One of the deadliest diseases in the world is once again gaining steam. A new report this week by the World Health Organization shows that global cases of tuberculosis and drug-resistant tuberculosis increased in 2021—the first such jump in years. A major reason for its resurgence is the covid-19 pandemic.
The bad news comes from the WHO’s latest Global Tuberculosis Report, released Thursday. According to the report, there were an estimated 10.6 million people who became sick from the bacterial disease in 2021, amounting to an increase in cases of 4.5% from 2020. There were also 1.6 million tuberculosis deaths last year, including nearly 200,000 deaths among people living with HIV. According to the WHO, tuberculosis is the 13th leading cause of death worldwide, and the second leading cause from any single infectious disease, following covid-19.
TB is caused by Mycobacterium tuberculosis. It spreads between people through the air and typically affects the lungs, though the bacteria can migrate to other parts of the body. Acute cases of TB usually result in respiratory symptoms like chest pains, chills, and coughing up blood. But the infection can also often become latent, not causing illness until years later when the immune system is weakened for another reason. HIV patients are especially vulnerable to TB, since they’re much more likely to develop an acute, life-threatening case.
Even before the pandemic emerged in late 2019, TB was one of the most prolific sources of misery and death in the world, with the burden largest in parts of Southeast Asia and Africa. But there had been slow progress in reducing active cases over time until 2021. Like many other bacterial diseases, antibiotic resistance has become a serious problem in combating TB. The incidence of drug-resistant TB rose by 3% last year, which included 450,000 cases resistant to the antibiotic rifampicin, one of the only two front-line drugs available to treat TB.
The pandemic is believed to have led to decreases in people seeking out health care services that could have diagnosed and treated acute cases or prevented latent TB infections from becoming acute. But it may have also sapped financial resources normally dedicated to fighting TB. The report notes that global spending on essential TB services dropped from $6 billion (USD) in 2019 to $5.4 billion in 2021—neither of which meets the global target of $13 billion in annual spending recommended by the WHO.
There have been some modest successes in recent years. Most notably, governments surpassed the WHO’s target and provided preventive TB treatment to about 10 million people living with HIV between 2018 and 2022. But without more resources and effort from countries and other partners around the world, the progress against TB threatens to erode further, WHO experts warn.
“The report provides important new evidence and makes a strong case on the need to join forces and urgently redouble efforts to get the TB response back-on-track to reach TB targets and save lives,” said Tereza Kasaeva, director of WHO’s Global TB Program, in a statement.