Equality, Equity, Tuberculosis
Tuberculosis in the World
Every year, on March 24, World Tuberculosis Day is commemorated. Despite being a preventable and treatable disease, tuberculosis remains a significant global public health issue. According to the World Health Organization's 2023 data, approximately 11 million people contracted tuberculosis, resulting in 1.25 million deaths, making it the deadliest infectious disease worldwide.
Elimination of Tuberculosis
In order to address this global issue, states and international organizations have made various commitments and developed diverse plans to combat tuberculosis.
In May 2014, the World Health Organization's (WHO) strategy to end the global tuberculosis epidemic was approved by member states. This strategy aims for "a world free of tuberculosis," where there are "zero deaths, disease, and suffering due to tuberculosis."
This strategy is based on achieving three objectives:
Reduce tuberculosis incidence (new cases) by 90% by 2030 compared to 2015.
Reduce tuberculosis deaths by 95% by 2030 compared to 2015.
No household affected by tuberculosis should face catastrophic costs by 2020.
Through the Sustainable Development Goals (SDGs), adopted in September 2015 but discussed by states since 2012 at the Rio+20 Conference, signatory states have also set a goal to end tuberculosis by 2030.
The WHO Director-General’s Flagship Initiative to fast-track progress towards ending TB, over the period 2023-2027, announced in March 2023, builds on the achievements of the first phase, launched in 2018, and aims to improve the quality of care for people affected by tuberculosis by ensuring equitable access to rapid diagnostics, shorter oral treatments, and better social protection, as well as other innovations such as digital health tools.
This year's World Tuberculosis Day’s theme is "Yes! We Can End TB: Commit, Invest, Deliver." To better understand the challenges and opportunities related to achieving this goal, it is crucial to examine the current state of countries' progress in implementing the WHO strategy, using the latest data from the WHO.
Current Situation
Number of New Tuberculosis Cases
The number of new tuberculosis cases worldwide decreased by 8% between 2015 and 2023, despite 10.8 million people being diagnosed in 2023. This decline varies by region, ranging from 3% in the WHO Eastern Mediterranean Region to 27% in the WHO European Region.
At the country level, outcomes vary. The United Kingdom achieved a notable 25% decline, whereas France reported a modest 1% decrease. In contrast, Antigua and Barbuda experienced a significant 72% decline.
Number of Tuberculosis-Related Deaths
Globally, tuberculosis-related mortality rates have decreased by an average of 25%. However, regional disparities persist, with declines ranging from 7% in Europe to 44% in the Americas Region. Furthermore, country-specific data reveal divergent trends, including a notable 80% increase in mortality rates in Brazil, whereas Armenia achieved a considerable 53% decline.
Social and Economic Burden
Ultimately, the socioeconomic burden of tuberculosis remains a pressing concern, with affected households continuing to face catastrophic costs, particularly in middle- and low-income countries, fragile states, and regions with significant variability. Notably, Afghanistan reports that 94% of households are affected, whereas Brazil reports 48%.
The progress toward global tuberculosis elimination is clearly uneven across regions. Several factors contribute to these disparities, including the COVID-19 pandemic, which has adversely impacted tuberculosis control. The incidence of new cases underscores the importance of prevention, which is often deprioritized. Tuberculosis-related deaths are frequently linked to limited access to effective treatments, particularly in resource-constrained countries or situations of fragility or humanitarian emergencies.
Adequate health system financing and prioritization of tuberculosis are also crucial. Some countries face deficits in their national tuberculosis control budgets, while others rely heavily on external funding. Notably, in low-income countries such as Afghanistan, Burundi, and Haiti, domestic funding accounts for less than 15% of their national tuberculosis budgets.. The current situation regarding USAID funding decisions will have a profound impact on the global tuberculosis epidemic.
This situation raises a critical question: Are we on track to meet the ultimate goal of eliminating tuberculosis by 2030?
What do you think?
What are your thoughts ?
This newsletter post is written by Dr. Anifa Kalay, founder of KALKIS Health Solutions/Solutions en Santé KALKIS, a social enterprise based in Ottawa.
Its mission is to contribute to addressing health inequalities in Canada and around the world by providing educational resources for healthcare professionals and researchers , as well as consulting services in health project development and management for organizations and individuals.