WHO warns global investments to end tuberculosis are falling far short
Governments have agreed on targets to end the tuberculosis (TB) epidemic both at the World Health Assembly and at the United Nations General Assembly within the context of the Sustainable Development Goals. They include a 90% reduction in TB deaths and an 80% reduction in TB cases by 2030 compared with 2015.
"We face an uphill battle to reach the global targets for tuberculosis," said Dr Margaret Chan, WHO Director General. "There must be a massive scale-up of efforts, or countries will continue to run behind this deadly epidemic and these ambitious goals will be missed."
The WHO 2016 "Global Tuberculosis Report" highlights the considerable inequalities among countries in enabling people with TB to access existing cost-effective diagnosis and treatment interventions that can accelerate the rate of decline in TB worldwide. The report also signals the need for bold political commitment and increased funding.
Higher global burden of disease and death
While efforts to respond to TB saved more than 3 million lives in 2015, the report shows that the TB burden is actually higher than previously estimated, reflecting new surveillance and survey data from India.
In 2015, there were an estimated 10.4 million new TB cases worldwide. Six countries accounted for 60% of the total burden, with India bearing the brunt, followed by Indonesia, China, Nigeria, Pakistan and South Africa.
An estimated 1.8 million people died from TB in 2015, of whom 0.4 million were co-infected with HIV. Although global TB deaths fell by 22% between 2000 and 2015, the disease was one of the top 10 causes of death worldwide in 2015, responsible for more deaths than HIV and malaria.
Closing critical gaps in TB financing
For TB care and prevention, investments in low- and middle-income countries fall almost US$ 2 billion short of the US$ 8.3 billion needed in 2016. This gap will widen to US$ 6 billion by 2020 if current levels of funding are not increased.
Overall, around 84% of the financing available in low- and middle-income countries in 2016 was from domestic sources, but this was mostly accounted for by the BRICS (Brazil, the Russian Federation, India, China and South Africa) group of countries. Other low- and middle- income countries continue to rely heavily on international donor financing, with more than 75% coming from The Global Fund to Fight AIDS, TB and Malaria.
In addition, WHO estimates that at least an extra US$ 1 billion per year is needed to accelerate the development of new vaccines, diagnostics, and medicines.
"The resources deployed against TB, the leading infectious killer in the world, are falling short," said Dr Ariel Pablos-Méndez, Assistant Administrator for Global Health, of the US Agency for International Development (USAID) – the leading bilateral funder of the TB response. "Everyone has a part to play in closing the gap. As the report shows, we need universal health coverage, social protection mechanisms, and public health financing in high burden countries. The development aid community needs to step up more investments now, or we will simply not end one of the world’s oldest and deadliest diseases."