Posted on October 24, 2014
Source: Science Magazine
The global toll of tuberculosis (TB) is larger than previously thought, with an estimated 9 million new cases and 1.5 million TB-related deaths in 2013, according to a survey released today by the World Health Organization (WHO). The number of new cases—400,000 more than were estimated a year ago—is a sobering reminder of the challenges posed by the second biggest killer among infectious diseases after HIV.
But the findings are also a sign of advances in fighting the disease, according to WHO’s latest annual Global Tuberculosis Report. The higher numbers reflect better data gathering around the world, rather than an actual surge in the disease, the report notes. Countries are boosting measures to diagnose and track TB, “providing us with much more and better data, bringing us closer and closer to understanding the true burden,” said Mario Raviglione, WHO’s director of the Global TB Programme in Geneva, Switzerland, in a statement.
The report comes as nations work to hit a 2015 deadline for meeting benchmarks to tame the disease, laid out in the United Nations' Millennium Development Goals. Some regions—the Americas and several Asian countries, including China—have already hit their targets. And there are other bright spots. The rate at which people came down with new cases of TB fell 1.5% each year worldwide between 2000 and 2013. The death rate also continues to drop—down 45% since 1990.
But the report underscores a fundamental failure to gain control of the disease, some experts say. “There has been some real progress, particularly in Asia, but the overall situation remains catastrophic,” writes Richard Chaisson, director of the Johns Hopkins Center for Tuberculosis Research in Baltimore, Maryland, in an e-mail to ScienceInsider. “Improvements in some countries are offset by disastrous situations in others, with MDR [multidrug-resistant] TB, HIV-related TB and continued high rates of missed diagnoses and deaths. The situation in Africa is particularly horrific, with TB killing more young people than any other cause.”
One prominent activist criticized WHO for issuing an overly upbeat report, saying claims of progress were overshadowed by huge gaps in detection and treatment and a lackluster performance in combating TB compared with global efforts to address HIV infections. “On the HIV side, we're doing stuff almost twice as fast in [reducing] deaths and multiple times as fast in incidence, even though TB is curable and HIV is not,” says Mark Harrington, executive director of the New York City–based Treatment Action Group, which lobbies for stronger efforts to address both HIV and TB.
