 cases in 2023.

However, there was an increase in notified TB relapse cases in 2023, marking the highest level of relapses since 2010. Most relapse cases were seen in men.
A relapse of tuberculosis (TB) is when a patient who was previously treated for TB and declared cured experiences a re-emergence of clinical symptoms. This can happen even if the initial treatment was effective.

Reduced Diagnosis Gap: The gap between estimated cases and actual reported cases in India is narrowing.

India reported 25.2 lakh TB cases in 2023 which are higher from 24.2 lakh in 2022.
India and Indonesia together accounted for 45% of the increase in globally reported cases between 2021 and 2023, highlighting significant improvements in diagnosis.

Progress Towards WHO End TB Targets: India achieved only an 18% reduction in TB cases between 2015 and 2023, which is short of the 50% reduction goal set for 2025.

TB-related deaths decreased by 24%, which still falls short of the 75% reduction target by 2025.

Preventive Treatment and High-Risk Groups: The number of people receiving preventive TB treatment has been steadily increasing.

High-risk groups include individuals with: Nutritional deficiencies, Diabetes, Smoking habits

Funding for TB: The funding for TB in India has been declining. Domestic funding in India has decreased from $345 million to $253 million.
Health Expenditure: Health expenditure per capita has substantially increased between 2000 and 2021 in several lower-middle-income countries, including India. This aims to support universal health coverage.
National TB Prevalence Survey: India is among three countries to have completed a national TB prevalence survey since 2019, strengthening its data for addressing TB.

“Find. Treat. All. #EndTB” Initiative: A collaborative effort by the World Health Organization (WHO), the Global Fund, and the Stop TB Partnership to find and treat all TB cases and work toward ending TB globally.
Global Plan to End TB (2023-2030): This plan is provided by ‘Stop TB Partnership’ and aims to end TB as a public health threat by 2030. It is supported by all UN member states and aligns with WHO’s objectives.
End TB Strategy: Part of UN Sustainable Development Goal 3.3, this strategy broadens the global effort to eliminate TB and includes ambitious targets for TB reduction.
#ENDTB Strategy (WHO Initiative): Global Goals for 2035 -

National Tuberculosis Elimination Programme: India aims to reduce TB burden and eliminate the disease by 2025, five years before the global target of 2030.
National Strategic Plan (2017-2025): India aims to reduce TB incidence to less than 44 new cases or 65 total cases per lakh population by 2025.
Pradhan Mantri TB Mukt Bharat Abhiyan: A national mission focused on making India TB-free.
TB Harega Desh Jeetega Campaign: A campaign aimed at increasing TB awareness and encouraging public participation in fighting TB.
Free TB Medicines: The government provides free medicines for TB treatment. It is very crucial because TB drugs can be costly and treatment may last up to two years.
Ni-kshay Portal: An online Ni-kshay portal tracks notified TB cases for better monitoring. Through the Ni-kshay Mitra program, community members can adopt TB patients and provide them with monthly nutritional support.
National TB Call Centre – Ni-kshay SAMPARK: This call center addresses TB-related questions and provides tele-counselling to patients on treatment procedures.