Superbugs and 3 million missing cases – the latest, greatest challenges in the TB fight
A nurse injects a child with a TB vaccine as part of the South African Tuberculosis Vaccine Initiative trials in January 2011. TB is one of the deadliest diseases in the medical lexicon. Untreated, it kills roughly half the people it infects. AFP PHOTO/RODGER BOSCH
MISSING: Nearly 3 million people with tuberculosis who are not getting diagnosed or receiving treatment.
WANTED: More resources for tackling the scourge of TB superbugs.
These are the two most urgent messages contained in the World Health Organization's latest tuberculosis report, released today. Tuberculosis is a highly contagious bacterial disease that is both curable and preventable — yet next to HIV/AIDS, it is the world's biggest killer due to a single infectious agent.
The WHO report provides a snapshot of the global TB problem and the emerging picture does contain some bright spots: TB treatment has saved 22 million lives since 1995; the number of cases dropped from 8.7 million in 2011 to 8.6 million last year; deaths have come down from 1.4 million to 1.3 million; and the world is on track to meet the UN Millennium Development goal of cutting TB deaths in half by 2015.
But two major challenges threaten to reverse the gains: an estimated 2.9 million people are still being "missed" by health systems (amounting to about one in three people getting sick with TB), and there is a growing threat from multidrug-resistant tuberculosis, which infected an estimated 450,000 people last year.
Both challenges have the same root problem, the WHO says: a lack of resources.
"Quality TB care for millions worldwide has driven down TB deaths," said Dr. Mario Raviglione, director of the WHO's TB program, in a news release. "But far too many people are still missing out on such care and are suffering as a result."
The WHO estimates that 75 per cent of the "missing" TB cases are in just 12 countries: India (where 31 per cent of the world's TB cases are located), South Africa, Bangladesh, Pakistan, Indonesia, China, the Democratic Republic of Congo, Mozambique, Nigeria, Ethiopia, the Philippines and Myanmar.
Even more alarmingly, the most dangerous TB infections — those that are drug resistant — are also being missed and fewer than 25 per cent of these superbug cases were diagnosed in 2012. As for the drug-resistant cases that do get picked up, many of them aren't being treated; last year, an estimated 16,000 TB superbug infections went untreated, according to the WHO.
"The unmet demand for a full-scale and quality response to multidrug-resistant tuberculosis is a real public health crisis," Raviglione said. "It is unacceptable that increased access to diagnosis is not being matched by increased access to (multidrug-resistant TB) care.
The WHO report listed five priorities in the fight against TB, including catching the missing 2.9 million cases and treating multidrug-resistant TB as a public health crisis.
The report also called for more funding to ensure a full response to the TB crisis. Funding for TB in 2013 is currently pegged at about $6 billion (U.S.) but at least $7 billion to $8 billion is needed, the report says.