Tuberculosis, Long Perceived as a "Scourge of the Underprivileged," Pose a Hazard to Everyone Globally
Tuberculosis: A Modern Plague in a Globalized World
Tuberculosis (TB), despite being treatable and curable, remains a formidable threat to public health. In 2023, TB claimed a staggering 1.25 million lives, making it the world's premier infectious disease killer. As a persistent, drug-resistant respiratory infection, TB poses a relentless threat to global health security.
Recent strides against the disease have been swift following the disruptions caused by COVID-19. However, looming reductions in development assistance for health cast a grim shadow on this progress. Many of the most vulnerable countries endure significant funding gaps for diagnostic tests and treatments. Any lapse in the fight against TB will only escalate costs and risks.
TB is a lethal, unforgiving disease. In 2023, roughly 10.8 million individuals fell victim to TB worldwide. Since 2020, new TB cases have been on a troubling upward trajectory. In an interconnected world, TB lurks in the heart of every major city across every nation. An active, untreated TB patient can infect as many as 10 to 15 individuals in a single year.
The tragic death toll of 1.25 million in 2023 corresponds to a mortality rate nearing 12%, far exceeding that of COVID-19. The overwhelming majority of these deaths were preventable. The majority of TB cases are "drug sensitive," signifying they can be cured using affordable, albeit somewhat prolonged treatment. The primary difficulties in combating this form of TB lie in identifying infected individuals, administering treatment, and ensuring completion. Given that most TB cases target impoverished and marginalized populations, overcoming these obstacles is fraught with complexity.
However, a deadlier form of TB exists. In 2023, an estimated 400,000 cases of drug-resistant TB emerged, which are far more difficult to treat and carry a higher fatality rate. Misdiagnosis and the complex, expensive nature of treatment hinder the provision of care for this strain of TB. Only approximately 40% of those diagnosed with drug-resistant TB received treatment in 2023, with a substantial portion meeting an unfortunate end. Drug-resistant TB is among the leading causes of death due to antimicrobial resistance.
Considered through the lens of global health security, the most dismal scenario envisions a rapid proliferation of drug-resistant TB versions, given its difficulty to treat and high lethality. This could occur through untreated individuals with drug-resistant TB infecting others or through people with drug-sensitive TB failing to complete treatment, enabling the pathogen to resurface in its resilient, drug-resistant form. We also must acknowledge that the evolutionary processes that foster drug-resistance are always in motion, dimming the possibility of eliminating even more resistant or easily transmissible versions of the disease.
Neglecting to control TB breeds immense risks for everyone. At present, TB is often referred to as the "pandemic of poverty," with a majority of fatalities striking the poorest communities, people living with HIV, or those in otherwise marginalized populations. Stigma and discrimination serve as barriers to life-saving services and exacerbate vulnerability. Left unchecked, TB poses a peril to us all. Bear in mind that it is barely a century since TB stood as the foremost killer in nearly all wealthy nations.
In addition to this health security imperative, there is an economically sound argument for eliminating TB. Owing to its disproportionate impact on those of working age and the complexity involved in treatment, TB generates colossal costs in terms of lost productivity and healthcare expenses. Investments in TB prevention, early detection, and treatment yield exceptionally high returns.
Despite the current turmoil in global health, there are reasons to feel hopeful. At the last United Nations High Level Meeting on the Fight Against Tuberculosis, nations reaffirmed their commitment to global targets aiming to quell the disease. Recent advancements promise significant improvements in diagnosis, prevention, and treatment. In 2024, more individuals were accurately diagnosed and successfully treated for TB than ever before.
This is no moment to decelerate the fight or abandon TB. Quite the contrary, this is the time to intensify our efforts to defeat the disease—to save millions of lives and secure our collective future. The tools exist, and we know what works. What we require is political will and financial support.
In 2023, the global health community faced a substantial challenge with Tuberculosis (TB) causing 1.25 million deaths, making it the world's deadliest infectious disease. Despite some progress in recent years, looming reductions in development assistance for health could hinder the fight against TB, especially in vulnerable countries. This disease, which has types such as drug-resistant TB, has an ongoing impact on global health security and the achievement of Sustainable Development Goals (SDGs), including the target to end the epidemics of AIDS, tuberculosis, and malaria by 2030. In 2023, only around 40% of those diagnosed with drug-resistant TB received treatment, underscoring the urgent need to safeguard global health through increased support and awareness.
