World Health Organization’s 2022 Global TB Report
An estimated 10.6 million people fell ill with tuberculosis in 2021, an increase of 4.5 percent from 2020, and 1.6 million people died from TB (including 187,000 among HIV positive people), according to the World Health Organization’s 2022 Global TB report. The burden of drug-resistant TB (DR-TB) also increased as this insidious strain continues to proliferate, with 450,000 new cases of rifampicin-resistant TB (RR-TB) in 2021.This is the first time in many years an increase has been reported in the number of people falling ill with TB and drug resistant TB. TB services are among many others disrupted by the COVID-19 pandemic in 2021. However, the pandemic’s impact on TB response has been particularly severe. Ongoing conflicts across Eastern Europe, Africa and the Middle East have further exacerbated the health situation for vulnerable populations.
Continued challenges with providing and accessing essential TB services have meant that many people with TB were not diagnosed and treated. The reported number of people newly diagnosed with TB fell from 7.1 million in 2019 to 5.8 million in 2020.
Reductions in the reported number of people diagnosed with TB suggest that the number of people with undiagnosed and untreated TB has grown, resulting first in an increased number of TB deaths and more community transmission of infection and then, with some lag-time, increased numbers of people developing TB. The number of people provided with treatment for RR-TB and multidrug-resistant TB (MDR-TB) has also declined between 2019 and 2020.
The report notes a decline in global spending on essential TB services from US$6 billion in 2019 to US$5.4 billion in 2021, which is less than half of the global spending target of US$13 billion annually by 2022. As in the previous 10 years, most of the funding used in 2021 (79 percent) was from domestic U.S. sources. In low- and middle-income countries, international donor funding remains crucial. The main source is the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund). The United States Government is the largest funding contributor to the Global Fund and is also the largest bilateral donor; overall, it contributes close to 50 percent of international donor funding for TB.
Despite ongoing challenges, there are notable successes, including countries increasing the uptake of new tools and guidance recommended by WHO, resulting in early access to TB prevention and care and better outcomes. The proportion of people diagnosed with TB who were initially tested with a rapid diagnostic increased from 33 percent in 2020 to 38 percent in 2021. 109 countries were using all-oral longer regimens (up from 92 in 2020) for the treatment of MDR/RR-TB, and 92 were using shorter regimens (up from 65 in 2020).
The report reiterates its call for countries to put urgent measures in place to restore access to essential TB services. The report further calls for increased investments, multisectoral action to address the broader determinants that influence TB epidemics and their socioeconomic impact as well as the need for new diagnostics, drugs and vaccines. To intensify vaccine development, building on lessons from the pandemic, WHO will be convening a high-level summit in early 2023.
