Tuberculosis epidemic larger than previously thought

The tuberculosis epidemic is larger than previously thought, infecting 10.4 million people last year, while research into vaccines and cures is "severely underfunded," the World Health Organisation (WHO) warned today.
Across the planet, 1.8 million people died of TB last year, 300,000 more than a year earlier, according to the WHO's Global TB Report 2016.
Two out of five people who fell sick with the disease -- caused by a bacteria that infects the lungs and makes people cough up blood -- went undiagnosed and untreated.
Nearly half a million people were diagnosed with multi-drug resistant TB (MDR-TB).
"WHO's annual look at the global state of tuberculosis this year makes for a shockingly bad report card," said a statement from Doctors Without Borders.

"The WHO Global TB Report is a wake-up call to break the status quo in how TB, and its drug-resistant forms, are being diagnosed and treated."

According to the report, the size of the epidemic rose largely because researchers realized that earlier estimates in India from 2000-2015 were too low.
Six countries accounted for 60 per cent of the new cases: India, Indonesia, China, Nigeria, Pakistan and South Africa.
Despite the year-on-year jump from 2014-2015, looking back over the past 15 years, the number of TB deaths fell by 22 per cent, said the report.
Still, TB remained one of the top 10 causes of death worldwide last year.

And while the overall rate of TB worldwide is falling, the pace is not fast enough, the WHO report warned.
"Worldwide, the rate of decline in TB incidence remained at only 1.5 per cent from 2014 to 2015," it said.
"This needs to accelerate to a four to five percent annual decline by 2020 to reach the first milestones of the End TB Strategy."
The goal aims for a 35 per cent reduction in the absolute number of TB deaths and a 20 percent reduction in the TB incidence rate by 2020, compared with levels in 2015.
Cash shortages are also a persistent problem.

"Funding during the decade 2005-2014 never exceeded $0.7 billion per year," said the report.
"This evidence includes household surveys, a state-wideTB
prevalence survey, studies of anti-TB drug sales in the private sector, notification data and new analysis of mortality data.
"Since India accounts for more than one quarter of the world's TB cases and deaths, these revisions have had a major impact on global estimates. Estimates for India are considered interim, pending a national TB prevalence survey scheduledfor 2017/2018," WHO said.
It said that in the African Region where the burden of HIV-associated TB is highest, 81 per cent of notified TB patients had a documented HIV test result.

"The proportion of known HIV-positive TB patients on ART was above 90 per cent in India, Kenya, Malawi, Mozambique, Namibia and Swaziland," it said.
Giving out details about India, WHO said mortality (HIV+TB only) was 37 per thousand while incidence (HIV+TB only) was 113 per thousand.
Estimated TB incidence in India in 2015 in the age group of 0-14 years for both males and females was 255 per thousand.
Commenting on the report and the disease in the South East Asian Region which also includes India, WHO Regional Director (SEARO) Poonam Khetrapal Singh said TB remains a serious problem across the region and requires the fullest attention and strongest commitment of governments.

"As outlined in WHO's new global report on TB, a number of countries in the region are among the world's highest TB burden countries, while revised estimates based on increased case-reporting and enhanced surveillance show that the TB caseload is higher than previously projected.
"TB is the single largest cause of death of any infectious disease in the region, and remains responsible for incalculable suffering, premature mortality, impoverishment and foregone development," she said.
She said though countries have been making efforts to end TB and the number of TB deaths and its incidence rate continues to fall, at the current trend the region would not be able to achieve the SDG targets.

"A newer and bolder approach is needed to bend the curve faster and sharper to achieve the global targets. This means intensifying measures to ensure early diagnosis and treatment, such as active case-finding and enhancing access to cutting-edge diagnostic tools.
"Adopting newer approaches of case diagnosis, community based treatment and treatment of latent infection. It means integrating TB programmes with existing health systems, thereby amplifying the effect these interventions have," she said.
Singh also said that funds must be allocated accordingly, while political commitment must be fortified and both must occur at national and international levels.