A drive to improve data collection on tuberculosis has exposed almost half a million more cases than had been previously estimated, according to the World Health Organization’s Global Tuberculosis Report 2014.
Dr. Mario Raviglione, director of the World Health Organization’s (WHO) Global Tuberculosis (TB) Program, says that “following a concerted effort by countries, by WHO and by multiple partners, investment in national surveys and routine surveillance efforts has substantially increased.”
“This is providing us with much more and better data, bringing us closer and closer to understanding the true burden of tuberculosis,” Raviglione says.
The report reveals that 9 million people developed tuberculosis in 2013, and 1.5 million people died. Though a curable disease, the report confirms that TB is the second biggest killer disease from a single infectious agent.
Also, around 3 million people with TB are being missed by health systems through either lack of diagnosis or failure to report diagnoses.
Insufficient funding is also a problem. The report estimates that, for a full response, an estimated $8 billion is needed each year, but currently there is an annual $2 billion shortfall.
However, the report also shows that the mortality rate from TB has fallen by 45% since 1990. The number of people developing TB is also declining by an average of 1.5% every year. Since 2000, the report estimates that 37 million people have been saved through diagnosis and treatment of TB.
A supplement to the report marks 20 years of anti-TB drug-resistance surveillance and examines the actions that must be taken in order to move from prevention of multi-drug-resistant TB (MDR-TB) to cure.
An increase over the past 5 years in laboratories able to perform rapid tests has led to three times as many cases of MDR-TB being diagnosed, the report says.
MDR-TB is difficult to treat and has significantly worse cure rates than standard TB. Treatment success rate is also described as “alarmingly low” in some countries. Globally, only 48% of MDR-TB patients were cured in 2013.
There were an estimated 480,000 new cases of MDR-TB, accounting for about 3.5% of all new TB cases. Although the global percentage of MDR-TB cases remains unchanged, the report notes that epidemics have emerged in Eastern Europe and Central Asia.
Extensively drug-resistant TB – a strain of TB that is even more difficult to treat than MDR-TB – has also now been reported in 100 countries.
Dr. Karin Weyer, WHO coordinator for Laboratories, Diagnostics and Drug Resistance, says that the progress made in combatting MDR-TB has been “hard won and must be intensified.” She adds:
“Improved diagnostic tools and access mean that we are detecting and treating more cases. But the gap between detecting and actually getting people started on treatment is widening and we urgently need increased commitment and funding to test and treat every case. In countries such as Estonia and Latvia, where there is universal access to rapid diagnostics and treatment, the number of MDR-TB cases has fallen significantly. This shows what can be achieved.”
The report estimates that 13% (1.1 million) of the 9 million people who developed TB in 2013 were also HIV positive. Although the number of deaths from TB among HIV-positive people has fallen over the past decade – from 540,000 in 2004 to 360,000 in 2013 – the report recommends that preventive and antiretroviral treatments need to be “scaled-up.”