2024-10-29 16:02:00
A doctor examines a patient with drug-resistant tuberculosis at the Pulmonology Hospital in Hanoi, Vietnam, April 2, 2024. NHAC NGUYEN/AFP
This is a mixed assessment drawn up by the World Health Organization (WHO) in its annual report on tuberculosis, published Tuesday October 29. The ambitious objectives set in 2015 by the UN agency are still far from being achieved, but progress has nevertheless been recorded in 2023, after several years of increase, accelerated by the Covid-19 pandemic. Indeed, the number of people developing the disease has started to stabilize, with 10.8 million cases worldwide in 2023, compared to 10.7 million in 2022.
Taking into account the growth of the world population, the incidence rate remains stable, at 134 new cases per 100,000 inhabitants. This rate is down 8.3% compared to the figures for 2015, which is very far from meeting the objective initially set, that is to say a number of patients halved by 2025.
“While it is encouraging to see some positive trends in our fight against tuberculosis, we must face a harsh reality: despite our efforts, we are only stalling, failing to make significant progress towards our goal of eradication of tuberculosis »commented Cassandra Kelly-Cirino, executive director of the International Union Against Tuberculosis and Lung Diseases (IUCTMR). Tuberculosis has thus once again become, after four years of the Covid-19 pandemic, the deadliest infectious disease in the world. In 2023, 1.25 million people died from this infection, a level nevertheless lower than during the pre-pandemic period (1.34 million in 2019).
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This progress is largely due to advances made in the development of diagnostic tools and new treatments – particularly against multi-resistant bacteria – which remain the nerves of war in this fight against the disease. Tuberculosis is caused by bacteria, Mycobacterium tuberculosisalso called Koch’s bacillus, which is transmitted through the air and most of the time reaches the lungs, but can also infect other organs.
Cases of multidrug-resistant tuberculosis
Although it is estimated that almost a quarter of the world’s population is infected with this bacteria, only 10% of these affected people develop the disease, most of the time due to immunosuppression, such as people with HIV, or those with poor living conditions (undernutrition, smoking, diabetes). Most cases of tuberculosis are recorded in around thirty countries in Asia, Africa and South America. More specifically, five countries alone account for more than half (56%) of the global burden: India (26%), Indonesia (10%), China (6.8%), Philippines (6.8%), .8%) and Pakistan (6.3%).
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**Interview with Dr. Cassandra Kelly-Cirino, Executive Director of the International Union Against Tuberculosis and Lung Diseases (IUCTMR)**
**Interviewer:** Thank you for joining us, Dr. Kelly-Cirino. The recent World Health Organization report has highlighted both progress and challenges in the fight against tuberculosis. Could you summarize the key findings?
**Cassandra Kelly-Cirino:** Thank you for having me. The WHO’s annual report indicates some stabilization in tuberculosis cases, with a slight increase to 10.8 million cases worldwide in 2023. This stabilization is a relief after years of rising numbers exacerbated by the Covid-19 pandemic. However, the incidence rate remains stagnant at 134 new cases per 100,000 people, which shows only a modest reduction of 8.3% since 2015. This is significantly below the target of halving the number of patients by 2025.
**Interviewer:** While any progress is positive, it seems clear we are not on track to meet the 2025 goals. What factors do you believe are contributing to this stagnation?
**Cassandra Kelly-Cirino:** Several factors are at play. The Covid-19 pandemic severely disrupted healthcare systems, resulting in missed diagnoses and treatment interruptions. Additionally, ongoing challenges such as lack of funding, inadequate healthcare infrastructure, and rising rates of drug-resistant tuberculosis hinder our efforts. The reality is that tuberculosis is once again the deadliest infectious disease globally, and we are struggling to reverse this trend.
**Interviewer:** You mentioned drug-resistant tuberculosis. Could you elaborate on the implications of this growing issue for public health?
**Cassandra Kelly-Cirino:** Drug-resistant tuberculosis is a significant challenge. It complicates treatment, requires more extensive and often toxic regimens, and can lead to higher mortality rates. Communities are facing an uphill battle as these strains spread, particularly in areas with limited healthcare resources. The fight against tuberculosis relies heavily on innovations in treatment and strategies to ensure access to quality care, which are crucial for curbing this public health crisis.
**Interviewer:** With the upcoming deadlines for action, what immediate steps do you believe are necessary to reignite efforts against tuberculosis?
**Cassandra Kelly-Cirino:** We need to prioritize funding and resources for tuberculosis programs, enhance surveillance to identify and treat cases early, and ensure we address the barriers faced in communities at risk. Moreover, raising awareness and engaging with local healthcare providers to ensure proper training and resources are essential. Collaboration between governments, NGOs, and international organizations is key to making significant headway.
**Interviewer:** Thank you, Dr. Kelly-Cirino, for providing these insights. It’s clear that while there is some progress, much work remains to be done in combating tuberculosis.
**Cassandra Kelly-Cirino:** Thank you for highlighting this important issue. Together, we can make strides towards eradicating tuberculosis and saving lives.
