The designations used and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or its authorities, or concerning the delimitation of its borders or boundaries. The production of the report's central document was coordinated by Katherine Floyd and Irwin Law. Nimalan arinaminpathy produced all estimates of TB incidence and mortality in 2020 and 2021 based on country- or region-specific dynamic models (27 and 26 countries, respectively), and peter Dodd produced all estimates related to drug-resistant Tb incidence rifampic, in period.
Hazim Timimi led and organized all aspects of data and code management, including the preparation and implementation of the online system used for the 2022 round of global Tb data collection from 215 countries, territories and territories. These are Tb-related innovations during the coViD-19 pandemic, prepared by Dennis Falzon and Nebiat Gebreselassie; international donor funding for TB, prepared by peter Nguhiu; ensuring meaningful engagement of civil society, communities and people affected by Tb prepared by lana syed with contributions from Tauhid islam, Farai Mavhunga and members of the WHO civil society Task Force on Tb1; and Multisectoral Accountability in the Tb Response, prepared by Hannah Monica Dias, தியுக்கு Hasanova, Tereza Kasaeva and liana oganezova. The technical appendix explaining the methods used to make estimates of TB disease burden was prepared by Anna Dean, Nimalan arinaminpathy (imperial college, london, united kingdom) and peter Dodd (university of sheffield, united kingdom).
The app was first developed by the WHO Global Tuberculosis Program in collaboration with adaptt in 2019, then maintained by adaptt throughout the year and then updated annually in conjunction with the publication of the report. 1 Membership of the task force is described at https://www.who.int/groups/civil-society-task-force-on-tb.
WHO End TB Strategy: 2025 milestones
UN high-level meeting on TB: treatment targets
UN high-level meeting on TB: TB preventive treatment targets
UN high-level meeting on TB: funding targets
The most visible and immediate impact was a large global decline in the reported number of people newly diagnosed with TB. The three countries that accounted for most of the reduction in 2020 were India, Indonesia and the Philippines (67% of the global total). They made partial recoveries in 2021, but still accounted for 60% of the global reduction compared to 2019.
Globally, the estimated number of TB deaths increased between 2019 and 2021, reversing the years of decline between 2005 and 2019. Globally, the success rate of people treated for TB was 86% in 2020, the same as in 2019, indicating that the quality of care in the first year of the coViD-19 pandemic. After a large drop in 2020, the number of people reported to be newly diagnosed with TB in 2021 has rebounded to 2019 levels (or more) in five high-burden TB countries: Bangladesh, Congo, Pakistan, Sierra Leone and Uganda.
The global number of people receiving preventive treatment against tuberculosis recovered in 2021 to near 2019 levels, and the global target for providing treatment to people living with HIV was exceeded. The need for action has become even more urgent in the context of the war in Ukraine, ongoing conflicts in other parts of the world, a global energy crisis and associated risks to food security, which are likely to exacerbate some of the broader determinants of tuberculosis .
The main outcome was a political declaration (11), which reaffirmed existing commitments to end the tuberculosis epidemic and set new global tuberculosis targets for the period 2018-2022. The statement called for a progress report in 2020 to be prepared by the UN Secretary General, with support from WHO; and concluded with a commitment to a “comprehensive review by the Heads of State or Government at a high-level meeting in 2023.” The 2020 progress report (12) included ten priority recommendations and invited WHO to work with Member States and other stakeholders to prepare for a second high-level meeting on tuberculosis.
WHO's multisectoral and multilateral platform will be used to support countries to undertake these reviews, in collaboration with the WHO Civil Society Task Force on Tb. The key requirements to achieve the milestones and objectives were defined within the three pillars of the final Tb strategy (Box 2). The third objective of the final TB strategy, that no TB patient and their families face catastrophic total costs1 as a result of the disease, was set in recognition of the fact that removing financial and economic barriers to access to TB diagnosis and treatment Tb is a prerequisite. - country for achieving targets and targets for reducing Tb incidence and Tb mortality.
Further details on the reasons for the milestones and objectives and how they were defined are available elsewhere (9). Global targets were set for the first time for the funding to be mobilized for TB prevention, care and research, and for the number of people to be treated for TB infection and disease (Table 1).
Main findings and messages
The top 10 countries that accounted for ≥ 90% of the global reduction in case notifications of people newly diagnosed with TB in 2020 and 2021 compared to 2019. The countries in these latter two groups are mostly in the WHO African Region , consistent with the regional data shown in Fig. The significant disruptions in TB case detection and reporting in 2020 and 2021 likely reflect both supply- and demand-side influences on TB diagnosis and treatment provision.
Case notifications of people newly diagnosed with TB in 2020 and 2021 compared to 2019, 30 high TB burden and 3 global TB watchlist countriesa. Nigeria Democratic Republic of Congo United Republic of Tanzania Central African Republic Mozambique, Cambodia, Vietnam, Thailand, Ethiopia, Zambia, Congo, Democratic People's Republic of Korea, Russian Federation, Papua New Guinea, Sierra Leone, South Africa, Bangladesh, Philippines, Zimbabwe razilChina-India. Case notifications of people newly diagnosed with TB in the 30 high TB burden and 3 global TB watchlist countries, categorized by the timing and degree of disruption during the COVID-19 pandemic.
Increases in 2020 and 2021
No or limited departure from pre-2020 downward trend
- million 2018–2022
- million 2018–2022
- million
- million
- million
- million
- million
- conclusions
The global pattern of decline in the absolute number of TB deaths by 2019, followed by increases in 2020 and 2021, was evident in four of the six WHO regions (Fig. 9). The estimated number of TB deaths increased in 2020 or 2021 in most of the 30 countries with a high burden of TB.3. The dashed horizontal line shows the 2020 milestone of the last TB strategy, which was a 35% reduction in the total number of TB deaths between 2015 and 2020.
The horizontal dashed line shows the first milestone of the End TB Strategy, which was a 35% reduction in total TB deaths between 2015 and 2020. The horizontal dashed line shows the first milestone of the End TB Strategy, which was a 20% reduction in TB incidence rates between 2015 and 2020. The horizontal dashed line shows the first milestone of the final TB strategy, which was 20%.
Countries with a high burden of TB and on the Global TB Watch List are estimated to have reached the first milestone of the End TB Strategy by 2021. Countries with a high burden of TB and on the Global TB Watch List are estimated to have reached the first milestone of the End TB Strategy by 2021. The horizontal dashed line shows the first milestone of the final TB strategy, which was a 20% reduction in TB incidence rates between 2015 and 2020. Shaded areas represent 95% uncertainty intervals.
The global number of people diagnosed with MDR/RR-TB (blue) and the number on an MDR/RR-TB treatment regimen (red) compared to estimates of the global number of MDR/RR-TB cases (green. Estimates of the percentage of TB patients and their households , facing catastrophic costs, concluded a national survey in 2016-2022. The total is even further below the estimated requirement in the Partnership's Global Plan to End TB, 2023-.
Most of the data held in the global Tb database is available online.3 The webpage provides access to comma-separated value (csV) data files and data visualizations, as well as country, regional and global profiles (Appendix A4). . The csV data files are the primary resource for anyone interested in performing their own analyzes of the records in the global Tb database. With a new era of the United Nations (UN) Sustainable Development Goals (SDGs) and the WHO End TB Strategy starting in 2016, a thorough review of the three lists was undertaken by the WHO Global TB Program in 2015 (1).
1 For two of the modeled countries, China and the Russian Federation, national vital registration (Vr) data on the number of deaths caused by TB were reported to the World Health Organization (WHO) in the period 2020–2021.
