One epidemic can hide another. For the first time in more than twenty years, new cases of tuberculosis have increased in the world, worried the World Health Organization (WHO). Last year, some 10.6 million people developed the disease, caused by a bacterium that mainly attacks the lungs and is transmitted by projecting bacilli into the air. That is an increase of 4.5% in one year. In 2022, the disease is set to regain its place among the deadliest, ahead of Covid-19.
“We unfortunately observed last year, for the first time in more than two decades, an increase in the number of people who develop the disease as well as its drug-resistant form,” said Tereza Kasaeva, director of the Global Disease Control Programme. WHO tuberculosis, during the presentation of the annual report on the disease, last Thursday. Two factors have led to this situation: the health crisis and the renewed tension in the world. “Tuberculosis services like many other services suffered disruptions due to the Covid-19 pandemic in 2021, with serious consequences for the fight against the disease, as conflicts in Eastern Europe , in Africa and the Middle East have further aggravated the situation of vulnerable populations,” the WHO said in a statement.
Eight countries harbor two-thirds of cases
Due to this reduced care, the number of untreated patients increased, which initially led to an increase in deaths and increased community transmission of infection, then, with a certain lag, an increase in number of patients. Thus, the incidence rate (new cases per 100,000 inhabitants per year) increased by 3.6% between 2020 and 2021, after having fallen by around 2% per year for most of the last two decades. Worse: the prevalence of drug-resistant tuberculosis has also increased – by 3% between 2020 and 2021 – with, in 2021, 450,000 new cases of rifampicin-resistant tuberculosis.
Most of the people who developed TB last year were in Southeast Asia (45%), Africa (23%) and the Western Pacific region (18%). Eight countries account for more than two-thirds of the cases worldwide: India, Indonesia, China, the Philippines, Pakistan, Nigeria, Bangladesh and the Democratic Republic of Congo.
Almost no region of the world is spared. The incidence rate of tuberculosis has increased everywhere on the planet except in Africa, where the disruptions in health services linked to the Covid-19 pandemic have had only a small impact on the number of people diagnosed. The number of deaths from tuberculosis stood at 1.6 million last year, an increase of more than 14% compared to 2019, when the disease killed 1.4 million people.
1.6 million deaths last year
Tuberculosis, for a time surpassed by Covid-19, could resume its sad place as the most deadly infectious disease in the coming months, according to scientists. Most of the estimated increase in deaths was recorded last year in four countries: India, Indonesia, Burma and the Philippines. In parallel, theWHO reported a decline in global spending on essential TB services. They have fallen from $6 billion in 2019 to $5.4 billion in 2021, i.e. less than half of the global target, set at $13 billion per year.
“If the pandemic has taught us anything, it’s that solidarity, determination, innovation and fair use of tools will allow us to overcome serious health threats. Let’s apply these lessons to the fight against tuberculosis “, noted the director general of the WHO, Tedros Adhanom Ghebreyesus. Reacting to the report, Médecins sans Frontières (MSF) called for the scaling up of “faster and safer” treatment for drug-resistant tuberculosis (DR-TB). The NGO asks that the price of a complete treatment against DR-TB not exceed more than 500 dollars per person. Before the pandemic, the WHO was aiming for a 90% reduction in TB-related deaths and 80% in the incidence rate, compared to 2015.