WHO Report: TB Epidemic “Even Bigger Than We Thought”
There are 500,000 more cases of tuberculosis worldwide than previously estimated, according to a new report released today by the World Health Organization.
The WHO’s Global Tuberculosis Report 2014 underscored that the highly contagious disease remains the second biggest infectious disease killer, infecting an estimated nine million people last year and killing 1.5 million.
The new numbers revealed “what many of us had feared, that the TB epidemic is even bigger than we thought,” said Dr. Joanne Carter, vice-chair of the STOP TB Partnership Coordinating Board.
“This treatable disease is becoming one of the major silent killers in the world,” said Dr. Aaron Motsoaledi, South Africa’s health minister.
However, the report indicated good news about the overall mortality trend, which fell 45 percent between 1990 and 2013. And WHO officials signaled that the rise in cases in 2013 reflected recent improvements in data gathering.
Multidrug-resistant TB (MDR-TB) — the form of the disease featured in FRONTLINE’s March film TB Silent Killer, continues to pose a serious threat. This variant of the disease is resistant to two of the first-line drugs used to treat TB.
“MDR-TB is much more difficult to treat. It is much more expensive to treat, and there are increased side effects,” said Dr. Mario Raviglione, director of the WHO’s Global Tuberculosis Program.
An estimated 480,000 people developed MDR-TB in 2013, and nine percent of those carried extensively drug resistant TB (XDR-TB), which is resistant to some second-line drugs used to treat TB. While the proportion of MDR-TB cases remained roughly the same as previous estimates, the report warned that some countries — especially in eastern Europe and central Asia — were experiencing drug-resistant epidemics.
While better diagnostic tests like GeneXpert have allowed patients suffering from MDR-TB to be identified more quickly, treatment of the drug-resistant form has not kept pace, and a staggering 39,000 people with MDR-TB remained on waiting lists untreated.
“We have a situation where patients with tuberculosis — detected and diagnosed with multidrug-resistant TB — are waiting to start treatment because of no availability of drugs, because of poor services that are not capable of enrolling patients in treatment and continuing treatment until the end,” Raviglione said.
“That creates a huge ethical issue because we have accelerated the capacity to diagnose, while at the same time the acceleration of the capacity to treat has not been at the same speed,” he added.
An estimated 97,000 people worldwide were treated for MDR-TB last year — a threefold increase since 2009. However, approximately 210,000 people died from MDR-TB in 2013. And despite the improvements in detection of MDR-TB, the report estimated that 55 percent of TB patients carrying the drug-resistant form remained undetected.
Carter pointed to a report from the Treatment Action Group, also released on Wednesday, that said that current investment in research toward new drugs, vaccines and diagnostics for TB amounted to $676 million, one third of the $2 billion that experts believe is needed for research and development.
“Also, in a worrying trend, private pharmaceutical investment in TB is actually down by over 30 percent just since 2011,” Carter added. The drop in funding “could really endanger critical new drugs in the pipeline as well as other tools,” she said.