The World Health Organization (WHO) has recently released the Global Tuberculosis Report 2022.

Key Messages:

TB is the second leading infectious killer after COVID-19 and the 13th leading cause of death worldwide. It is also the leading killer of people with HIV and a major cause of deaths related to antimicrobial resistance.

In 2021, an estimated 10.6 million (95% confidence interval 9.9-11 million) people fell
ill with TB worldwide, of which 6.0 million were men, 3.4 million were women and 1.2
million were children. People living with HIV accounted for 6.7% of the total.

The TB incidence rate (new cases per 100 000 population per year) rose by 3.6% between 2020 and 2021, reversing declines of about 2% per year for most of the past 2 decades.

Globally, the estimated number of deaths from TB increased between 2019 and 2021, reversing years of decline between 2005 and 2019. In 2021, 1.6 million people died from TB, including 187 000 people with HIV.

Eight countries accounted for more than two thirds of the global total:

• India
• Indonesia
• China
• The Philippines
• Pakistan
• Nigeria
• Bangladesh, and
• The Democratic Republic of the Congo.

TB treatment saved 74 million lives globally between 2000 and 2021.

Globally, the number of people newly diagnosed with TB and those reported to national governments fell from 7.1 million in 2019 to 5.8 million in 2020. There was a partial recovery to 6.4 million in 2021.

The burden of drug-resistant TB (DR-TB) is also estimated to have increased between 2020 and 2021, with 450 000 (95%CI: 399 000–501 000) new cases of rifampicin-resistant TB (RR-TB) in 2021.

The number of people provided with treatment for RR-TB and multidrug-resistant TB (MDR-TB) declined between 2019 and 2020. The reported number of people started on treatment for RR-TB and MDR-TB in 2021 was 161 746, covering only about one in three of those in need.

The treatment success rate for drug-resistant TB, at 60% globally, remains low.

In 2021, 703 000 people living with HIV fell ill with TB, only 46% accessed life-saving antiretroviral therapy.

Most of the gaps in access to antiretroviral therapy were in WHO’s African Region,
where the burden of HIV-associated TB is highest.

WHO recommends TB preventive treatment for people living with HIV, household contacts of those with bacteriologically confirmed pulmonary TB, and clinical risk groups (e.g. those receiving dialysis).

Globally in 2021, TB preventive treatment was provided to 3.5 million people, – still slightly below the level of 3.6 million that was reached in 2019 but a good recovery from 3.2 million in 2020.

From 2018-2021, 12.5 million people were treated with TB preventive treatment. This is only 42% of the UN High Level Meeting TB target of 30 million for the 5-year period 2018–2022.

Most of those provided with TB preventive treatment were people living with HIV. The global sub-target of providing TB preventive treatment to 6 million people living with HIV between 2018 and 2022 was achieved well ahead of schedule.

The cumulative number of household contacts initiated on TB preventive treatment in the 4-year period 2018–2021, at 2.2 million. This is only 9.2% of the 5-year target of 24 million for the period 2018–2022.

The cumulative number of people treated between 2018 and 2021 was 26.3 million, equivalent to 66% of the 5-year (2018–2022) UN High Level Meeting TB target of 40 million. This included 1.9 million children, 54% of the 5-year target of 3.5 million.

There is still a large global gap between the estimated number of people who fell ill
with TB and the number of people newly diagnosed, with 4.2 million people not
diagnosed with the disease, or not officially reported to national authorities in 2021,
up from 3.2 million in 2019.

Additional efforts are required to achieve the End TB target on catastrophic costs
due to TB. 48% (95% CI: 36-61%) of people with TB and their households face
catastrophic costs according to latest survey evidence.

Globally in 2021, an estimated 2.2 million incident cases of TB were attributable to
undernourishment, 0.86 million to HIV infection, 0.74 million to alcohol use disorders, 0.63 million to smoking and 0.37 million to diabetes.

There was a decline in global spending on essential TB services from US$ 6.0 billion in 2019 to US$ 5.4 billion in 2021, which is less than half of the global target.

As in the previous 10 years, most of the spending on TB services in 2021 (79%) was from domestic sources.

Financing for TB research at US$ 0.9 billion in 2020 also continues to fall far short of the global target of US$ 2 billion per year, constrained by the overall level of investment.

Useful Links:

Link to the related WHO news release:

https://www.who.int/news/item/27-10-2022-tuberculosis-deaths-and-disease-increase-during-the-covid-19-pandemic

Link to the Global TB Report 2022:

https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022

Link to Country, Regional, and Global Profiles:

https://www.who.int/teams/global-tuberculosis-programme/data