This time, “unfortunately, we observed last year for the first time in more than two decades an increase in the number of people who develop the disease as well as its drug-resistant form”, said Dr Tereza Kasaeva, director of the Global Program of fight against tuberculosis, during the presentation of the annual report. Last year, some 10.6 million people developed the disease – caused by a bacterium that mainly attacks the lungs, a 4.5% increase in one year.
The incidence rate (new cases per 100,000 people per year) increased by 3.6% between 2020 and 2021, after falling by around 2% per year for most of the past two decades. The prevalence of drug-resistant tuberculosis has also increased – by 3% between 2020 and 2021 – with 450,000 new cases of rifampicin-resistant tuberculosis in 2021.
After declining between 2005 and 2019, the number of deaths from tuberculosis rose to 1.6 million last year, returning to its 2017 level. That is an increase of more than 14% compared to 2019, when this disease had killed 1.4 million people (1.5 million in 2020). Most of the estimated increase in deaths was recorded last year in four countries: India, Indonesia, Burma and the Philippines.
Lower global spending
At the regional level, the incidence rate of tuberculosis has increased between 2020 and 2021 everywhere in the world, except in Africa where the disruptions in health services linked to the Covid-19 pandemic have had only a small impact. on the number of people diagnosed.
Most of the people who developed TB last year were in Southeast Asia (45%), Africa (23%) and the Western Pacific region (18%). Eight countries account for more than two-thirds of the cases worldwide: India, Indonesia, China, the Philippines, Pakistan, Nigeria, Bangladesh and the Democratic Republic of Congo. The Covid pandemic has thus greatly slowed progress in the fight against tuberculosis and jeopardizes the WHO’s objectives of reducing deaths from the disease by 90% and the incidence rate by 80% by to 2030, compared to 2015.
But “if the pandemic has taught us anything, it’s that solidarity, determination, innovation and the fair use of tools will allow us to overcome serious health threats. Let’s apply these lessons to the fight against tuberculosis,” WHO Director-General Dr Tedros Adhanom Ghebreyesus said in the report.
Tuberculosis, the deadliest contagious disease
But WHO reports a drop in global spending on essential TB services, from $6 billion in 2019 to $5.4 billion in 2021, less than half of the global target of 13 billion per year. Reacting to the report, the NGO Médecins sans Frontières (MSF) called for the scaling up of “faster and safer” treatment for drug-resistant tuberculosis (DR-TB) and asked that the price of a complete treatment against DR-TB does not exceed $500 per person.
Tuberculosis was in 2019 on a global scale the first due to an infectious disease, but has become since 2020 the second, behind Covid-19 and before AIDS.
Last week, Mel Spigelman, president of the non-profit association TB Alliance, told AFP that tuberculosis had regained its place as the most deadly contagious disease. Dr Kasaeva said the WHO would analyze the data and make a decision before the end of the year.