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Higher global burden of tuberculosis

Star Health Desk
Recent intensive efforts to improve collection and reporting of data on tuberculosis (TB) are shedding new light on the epidemic, revealing that there are almost half a million more cases of the disease than previously estimated. WHO's “Global Tuberculosis Report 2014", published recently, shows that 9 million people developed TB in 2013, and 1.5 million died, including 360000 people who were HIV positive.
The report stresses, however, that the mortality rate from TB is still falling and has dropped by 45% since 1990, while the number of people developing the disease is declining by an average 1.5% a year. An estimated 37 million lives have been saved through effective diagnosis and treatment of TB since 2000.
"Following a concerted effort by countries, by WHO and by multiple partners, investment in national surveys and routine surveillance efforts has substantially increased. This is providing us with much more and better data, bringing us closer and closer to understanding the true
burden of tuberculosis," says Dr Mario Raviglione, Director of the Global TB Programme, WHO.
Although higher, these revised figures fall within the upper limit of previous WHO estimates. The report, however, underlines that a staggering number of lives are being lost to a curable disease and confirms thatTB is the second biggest killer disease from a single infectious agent. In
addition, around 3 million people who fall ill from TB are still being 'missed' by health systems each year either because they are not diagnosed, or because they are diagnosed but not reported.
Insufficient funding is hampering efforts to combat the global epidemic. An estimated US$ 8 billion is needed each year for a full response, but there is
currently an annual shortfall of US$ 2 billion, which must be addressed.
Diagnostic capacity for MDR-TB increasing faster than treatment capacity The multidrug-resistant TB (MDR-TB) crisis continues, with an estimated 480000 new cases in 2013. Worldwide, about 3.5% of all people who
developed TB in 2013 had this form of the disease, which is much harder to treat and has significantly poorer cure rates. While the estimated percentage of new TB cases that have MDR-TB globally remains unchanged, there are severe epidemics in some regions, particularly in Eastern Europe and Central Asia. In many settings around the world, the treatment success rate is alarmingly low. Furthermore, extensively drug-resistant TB (XDR-TB), which is even more expensive and difficult to treat than MDR-TB, has now been reported in 100 countries.
Since 2009, with more laboratories rolling out rapid tests, there has been a tripling of MDR-TB cases being diagnosed. In 2013, 136000 MDR-TB cases were detected and 97000 people were started on treatment. Although the number of patients treated has increased three-fold since 2009, at least 39000 patients, diagnosed with this form of TB, were not being treated last year and globally only 48% of patients were cured.
Source: World Health Organisation