In developed countries TB is considered to be virtually extinct. Nineteen Eighty-Four author George Orwell was one of the last famous people to die from TB in England in 1950.
However globally it is a very different story, particularly in the southern hemisphere.
Global cases of tuberculosis — also known as TB — continued to rise last year as disruption to health services caused by the COVID-19 pandemic set back efforts to fight the disease, according to the latest report from the World Health Organization which says that TB still caused well over a million deaths last year.
Tuberculosis, an infectious disease that usually attacks the lungs, is both preventable and curable. It spreads by tranmission from person to person, usually through living at close quarters.
However, there was a small increase in the number of global TB cases to an estimated 10.6 million. Some 40% of people living with TB are undiagnosed and untreated.
The disease is just behind COVID-19 as the world’s deadliest infectious illness, with India, Indonesia and the Philippines particularly affected.
COVID disruption
The COVID-19 pandemic, which began in 2020, saw health services overwhelmed in many parts of the world. TB diagnosis and treatment levels plummeted, said Dr. Lucica Ditiu, the executive director of the Geneva-based Stop TB Partnership.
“Unfortunately, the incidence of TB is growing. We used to have a decline of 2% per year. And then due to COVID, we have now an increase for the last two years — 2021 and 2022 — of almost 4%,” she told VOA.
The World Health Organization estimates COVID-related disruptions resulted in almost half a million excess deaths from TB in the three years from 2020 to 2022.
Childhood TB
The report also reveals a concerning lack of progress in some areas, according to Ditiu.
“We see … a pretty difficult situation for people with drug-resistant TB as well as childhood TB. So [with] drug-resistant TB, just short of 200,000 were diagnosed and put in treatment,” she said. “And exactly as the WHO said, two out of five people with drug-resistant TB had access to drug-resistant TB treatment. It’s actually the access to diagnosis which is limiting that.”
Ditiu said there are an estimated 1.3 million children with TB, about 12% of the world total. Children make up 16% of those who die from TB, she said.
Improved diagnosis
However, the focus on fighting tuberculosis appears to be getting back on track. The total number of cases diagnosed globally last year was 7.5 million, the highest ever recorded.
“This shows that the countries buckled up to recover after COVID – and even jump above the level before COVID,” Ditiu said.
Vaccine hopes
There is already a vaccine for tuberculosis called BCG which has been in use since 1921, and is widely used in British Commonwealth Countries, but there is just one snag.
The most controversial aspect of BCG is the variable efficacy found in different clinical trials, which appears to depend on geography. Trials conducted in the UK have consistently shown a protective effect of 60 to 80%, but those conducted elsewhere have shown no protective effect, and efficacy appears to fall the closer one gets to the equator.
The duration of BCG is also questionable. Some studies suggest that it has little or no effect protective after 20 years.
Even today in developed countries every single person admitted to a prison must be tested for TB before they are allowed to hang out with other inmates.
So a modern vaccine would be a godsend and could help to finally eradicate the dreaded disease.
Even today in developed countries every single person admitted to a prison must be tested for TB before they are allowed to hang out with other inmates.
A promising TB vaccine made by GlaxoSmithKline, known as M72, is currently in the final stage of trials and no lessthan sixteen other vaccines are undergoing earlier stages of testing.
“We need a vaccine. So that will be the game changer,” said Ditiu.
The 19% fall in deaths from TB from 2018 to 2022 is still far short of the World Health Organization’s target of a 75% reduction by 2025.
Funding also fell short, reaching less than half of the WHO target of at least $13 billion on TB diagnosis, treatment and prevention services in 2022.
Governments committed to spending $22 billion a year on TB by 2027 at a special U.N. meeting in September.
Sources: VOA, CDC, Wikipedia.
