WHO sounds pandemic alarm as world’s deadliest infection at highest level since records began

This represents a significant increase from the 7.5 million cases reported in 2022.

The alarming figures have propelled TB back to its position as the leading infectious disease killer in 2023, surpassing COVID-19.

Cases are rising everywhere.

The latest provisional data from the UK Health Security Agency (UKHSA) shows that TB notification rates in the UK in 2023 increased by 12.5 per cent compared with 2022, the largest year-on-year increase in the current reporting period (2000 to 2023).

TB notification rates increased for all UK nations, with the largest increase (41.2 per cent) in Scotland and the lowest increase in England (11.0 per cent).

It is important to note that cases in Britain are relatively low compared to other countries. In 2023, they were 7.84 per 100,000 population, below WHO’s threshold of 10 per 100,000 population.

However, resistance to the antibiotics used to treat TB has risen in the UK, with the highest number of individuals (74) resistant since 2013 – this is the highest proportion since enhanced surveillance began.

The same concerning picture is emerging in America. Last year saw the highest number of cases reported in the last decade.

Tuberculosis is a bacterial infection caused by the bacteria Mycobacterium tuberculosis that primarily affecting the lungs.

It spreads through the air when infected individuals cough, sneeze, or spit. Inhaling just a few germs can lead to infection.

Common symptoms include a persistent cough lasting over three weeks, chest pain, and coughing up blood. Fatigue, fever, night sweats, loss of appetite, and weight loss are also typical signs.

TB is the leading cause of death among people with HIV and contributes significantly to antimicrobial resistance.

Despite being treatable with antibiotics, TB continues to claim 1.5 million lives annually, equating to an average of 2.5 deaths per minute.

The WHO’s Global Tuberculosis Report 2024 highlights mixed progress in the fight against TB.

Whilst TB-related deaths decreased from 1.32 million in 2022 to 1.25 million in 2023, the total number of people falling ill with TB rose slightly to an estimated 10.8 million.

The disease disproportionately affects 30 high-burden countries, with India, Indonesia, China, the Philippines, and Pakistan accounting for 56 per cent of the global TB burden. Men represented 55 per cent of TB cases, women 33 per cent, and children and young adolescents 12 per cent.

Doctor Tedros Adhanom Ghebreyesus, WHO Director-General, said: “The fact that TB still kills and sickens so many people is an outrage when we have the tools to prevent it, detect it and treat it.”

He urged countries to expand the use of these tools to end TB.

The gap between estimated new TB cases and those reported narrowed to about 2.7 million in 2023, down from around four million during the COVID-19 pandemic in 2020 and 2021.

This improvement follows substantial efforts to recover from pandemic-related disruptions to TB services.

However, multidrug-resistant TB (MDR-TB) remains a critical public health concern. Only 44 per cent of the estimated 400,000 people with MDR-TB were diagnosed and treated in 2023.

Global funding for TB prevention and care decreased further in 2023, falling far short of targets. Low-and middle-income countries, which bear 98 per cent of the TB burden, faced significant funding shortages.

Only £4.5 billion of the £17.4 billion annual funding target was available in 2023, equivalent to just 26 per cent of the global target.

International donor funding in these countries has stagnated at around £870-950 million per year. The United States remains the largest bilateral donor for TB.

The Global Fund to Fight AIDS, Tuberculosis and Malaria’s contribution, while important, remains insufficient to cover essential TB service needs.

The report emphasises that sustained financial investment is crucial for successful TB prevention, diagnosis, and treatment efforts.

TB research remains severely underfunded, with only one-fifth of the £4 billion annual target reached in 2022.

The WHO report highlights the economic impact of TB on affected households. For the first time, estimates show that half of TB-affected households in low- and middle-income countries face catastrophic costs, exceeding 20 per cent of annual household income, for diagnosis and treatment.

Five major risk factors are driving new TB cases: undernutrition, HIV infection, alcohol use disorders, smoking (especially among men), and diabetes. Addressing these issues requires coordinated multisectoral action.

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