To eventually eradicate tuberculosis (TB), the World Health Organization (WHO) created the End TB Strategy. The policy, which seeks to "stop the global TB pandemic" by 2035, was approved in 2014 by the Sixty-seventh World Health Assembly. By this date, the strategy's primary goals are to reduce the number of TB cases by 90%, cut TB-related deaths by 95%, and shield families from the disease's detrimental effects.
Here, we define the plan and go into greater detail about what TB is and why it is crucial to concentrate on eradicating it.
How is TB hurting the world, and what is it?
Mycobacterium tuberculosis infections are the cause of TB, which typically affects the lungs. When persons with the germs cough, sneeze or spit, the bacteria are released into the air and can be inhaled by another person, readily spreading the sickness.
Each year, ten million people get TB. Although the illness is treatable with medication, 1.5 million people who catch it will pass away. According to these figures, TB is the leading infectious cause of death worldwide. It also ranks as the primary killer of HIV-positive people and has a substantial impact on the development of antibiotic resistance.
Despite the fact that the bacteria exist everywhere, low- and middle-income countries are where the sickness is most common. A quarter of the population is thought to be infected with the TB bacteria, but only a small percentage of those (5–15%) will go on to develop active TB disease. Those who don't get sick can't spread the illness. The eight nations of Bangladesh, China, India, Indonesia, Nigeria, Pakistan, Philippines, and South Africa are home to almost 50% of those who get TB.
According to estimates, 31.8 million people will have perished from TB between 2020 and 2050, and the disease's economic toll will total almost $17.5 trillion. Women, children, and those with HIV/AIDS are especially susceptible to the illness. Scientists have noticed an increase in TB treatment resistance in recent years. As a result, treating TB is getting more challenging, increasing the risk of disease and mortality for at-risk groups. Given that more than 500,000 TB cases per year are categorized as drug-resistant, it is crucial that the WHO's End TB strategy be adopted in order to combat the leading infectious killer in the world.
Focusing global health initiatives on TB
Action from the healthcare industry, as well as the business and social sectors, is necessary to end TB. The World Health Assembly accepted the WHO's End TB plan in 2014 as one of the newly created Sustainable Development Goals (SDGs). By 2030, these objectives seek to reduce tuberculosis-related fatalities by 90% from 2015 levels.
A framework with three pillars was designed to make it easier for the End TB Strategy to be adopted: integrated, patient-centered care and prevention; bold policies and supportive systems; and accelerated research and innovation. The plan will make an effort to build on earlier achievements in the fight against TB. A total of 43 million lives were spared between 2000 and 2014 as a result of efficient TB diagnosis and care. From 1990 to 2014, there was a 42% decrease in TB prevalence and a 47% decrease in TB mortality. In 2014, HIV-related TB fatalities decreased by 32% from the preceding ten years.
Although there has been significant success in lowering TB prevalence and TB-related fatalities, the disease still faces several obstacles. Healthcare systems yearly miss about 3.6 million patients with TB. Accelerating antiretroviral therapy and latent TB infection treatment are also urgently needed in order to preserve the lives of people with HIV/AIDS.
Why take action against TB at this time?
Many people have criticized the End TB approach for having unrealistic goals, especially given that the TB crisis is getting worse and that the first check-in is still five years away. Global health was adversely affected by the COVID-19 pandemic, and TB services were disproportionately hit. The WHO Global Tuberculosis Report 2021 highlighted that TB mortality climbed rather than reduced for the first time in more than ten years. This new information raises fresh doubts about the viability of achieving the End TB strategy's objectives. Prior to the pandemic, it was thought that achieving the goals would be difficult. They will be even more difficult to approach after the COVID-19 pandemic's destructive effects.
In order to achieve the goals of the End TB strategy, it is now more crucial than ever that healthcare systems collaborate. If progress is not made in eradicating TB, prevalence and mortality could increase further, disproportionately affecting low- and middle-income countries, women, children, and people living with HIV/AIDS.
What does the future hold for treating TB?
Would you kindly introduce yourself and let us know what led you to pursue a profession in tuberculosis (TB)?
As Head of Therapeutics Development at the Bill & Melinda Gates Medical Research Institute, I have the honor to do my job. I started working at the institute a little more than three years ago after holding executive positions at the CDC and in the pharmaceutical sector.
I've worked on tuberculosis for decades and have devoted my career to infectious diseases. After I graduated from medical school and "learned" that TB was a disease of the past, I began working on TB. But I quickly realized that wasn't the case when I relocated to Atlanta in 1992 to begin my residency training in the vast public hospital network of the city. I provided care for a huge number of patients with TB in that urban setting, which was progressively rising largely as a result of the expanding HIV epidemic in the city and the US as a whole.
Midway through my applied epidemiology training at the CDC's Epidemic Intelligence Service (EIS), I discovered that TB remained one of the most lethal infectious illnesses in the world, especially in low- and middle-income nations (LMICs). As part of a bigger US Government response to the global HIV and TB epidemics, I concentrated on fighting the global TB epidemic throughout my training and later as a permanent employee.
After COVID-19, TB is the second most common infectious cause of death, with 1.5 million fatalities in 2020 alone. What contemporary medical treatments are available for TB, and why is it so widespread throughout the world?
It is estimated that up to 25 percent of people on the planet have latent TB infection. Estimates for 2020 show that 1.5 million people died from TB, including an estimated 214,000 individuals living with HIV, and that 10 million people had active TB, including 1.1 million children. Since LMICs account for 98% of all reported TB cases, they continue to carry the heaviest disease burden.
TB was the most common infectious disease-related cause of death prior to the COVID-19 pandemic. The COVID-19 pandemic and the strain it placed on the provision of healthcare services have increased the burden of TB, with access to care and case notifications dramatically declining in 2020 and the number of TB deaths rising.
The only TB vaccination that is currently approved is called BCG (bacille Calmette-Guérin). On the other hand, it does little to prevent adult TB illness and Mtb infection. Although curable, TB disease treatment is time-consuming, and compliance is frequently insufficient. There is a significant global prevalence of drug-resistant TB. To hasten the process of putting an end to the TB epidemic, improved preventative measures and potent vaccines are urgently required. However, only a small number of innovative vaccine candidates have moved through clinical efficacy trials since the BCG vaccine's launch in 1921.
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