Tuberculosis – The Untamed Monster

Tuberculosis outweighed HIV and malaria in global deaths  with an alarming figure of 1.4 million in 2015. Looking at the new cases, South East Asia and Africa accounted for about 60% of the reported cases  which were mainly distributed in India, Indonesia, China, Nigeria, Pakistan and South Africa. Way behind the projected target of 4-5% decline in annual TB cases set by the World Health Organization (WHO), the actual reported decline was only 1.5% annually.  Much more serious in treatment of TB  is the situation of multidrug-resistant TB (MDR-TB) which adds up to  about 5 lakh people annually half of which come from India, China and Russia. However, the silver lining is that proper  treatment  helped save the lives of  49 million people suffering from  TB during 2000 to 2015. Gap in the timings of contracting the disease  and treatment of multidrug-resistant TB (MDR-TB) is a major problem in its treatment.  This gap between eligible cases for multidrug-resistant TB (MDR-TB) and those enrolled was about 80%. It means that only 20% actually enrolled for treatment.  Low and middle- income countries generate their own resources to the tune of 84% of the total reuirements for the treatment of TB but the allocation of funds are so meagre that these can’t meet  the targets set by WHO. The countries overloaded with the burden of disease should allocate more funds for overall health budgets.  WHO set up a target allocation of funds for health to the tune of at least 6% of the gross domestic product (GDP) which 150 countries of the world could not afford. The problem of tuberculosis treatment  is confounded by about 55% of TB patients having a history of  HIV where the treatment has to take place for both the diseases simultaneously. The global target of deaths of TB patients  (the case fatality ratio or CFR) is set at reducing  it from 17% during 2015 to 10% till 2020. The Sustainable Development Goals (SDGs) for 2030 adopted by the United Nations in 2015 calls for a huge reduction of up to 90% in TB deaths and 80% in incidence of TB till 2030 from the  baseline year of 2015, a really Herculean task to achieve.

Professor S. P. Singh, Ph.D.
Editor-in-Chief, Human Biology Review
Former Dean, Faculty of Life Sciences,
Punjabi University, Patiala, India

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