In the 2016 report on the state of the global tuberculosis (TB) epidemic and response, the World Health Organization announced that there were an estimated 10.4 million new TB cases in 2015, higher than previous estimates. However, only 6.1 million TB cases were detected and officially reported in 2015, demonstrating a major gap in finding and testing people who may have TB. Six countries accounted for 60% of the total global burden of TB—China, India, Indonesia, Nigeria, Pakistan and South Africa. Tuberculosis remains a leading cause of death among people living with HIV, despite being curable at low cost. The cost of not treating TB, however, is high in terms of disease spread and death.
In 2015, an estimated 1.8 million people died from TB—of these deaths, 0.4 million occurred among people who were also HIV-positive. More than 20% of people living with HIV and TB disease were not receiving life-saving antiretroviral medicines, a missed opportunity to deliver comprehensive and integrated care and treatment. TB can also be prevented among people living with HIV with early antiretroviral treatment and isoniazid preventive therapy, but uptake of preventive therapy remains inadequate.
A particularly worrying finding from the report is the inadequate response to the rising burden of multi-drug resistant (MDR) TB. Only one in five people who are eligible received treatment for MDR TB in 2015. Furthermore, the cure rate for MDR TB remains disappointingly low, at 52% globally, despite recent improvements in access to new treatments.
Increasing drug resistance is one of the greatest threats to reducing the burden of illness and deaths from infectious diseases, such as HIV, TB and malaria, that prevent many people living in low- and middle-income countries from achieving their full potential. Urgent action is needed to prevent the development and spread of drug resistance, and investment in research to find new therapies to replace those rendered ineffective through drug resistance is critical.
“We face an uphill battle to reach the global targets for tuberculosis. There must be a massive scale-up of efforts, or countries will continue to run behind this deadly epidemic and these ambitious goals will be missed.”
Margaret Chan Director-General, World Health Organization
“Whenever we lose an effective first-line treatment for infectious disease owing to the development of drug resistance, the world loses another opportunity to save lives and promote the health, well-being and development of people, especially people living in poverty. Urgent attention, action, investment and research are needed to deal with this looming crisis.”
Michel Sidibé Executive Director, UNAIDS
