- According to official WHO figures, during 2021, 10.6 million new cases of tuberculosis and 1.6 million deaths were detected.
- The burden of drug resistance to care for patients also increased, especially towards rifampin.
- Among the positive developments are 30 highest burden countries that increased their treatment coverage in 2021, including Bangladesh, Brazil, China, Uganda and Zambia.
To date, the origin of the Covid-19 pandemic is still not known with certainty, but what is known is that it has caused quite profound damage. Until now, it has caused 6.58 million deaths, although the figure is constantly increasing. While it has also harmed other health problems that were already serious, such as tuberculosis.
In this sense, today the World Health Organization (WHO) published the World Tuberculosis Report 2022. In the first instance, it mentions that around 10.6 million people contracted this disease in 2021 —a figure 4.5% higher than that corresponding to 2020— and 1.6 million died from it.
Drugs no longer work as before
In addition, the burden of drug resistance increased by 3% between 2020 and 2021, the year in which they were detected. 450 thousand new cases resistant to rifampicin. It is the first time in many years that the number of people contracting the disease who are infected with drug-resistant bacilli has increased.
The Covid-19 pandemic caused disruptions in tuberculosis control services in 2021 and especially affected activities aimed at controlling the disease. Furthermore, the conflicts affecting Eastern Europe, Africa and the Middle East have further aggravated the situation of vulnerable groups.
The Dr Tedros Adhanom Ghebreyesus, Director General of the WHO, indicated that the pandemic showed the importance of solidarity. At the same time, equitable use must be made of the tools available to combat other serious threats to health.
“Due to ongoing difficulties in providing and accessing basic TB services, many cases remain undiagnosed and untreated. The number of new cases went from 7.1 million in 2019 to 5.8 million in 2020. Although 6.4 million cases were diagnosed in 2021, we are still well below pre-pandemic levels.”
Reductions in the reported number of diagnoses seem to indicate that there are more undetected and untreated cases, leading to an increase in deaths and community-acquired transmission of infection and, over time, the number of patients.
In addition, between 2019 and 2020 the number of people being treated with rifampicin-resistant and multidrug-resistant tuberculosis drugs. In 2021, only 161,746 people with rifampicin-resistant tuberculosis began to be treated, that is, only one in three who needed it.
📣 The WHO has published the world report on the #Tuberculosis 2022.
Morbidity and mortality from this disease increases during the COVID-19 pandemic.
ℹ️ Expanded information 👇🏼https://t.co/aVZgFtI3Pa pic.twitter.com/IoEjQXb9yY
— PAHO/WHO (@opsoms) October 27, 2022
On the other hand, the report notes a decline in global spending on essential services against this disease. It has gone from 6,000 million dollars in 2019 to 5,400 million in 2021. With this, a figure well below half of the global goal of 13,000 million dollars per year foreseen for 2022 is observed.
As in the previous 10 years, the majority of funding used in 2021 (79%) came from domestic sources. However, funding from international donors remains essential in other low- and middle-income countries.
The main source is the Global Fund to Fight AIDS, Tuberculosis and Malaria. The Government of the United States of America is the largest contributor to the Global Fund and also the largest bilateral donor. Together, it contributes about 50% of international donor funding for tuberculosis.
Some positive developments
Despite the observed stagnation, some progress has also been made. Between 2018 and 2021, 26.3 million people were treated for tuberculosis. Although there is still a long way to go to reach the goal set at the first high-level meeting of the United Nations of treating 40 million in the period 2018-2022.
Among the 30 highest burden countries, the highest levels of treatment coverage in 2021 were obtained in Bangladesh, Brazil, China, Uganda and Zambia. The number of people receiving preventive treatments rebounded in 2021 to levels close to those of 2019, but the cumulative total of 12.5 million between 2018 and 2021 was still far from the 30 million projected for the end of 2022.
As a more positive fact, the tuberculosis preventive treatment for people with HIV has far exceeded the global target of 6 million set for the period 2018-2022 and has reached more than 10 million in just four years. Seven countries—India, Nigeria, the United Republic of Tanzania, South Africa, Uganda, Zambia, and Zimbabwe—accounted for 82% of people in whom this treatment was initiated.
Meanwhile, seven countries—Ethiopia, Kenya, Lesotho, Namibia, South Africa, United Republic of Tanzania, and Zambia—have met or exceeded the 2020 target of reducing disease incidence by 20% relative to baseline levels. 2015.
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