Global Tuberculosis Report 2023, a Glimpse of Hope

The Global Tuberculosis Report 2023 brings two positive news: we are reverting the impact of the COVID-19 and TB in prisons is getting a spotlight.

On 7 November 2023, the WHO launched its annual Global Tuberculosis Report to inform on the status of tuberculosis worldwide, its progress, and its main challenges. It’s considered the most complete document on burden of disease estimates. In 2022, it collected data from national Ministries of Health of 192 countries accounting for more than 99% of the world’s population and TB burden.

The 2023 report brings two positive news: we are finally reverting the negative impact of the COVID-19 pandemic and TB in prisons is getting a spotlight.

A glimpse of hope

After the disruption caused by the COVID-19 pandemic, we can see a glimpse of hope in the fight against tuberculosis (TB). The report shows that 7.5 million people were diagnosed with TB in 2022, making it the highest figure recorded since WHO began global TB monitoring in 1995. Even though it probably includes a sizable backlog of people who developed TB in previous years, it shows that countries worldwide are recovering access to and provision of health services. A stark example is that of India, Indonesia and the Philippines, which together accounted for over 60% of the global reductions in the number of people newly diagnosed with TB in 2020 and 2021, all recovered to beyond 2019 levels in 2022.

Encouragingly, the number of global TB deaths decreased for the first time in two years, and on 22 September 2023, at the second United Nations (UN) high-level meeting on the fight against tuberculosis, world leaders adopted a political declaration with commitments to mobilise sufficient and sustainable funding to eradicate TB and enhance equitable access to prevention, testing, treatment and care.

Source: WHO.

As Tedros Adhanom Ghebreyesus, WHO Director-General said: “For millennia, our ancestors suffered and died with tuberculosis, without knowing what it was, what caused it, or how to stop it. Today, we have knowledge and tools they could only have dreamed of. We have political commitment, and we have an opportunity that no generation in the history of humanity has had: the opportunity to write the final chapter in the story of TB.”

However, current global TB elimination efforts are still insufficient if we want to eradicate tuberculosis. TB was the second leading infectious disease killer worldwide, responsible for 1.3 million deaths in 2022 alone. TB mortality disproportionately affects people living in the most vulnerable conditions who are the most affected by this disease, contributing to a cycle of ill health and poverty.

Leave no one behind: Tuberculosis in prisons

In the context of tuberculosis, there is one group in particular that has a high risk of developing this illness and of having poorer TB treatment outcomes than the general population: people deprived of their liberty. Overcrowding, confinement in poorly ventilated closed spaces, inadequate nutrition, poor healthcare and the prevalence of other risk factors for TB such as HIV infection, alcohol use disorders and smoking are all elements contributing to higher rates of tuberculosis in prison.

The problem often doesn’t get the attention it deserves, but the numbers speak loudly: the burden of TB in prisons is about 10 times higher than in the general population.

With these numbers in mind, it is a welcoming decision that the 2023 Global Tuberculosis Report has a chapter dedicated to TB in prison in its featured topics. Researchers from ISGlobal and other institutions have been part of several publications of burden of disease in prisons in Latin American countries, requesting higher visibility by the WHO to this particular vulnerable group.

Hopefully, it will help raise awareness of a public health issue often forgotten. In line with the UN commitment to “leave no one behind”, this epidemic will not end until we take care of the health and human rights of every sector of the population.

Ending TB, together

Eradicating tuberculosis is possible, but only with collective efforts, the same that have saved an estimated 75 million lives since the year 2000. To make tuberculosis an illness of the past will require the involvement of communities and a significant increase in funding to develop new treatments and vaccines.

We have fallen short of reaching the global targets set at the first UN high-level meeting on TB for 2018–2022. Last year, only US$ 5.8 billion was available for TB diagnosis, treatment and prevention services, and investment in TB research averaged just under US$ 1 billion per year.

But we are still in time to reach the new and ambitious funding targets agreed upon at the second UN high-level meeting on TB. If we are serious about ending tuberculosis, we will need US$ 22 billion per year by 2027 for TB diagnostic, treatment and prevention services and US$ 5 billion per year by 2027 for investment in TB research.

CLICK HERE TO ACCESS THE THE GLOBAL TUBERCULOSIS REPORT 2023