WHO 2017 TB Report: Progress, funding, health coverage all fall short of need to confront impacts of disease

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The World Health Organization’s Global Tuberculosis Report released today is available here

In 2016, an estimated 10.4 million people worldwide got sick with tuberculosis, and, although the majority of deaths from the disease can be prevented by early diagnosis and treatment,  1.7 million people died of the illness. Only 13 percent of children who should have received preventive treatment to keep them from getting sick with tuberculosis received the treatment, while only 12 of 30 countries with high rates of HIV and TB reported providing any preventive treatment to those at greatest risk of illness, including people living with HIV. More than 600,000 people became sick with tuberculosis resistant to the most effective first-line drug, and 490,000 of them had TB resistant to additional medicines as well.

All of this represents progress across the modern global landscape of an ancient disease that caused more deaths than any other single infection last year, according to  data from the World Health Organization released today. Some of the numbers represent meaningful strides in life-saving interventions since the beginning of this century. But they also represent inadequate progress against now long-recognized challenges, and in the context of goals that governments around the world, including the U.S. have set to control the disease, the inequities that fuel it, its impacts on global security, stability and development, and the public health threat of antimicrobial resistance.

Of the 10.4 million estimated new cases of tuberculosis in 2016, just 6.3 million were reported — indicating that they were treated appropriately, according to data collected from 201 countries that are home to 99 percent of the world’s population. But that’s an improvement over last year, when only 6.1 million cases were reported.

The 161,740 children under five years old who received preventive treatment to protect them from getting sick with tuberculosis represent an 85 percent increase in the numbers of eligible children who received treatment the year before.

And while the 129,689 people started on treatment for drug-resistant tuberculosis represents just 22 percent of those sick with disease resistant to the most common medicines, and while the success rate of that treatment remains at a discouraging 54 percent, it also represents a small increase over the numbers treated appropriately for drug-resistant disease the year before.

The incremental nature of this progress, the WHO report notes, falls far short of the numbers necessary to hit targets — in lowered infections, deaths, and costs to individuals, families and communities — calculated as critical to ending the impacts of tuberculosis as a global health threat.

The report notes that some of the most daunting challenges remain clustered in a “subset” of heavily burdened countries: India, Indonesia, Nigeria, the Philippines, South Africa, Pakistan, Bangladesh, the Democratic Republic of the Congo, China and the United Republic of Tanzania. Some of the countries have made more significant strides than others in tackling the gaps and inequities fueling the disease, the report shows, highlighting numbers in Brazil, Indonesia, South Africa, Thailand and Viet Nam. But funding continues to fall at least $2.3 billion short of what is needed for tuberculosis programs across the global health landscape — in both domestic health funding in middle-income countries, and donor funding to support health responses in low-income countries, according to WHO. And, while the work to develop new medicines, treatment regimens, diagnostic tools and vaccines has picked up, at least $1.2 billion more than is committed to research and development efforts now will be needed if innovations are to be available on the schedule necessary to reach 2030 goals.

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