WHO Appreciates India’s Efforts In Enhancing Funding To End TB By 2025
Prime Minister Narendra Modi’s efforts in enhancing funding to end tuberculosis (TB) by 2025, has been appreciated by the World Health Organisation (WHO).
In its annual Global Tuberculosis Report, 2017, the WHO has said that India stood out as a country in which the budget envelope for TB was substantially increased in 2017 (to US$ 525 million, almost double the level of 2016), following political commitment from the Prime Minister to the goal of ending TB by 2025.
The budget is fully funded, including US$ 387 million (74%) from domestic sources (triple the amount of US$ 124 million in 2016) and the remainder (26%) from international donor sources, the report has said.
According to the report, global efforts to combat tuberculosis (TB) have saved an estimated 53 million lives since 2000 and reduced the TB mortality rate by 37%.
Despite these achievements, the latest picture is grim. Tuberculosis remains the top infectious killer in 2016 and is also the main cause of deaths related to antimicrobial resistance and the leading killer of people with HIV. Progress in most countries is stalling and is not fast enough to reach global targets or close persistent gaps in TB care and prevention, it says.
Making large inroads into these gaps requires progress in a particular subset of high TB burden countries. Ten countries accounted for 76% of the total gap between TB incidence and reported cases; the top three were India (25%), Indonesia (16%) and Nigeria (8%).
Ten countries accounted for 75% of the incidence-treatment enrolment gap for drug-resistant TB; India and China accounted for 39% of the global gap.
“While the world has committed to ending the TB epidemic by 2030, actions and investments don’t match the political rhetoric. We need a dynamic, global, multisectoral approach,” said dr tedros Adhanom Ghebreyesus, Director-General of WHO.
In 2016, there were an estimated 10.4 million new TB cases worldwide, 10% of which were people living with HIV. Seven countries accounted for 64% of the total burden, with India bearing the brunt, followed by Indonesia, China, Philippines, Pakistan, Nigeria and South Africa. An estimated 1.7 million people died from TB, including nearly 400 000 people who were co-infected with HIV. This is a drop by 4% compared to 2015.
Multidrug-resistant TB (MDR-TB) remains a public health crisis and a health security threat. WHO estimates that there were 600 000 new cases with resistance to rifampicin – the most effective first-line drug, of which 490 000 had MDR-TB. Almost half of these cases were in India, China and the Russian Federation.
Underreporting and underdiagnosis of TB cases continues to be a challenge, especially in countries with large unregulated private sectors and weak health systems. Of the estimated 10.4 million new cases, only 6.3 million were detected and officially notified in 2016, leaving a gap of 4.1 million. India, Indonesia and Nigeria accounted for almost half of this global gap.
Only one in five MDR-TB cases were started on treatment. India and China accounted for 39% of the global gap. Treatment success remains low, at 54% globally. Of the almost half a million reported cases of HIV-associated TB, 15% were not on antiretroviral therapy (ART) as recommended by WHO. Most of the gaps related to HIV-associated TB were in the WHO African Region.
The report said TB preventive treatment is expanding in two priority risk groups – people living with HIV and children under 5 years. However, most people eligible for TB preventive treatment are not accessing it.
For TB care and prevention, investments in low- and middle-income countries fall almost US$ 2.3 billion short of the US$ 9.2 billion needed in 2017. In addition, at least an extra US$ 1.2 billion per year is required to accelerate the development of new vaccines, diagnostics, and medicines.
TB is the ninth leading cause of death worldwide and the leading cause from a single infectious agent, ranking above HIV/AIDS. In 2016, there were an estimated 1.3 million TB deaths among HIV-negative people (down from 1.7 million in 2000) and an additional 374 000 deaths among HIV-positive people. Globally, the TB mortality rate is falling at about 3% per year. TB incidence is falling at about 2% per year and 16% of TB cases die from the disease; by 020, these figures need to improve to 4–5% per year and 10%, respectively, to reach the first (2020) milestones of the End TB Strategy.
Funding for TB care and prevention reached US$ 6.9 billion in 2017 in 118 low and middle-income countries that reported data (and accounted for 97% of reported TB cases globally). This was an increase from US$ 6.3 billion in 2016 and more than double the US$ 3.3 billion that was available in 2006. Overall, most funding during the period 2006–2016 has been provided from domestic sources, and this remains the case in 2017 (84% of the global total