World Tuberculosis Report 2022: WHO

• 29 Oct 2022

For Prelims: Tuberculosis, World TB Report, World Health Organisation, PM TB Mukt Bharat Abhiyan, BCG Vaccine, DR-TB, MDR-TB.

For Mains: India’s performance in World TB Report, Challenges to eliminating TB, India’s progress in eliminating TB

Why in News?

The World Health Organisation (WHO) recently released the World Tuberculosis Report 2022 noting the impact of Covid-19 pandemic on the diagnosis, treatment and burden of disease for Tuberculosis (TB) all over the world.

• The 2022 report features data on trends of disease and the response to the epidemic from 215 countries and areas, including all 194 WHO member states.

What are the Key Findings of the Report?

• Diagnosis and Mortality Globally:
  • Around 10.6 million people across the world were diagnosed with TB in 2021, an increase of 4.5% from 2020, while 1.6 million patients died of the disease.
  • Of the total TB deaths, 187,000 patients were also positive for HIV (human immunodeficiency virus).
    • Nearly 82% of global TB deaths among HIV-negative people occurred in the African and South-East Asia regions.
  • The reported number of people newly diagnosed with TB fell from 7.1 million in 2019 to 5.8 million in 2020.
    • There was a partial recovery to 6.4 million in 2021, but this was still well below pre-pandemic levels.

• India and TB:
  • With 28% cases, India was among the eight countries accounting for more than two-third (68.3%) of the total TB patients’ count.
    • The other countries were Indonesia (9.2% cases), China (7.4%), the Philippines (7%), Pakistan (5.8%), Nigeria (4.4%), Bangladesh (3.6%) and the Democratic Republic of the Congo (2.9%).
  • India accounted for 36% of the global TB related deaths among HIV negative people.
  • India was among the three countries (along with Indonesia and the Philippines) that accounted for most of the reduction in 2020 (67% of the global) and made partial recoveries in 2021.
  • India’s Stand on the Report: India has performed far better on major metrics as compared to other countries over time.
    • India’s TB incidence for the year 2021 is 210 per 100,000 population – compared to the baseline year of 2015 (which was 256 per 100,000 population).
    • There has been an 18% decline (7 percentage points); better than the global average of 11% placing India at the 36th position in terms of incidence rates.
• Major Challenges to TB Elimination:
  • Rise in Drug-Resistant TB:
    • The burden of drug-resistant TB (DR-TB) increased by 3% globally between 2020 and 2021, with 450,000 new cases of rifampicin-resistant TB (RR-TB) being reported in 2021.
• Disruptions due to Covid-19:
  • This is the first time in several years that an upward trend has been reported in the number of people developing both TB and DR-TB. Experts attribute this trend to the Covid-19 pandemic.
  • Many services were disrupted by the Covid-19 in 2021 but its impact on the TB response has been particularly severe.
• Underreporting - A Major Concern:
  • Ten countries collectively accounted for 75% of the global gap between estimated TB incidence and the reported number of people newly diagnosed with the disease. These gaps are due to:
    • Underreporting (of people diagnosed with TB)
    • Underdiagnosis (people with TB being unable to access health care or not being diagnosed when they do).
  • Underreporting is more of a problem in India; the country is among the top five contributors - India (24%), Indonesia (13%), the Philippines (10%), Pakistan (6.6%) and Nigeria (6.3%).
• Decline in Diagnosis and Expenditure:
  • Reductions in the reported TB cases suggest an increase in the number of people with undiagnosed and untreated TB.
  • The number of people provided with treatment for RR-TB and multidrug-resistant TB (MDR-TB) also declined between 2019 and 2020.
    • The reported number of people receiving treatment for RR-TB in 2021 was 161,746, which is only about one in three of those in need.
• The report also 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 target of US$13 billion annually by 2022.

What is Tuberculosis?

• About:
  • TB is caused by a bacterium called Mycobacterium tuberculosis, belonging to the Mycobacteriaceae family consisting of about 200 members.
  • In humans, TB most commonly affects the lungs (pulmonary TB), but it can also affect other organs (extra-pulmonary TB). It can spread from person to person through the air.
  • Most people who develop the disease are adults — in 2021, men accounted for 56.5% of the TB burden, adult women - 32.5% and children - 11%.
  • TB is preventable and curable - around 85% of people who develop the disease can be successfully treated with a 4/6-month drug regimen.
• India’s Initiatives to Eliminate TB:
  • Under the Pradhan Mantri TB Mukt Bharat Abhiyan, India aims to eliminate TB from the country by 2025 (5 years earlier than the global target of 2030).
    • Ni-kshay Mitra is a component of this initiative that ensures additional diagnostic, nutritional, and vocational support to those on TB treatment.
  • India conducts its own National TB Prevalence Survey to assess the true TB burden in the country which is the world’s largest such survey ever conducted.
    • The Union Ministry for Health and Family Welfare also launched the ‘TB Harega Desh Jeetega Campaign’, along with the Survey.
  • Currently, two vaccines VPM (Vakzine Projekt Management) 1002 and MIP (Mycobacterium Indicus Pranii) have been developed and identified for TB which are under clinical trials.
• Note:
  • The World Tuberculosis (TB) Day is observed on 24th March to spread awareness about the disastrous health, social, and economic consequences of TB and to make efforts to end the TB epidemic globally.
  • The Bacille Calmette-Guérin (BCG) vaccine is presently the sole vaccine available for the prevention of TB.

Way Forward

• The report reiterates its call for countries to put in place urgent measures to restore access to essential TB services.
  • It further calls for increased investments, multi-sectoral 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.
• For the TB mitigation strategy to be effective, it is important to increase levels of awareness of people about the disease and ensure that the people affected by TB overcome their social insecurities and access TB care.

Source: HT