Cases of drug-resistant tuberculosis rise for first time in almost 20 years

The World Health Organization has warned of the first rise in drug-resistant tuberculosis for almost two decades, as it released a report highlighting the resurgence of the disease during the coronavirus pandemic.

An estimated 10.6mn people developed the disease last year and 1.6mn people died, with both metrics rising from 2020 when they also registered a year-on-year increase.

The rises underscore the profound effect that the pandemic had on the treatment of diseases because resources were diverted to tackle the coronavirus crisis and services were severely interrupted. Before the pandemic, the incidence of TB had been falling globally.

Tedros Adhanom Ghebreyesus, WHO director-general, said as the report was released that it was “time to put a stop to this longtime killer”.

“If the pandemic has taught us anything, it’s that with solidarity, determination, innovation and the equitable use of tools, we can overcome severe health threats,” he said.

TB, a transmittable disease caused by bacteria and spread by coughing, is preventable and curable. About 85 per cent of those who develop TB can be treated with a four- to six-month drug regimen, which also cuts onward transmission.

“Continued challenges with providing and accessing essential TB services have meant that many people with TB were not diagnosed and treated,” during the pandemic, the WHO said, with regional conflicts also playing a significant role.

Cases of drug-resistant TB, or DR-TB, rose 3 per cent in 2021 from the previous year, the first such increase since records began in 2004, according to the WHO. DR-TB is complex to treat and is a leading contributor to antimicrobial resistance or the weakening of existing antibiotics that causes the rise of so-called superbugs.

Vaccination campaigns for other illnesses have suffered, too, as has the care for other diseases. Health systems globally have been under-diagnosing patients for months, say experts. One acute example of the disruption caused by coronavirus is the UK’s NHS, where waiting lists have hit record highs. But the effect had been particularly marked with TB, the WHO said.

Undercounting continued to be an issue, too, the WHO said, with millions not diagnosed and treated because of the disruption in the provision of essential TB services. Confirmed diagnoses fell from 7.1mn in 2019 to 5.8mn in 2020, recovering to 6.4mn in 2021, still lagging pre-pandemic levels. Only one in three of those in need of treatment accessed the drugs they needed.

The world has missed the vast majority of the TB targets for case numbers and deaths. Funding for essential TB services also fell from $6bn in 2019 to $5.4bn in 2021.

The WHO reiterated its call for countries to urgently restore access to essential services to treat the disease, and for increased efforts and investment to develop new diagnostics, drugs and vaccines. The Geneva-based health body said it would convene a summit next year to intensify these efforts.