2022-10-25-世界卫生组织-Global_Tuberculosis_Report_2022_Factsheet_2页_3mb

Global Tuberculosis Report 2022 Summary

Core Content

The Global Tuberculosis Report 2022 outlines the current status of tuberculosis (TB) globally and the challenges and responses in addressing the disease. It emphasizes the impact of TB on public health, its association with other epidemics, and the financial and research gaps that hinder progress towards ending TB.

TB Situation and Response

• TB is contagious and airborne, making it a significant public health threat.
• It is the second leading infectious killer globally, after COVID-19, and the 13th leading cause of death worldwide.
• TB is the leading killer of people with HIV and a major contributor to antimicrobial resistance-related deaths.

TB Burden

• In 2021, an estimated 10.6 million people fell ill with TB, with 6.0 million being men, 3.4 million women, and 1.2 million children.
• People living with HIV accounted for 6.7% of all TB cases.
• The TB incidence rate increased by 3.6% between 2020 and 2021, reversing a 2% annual decline over the previous two decades.
• TB deaths rose between 2019 and 2021, with 1.6 million deaths in 2021, including 187,000 among people living with HIV.
• Eight countries accounted for over two-thirds of global TB cases: India, Indonesia, China, the Philippines, Pakistan, Nigeria, Bangladesh, and the Democratic Republic of the Congo.

TB Care and Prevention

• TB treatment saved 74 million lives between 2000 and 2021.
• The number of people newly diagnosed with TB and reported to national governments decreased from 7.1 million in 2019 to 5.8 million in 2020, with a partial recovery to 6.4 million in 2021.
• 26.3 million people were treated between 2018 and 2021, which is 66% of the 5-year UN target of 40 million.
• 1.9 million children were treated, which is 54% of the 3.5 million target for children.
• 4.2 million people were not diagnosed or reported in 2021, an increase from 3.2 million in 2019.

Drug-Resistant TB

• Drug-resistant TB (DR-TB) burden increased between 2020 and 2021, with 450,000 new cases of rifampicin-resistant TB (RR-TB) in 2021.
• Treatment access for RR-TB and MDR-TB declined between 2019 and 2020, with 161,746 people started on treatment in 2021, covering only one in three of those in need.
• Global treatment success rate for drug-resistant TB is 60%, which remains low.

Co-Epidemics of TB and HIV

• In 2021, 703,000 people living with HIV developed TB, but only 46% accessed life-saving antiretroviral therapy.
• Most gaps in access to antiretroviral therapy were in the WHO African Region, where the burden of HIV-associated TB is highest.

Impact of the COVID-19 Pandemic

• The pandemic has reversed years of progress in the fight against TB.
• It continues to damage access to TB services.

TB Financing

• US$13 billion is required annually for TB prevention, diagnosis, treatment, and care to meet the UN High Level Meeting 2018 targets.
• Global spending on essential TB services declined from US$6.0 billion in 2019 to US$5.4 billion in 2021, which is less than half of the global target.
• 79% of TB funding in 2021 came from domestic sources, while US$1.1 billion was from international donors, mainly the Global Fund.
• US$2 billion is needed annually for TB research, but US$0.9 billion was spent in 2020, falling short of the target.

Research and Innovation

• The diagnostic pipeline has expanded with new tests and methods, including molecular tests, interferon-gamma release assays (IGRAs), biomarker-based assays, computer-aided detection (CAD), and aerosol-capture technologies.
• Three new antigen-based skin tests for TB infection were evaluated and recommended by WHO in 2022 for better specificity.
• In September 2022, 16 vaccine candidates were in clinical trials, with four in Phase III.
• 26 drugs for TB treatment were in Phase I, II, or III trials, including 17 new chemical entities and six repurposed drugs.

Universal Health Coverage and Social Determinants

• Universal health coverage (UHC), social protection, and multisectoral action are essential to reduce TB burden.
• 48% of people with TB and their households faced catastrophic costs.
• Social determinants such as undernourishment, HIV, alcohol use, smoking, and diabetes contribute to TB incidence.
• WHO has worked with high TB burden countries to include accountability mechanisms in national budget planning and assessments.

TB Preventive Treatment

• WHO recommends TB preventive treatment for people living with HIV, household contacts of those with confirmed pulmonary TB, and clinical risk groups.
• In 2021, 3.5 million people received TB preventive treatment, slightly below the 3.6 million in 2019 but a recovery from 3.2 million in 2020.
• From 2018-2021, 12.5 million people were treated, which is 42% of the 5-year target of 30 million.
• Most recipients were people living with HIV, with the 6 million target achieved ahead of schedule.
• 2.2 million household contacts were initiated on TB preventive treatment from 2018-2021, only 9.2% of the 5-year target of 24 million.

WHO's Global TB Programme

• The WHO Global TB Programme supports policy development, programme performance, financing, research, and multisectoral partnerships.
• It collaborates with WHO regional and country offices to achieve global TB targets.

Key Statistics

• TB deaths in 2021: 1.6 million (187,000 with HIV)
• TB lives saved (2000-2021): 74 million
• TB cases in 2021: 10.6 million
• TB treatment access (2021): 161,746 people (only one in three in need)
• TB preventive treatment (2021): 3.5 million people
• Annual TB financing required (2022): US$13 billion
• TB research funding required annually: US$2 billion
• TB research funding in 2020: US$0.9 billion
• TB diagnostic tests used in 2021: 38% of new cases
• TB preventive treatment target (2018-2022): 30 million people

Conclusion

Despite progress in TB treatment, the disease remains a significant public health crisis, exacerbated by the COVID-19 pandemic, drug resistance, and limited access to care and prevention. Increased funding, improved diagnostics, and multisectoral action are critical to achieving the End TB Strategy and global targets.