2021-10-13-世界卫生组织-Factsheet_Global_TB_report_2021_2页_1mb

2021 GLOBAL TUBERCULOSIS REPORT Summary

Core Content

The 2021 Global Tuberculosis Report highlights the significant setback in the global fight against tuberculosis (TB) due to the impact of the COVID-19 pandemic. The report outlines the current burden of TB, the progress made over the years, and the challenges that remain in addressing the disease.

Main Points

TB Burden and Progress

• In 2020, 9.9 million people were estimated to have fallen ill with TB worldwide, with 5.5 million men, 3.3 million women, and 1.1 million children affected.
• 1.5 million people died from TB in 2020, including 214,000 with HIV.
• The global TB incidence rate decreased by 11% between 2015 and 2020, from 142 to 127 new cases per 100,000 population.
• 66 million lives were saved globally between 2000 and 2020 due to TB treatment.

TB Care and Prevention

• The number of people newly diagnosed with TB and reported to national governments dropped from 7.1 million in 2019 to 5.8 million in 2020.
• 4.1 million people were not diagnosed or officially reported in 2020, an increase from 2.9 million in 2019.
• TB preventive treatment was provided to 2.8 million people in 2020, a 21% reduction from 2019.
• 7.2 million people living with HIV received TB preventive treatment between 2018 and 2020, exceeding the global subtarget of 6 million.

Drug-Resistant TB

• 150,000 people were treated for drug-resistant TB in 2020, a 15% decline from 2019, representing only 1 in 3 of those in need.
• The global treatment success rate for drug-resistant TB is 59%, which remains low.

TB and HIV Co-Epidemic

• In 2020, 376,000 people living with HIV were diagnosed with TB, with 88% on antiretroviral therapy.
• The burden of HIV-associated TB is highest in the WHO African Region.

Diagnostics and Research

• Only 33% of TB cases in 2020 were diagnosed using WHO-recommended rapid molecular tests.
• 65 countries used shorter MDR-TB regimens, and 90 used all-oral longer MDR-TB regimens by the end of 2020.
• 109 countries reported using bedaquiline.
• 14 vaccine candidates are in clinical trials, with 2 in Phase I, 8 in Phase II, and 4 in Phase III.
• 25 drugs and several combination regimens are in clinical trials.
• US$ 2 billion per year is needed for TB research, but US$ 0.9 billion was invested in 2019.

TB Financing

• US$ 13 billion is required annually for TB prevention, diagnosis, treatment, and care by 2022.
• US$ 5.3 billion was available in 2020, with 81% from domestic sources and 18% from international donors.
• BRICS countries (Brazil, Russia, India, China, South Africa) accounted for 65% of domestic TB funding.
• The Global Fund is the largest international donor, but its TB funding share is fixed at 18%.
• A US$ 1.1 billion funding gap exists for TB research and development.

Key Challenges

• The COVID-19 pandemic reversed progress in TB control, leading to increased deaths, reduced diagnoses, and lower treatment rates.
• Disruption in TB services due to resource reallocation to the pandemic response.
• Gaps in detection and treatment of drug-resistant TB.
• Underfunding of TB care and research, with global investment far below required levels.
• Catastrophic costs for TB patients and their households, affecting 47% of those impacted.

Recommendations and Actions

• Multisectoral action is needed to address the social determinants of TB, including undernourishment, HIV, smoking, diabetes, and alcohol use.
• Universal Health Coverage (UHC) is essential for high TB burden countries.
• Strengthening engagement with civil society and ensuring high-level review mechanisms are in place.
• Increasing investment in TB diagnostics, drugs, and vaccines to accelerate the development of new tools.
• Maintaining essential health services for TB, especially in the context of the ongoing pandemic.

Conclusion

Despite significant progress over the years, the COVID-19 pandemic has severely impacted global efforts to combat TB. The report underscores the urgent need for increased funding, improved access to care, and multisectoral collaboration to achieve the End TB targets.