• An estimated 10.6 million people fell ill with tuberculosis (TB) in 2021, an increase of 4.5 per cent from 2020, and 1.6 million people died from tuberculosis, according to the World Health Organisation’s 2022 Global TB report.

• The burden of drug-resistant TB (DR-TB) also increased by 3 per cent between 2020 and 2021, 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. 

• With 28 per cent cases, India was among the eight countries accounting for more than two-third (or 68.3 per cent) of the total TB patients’ count. 

• The other countries were Indonesia (9.2 per cent), China (7.4 per cent), the Philippines (7 per cent), Pakistan (5.8 per cent), Nigeria (4.4 per cent), Bangladesh (3.6 per cent) and the Democratic Republic of the Congo (2.9 per cent).

• A total of 21.4 lakh TB cases were notified in India in 2021, around 18 per cent higher than 2020, with over 22 crore people screened for the disease across the country for early detection and treatment.

Tuberculosis

• Tuberculosis, the second (after COVID- 19) deadliest infectious killer, is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. It can spread when people who are sick with TB expel bacteria into the air – for example, by coughing.

• Every year, 10 million people fall ill with TB. Despite being a preventable and curable disease, 1.5 million people die from TB each year.

• TB is the leading cause of death of people with HIV and also a major contributor to antimicrobial resistance.

• Most people who develop the disease are adults.

• Many new cases of TB are attributable to five risk factors: undernutrition, HIV infection, alcohol use disorders, smoking and diabetes.

• TB is preventable and curable. About 85 per cent of people who develop TB disease can be successfully treated with a 4/6-month drug regimen. Treatment has the added benefit of curtailing onward transmission of infection.

• Economic and financial barriers can affect access to health care for TB diagnosis and completion of TB treatment; about half of TB patients and their households face catastrophic total costs due to TB disease. 

• Progress towards universal health coverage (UHC), better levels of social protection and multisectoral action on broader TB determinants are all essential to reduce the burden of TB disease.

Key points of the report:

• Three countries accounted for 42 per cent of global cases in 2021. India (26 per cent), the Russian Federation (8.5 per cent) and Pakistan (7.9 per cent). 

• Progress made in the years up to 2019 has slowed, stalled or reversed, and global TB targets are off track.

• The most obvious and immediate impact was a large global drop in the reported number of people newly diagnosed with TB. From a peak of 7.1 million in 2019, this fell to 5.8 million in 2020 (–18 per cent), back to the level last seen in 2012. 

• Reductions in the reported number of people diagnosed with TB in 2020 and 2021 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. 

• In 2021, there was a partial recovery, to 6.4 million (the level of 2016–2017). The three countries that accounted for most of the reduction in 2020 were India, Indonesia and the Philippines (67 per cent of the global total). 

• They made partial recoveries in 2021, but still accounted for 60 per cent of the global reduction compared with 2019. 

• Globally, the estimated number of deaths from TB increased between 2019 and 2021, reversing years of decline between 2005 and 2019.

• In 2021, 82 per cent of global TB deaths among HIV-negative people occurred in the WHO African and South-East Asia regions. India alone accounted for 36 per cent of such deaths. 

Urgent measures needed 

• In the midst of stalling progress, there are some successes.

• Worldwide, 26.3 million people were treated for TB between 2018 and 2021, though again, still far short of the 40 million target set four years ago. 

• TB preventive treatment for people living with HIV also far surpassed the global target of six million, reaching more than 10 million in the same period.  

• The report underscores the need for countries to implement urgent measures to restore access to essential TB services.  

• It also calls for increased investments, and 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. 

Indian govt’s initiatives to combat TB

• Under the Pradhan Mantri TB Mukt Bharat Abhiyan, an initiative of the government, more than 40,000 Nikshay Mitra are supporting over 10.45 lakh TB patients all over the country presently.  

• The National Strategic Plan for TB Elimination (2017-25) was approved on May 8, 2017 and is being implemented in the entire country with the goal of Ending TB by 2025.

• India conducted its own National Prevalence Survey to assess the true TB burden in the country. It is the world’s largest such survey ever conducted. The only country in which a national TB prevalence survey has been completed since 2019 is India. The survey was started in 2019 but was interrupted for several months in 2020 due to the COVID-19 pandemic and then completed in 2021.

• During 2020-21, India made cash transfers of Rs 670 crore to TB patients through a Direct Benefit Transfer programme.

• In September 2022, the President of India launched a first-of-its-kind initiative, Pradhan Mantri TB Mukt Bharat Abhiyan, to provide additional nutritional support to those on TB treatment, through contributions from community and organisations.

• Till date, 40,492 donors have come forward to support over 10,45,269 patients across the country.

Manorama Yearbook app is now available on Google Play Store and iOS App Store