WHO on TB

WHO on TB

Syllabus Areas:

GS II - Governance

The World Health Organization (WHO) has released its much-anticipated Global Tuberculosis Report 2025, offering an updated, sobering snapshot of the global TB epidemic. While there are encouraging signs of progress, the report warns that the world is still far from winning the fight against this age-old scourge.

Major Findings

1. Slight Decline in TB Incidence
   • According to the report, approximately 7 million people contracted TB in 2024, a modest dip from 10.8 million in 2023.
   • This marks the first fall in incidence since the COVID-19 pandemic, signaling a rebound in efforts to detect and treat TB
2. Deaths From TB Still High
   • In 2024, 23 million people died from tuberculosis—a distressingly high number for a curable, preventable disease
   • Though this is a slight decline, it underscores that TB remains one of the leading infectious killers worldwide.
3. Funding Shortfall Threatens Progress
   • The WHO estimates that only US$ 5.9 billion was available in 2024 for TB prevention, diagnosis, and treatment—well below the US$ 22 billion annual target projected for 2027.
   • WHO leadership cautions that gaps in global funding, especially from major donors, could undo the recent gains.
4. Risk of Reversal
   • Tereza Kasaeva, director of WHO’s tuberculosis program, warned that significant cuts to donor funding could fuel a large-scale resurgence. Modeling studies predict up to 2 million additional TB deaths and 10 million more cases between 2025 and 2035 under sustained underfunding.
   • In particular, WHO flagged the impact of reduced US contributions following its withdrawal from the agency, which has forced budgetary contractions.

Regional & Country Highlights

• India remains the epicenter of the TB burden:
  • The country accounted for 25% of all global TB cases in 2024, according to WHO.
  • On a per-population basis, India’s TB incidence fell from 237 per 1 lakh in 2015 to 187 per 1 lakh in 2024—a 21% decline.
  • However, despite this progress, its TB mortality rate remains significant: 21 deaths per 1 lakh in 2024, down from 28 per lakh in 2015.
  • India also continues to carry a disproportionate burden of drug-resistant TB: about 32% of global multidrug-resistant (MDR) or rifampicin-resistant TB cases are in India.
• Global Concentration of Cases:
  • Eight countries account for 67% of the global TB burden, underscoring the concentration of disease in specific high-burden regions
  • The WHO regions most affected are South-East Asia (34%), Western Pacific (27%), and Africa (25%).
    

Strategic Implications

• “Progress is Not Victory”:
  WHO Director-General Tedros Adhanom Ghebreyesus emphasized that while the latest data shows improvement, the annual death toll remains “simply unconscionable.”
• Urgent Need for Political Commitment & Funding:
  The report calls for renewed political will and sustained financial investments, especially in high-burden countries, to consolidate progress and avoid backsliding.
• Accelerated Diagnostics & Treatment:
  Strengthening molecular diagnostics, scaling up upfront drug-resistance testing, and improving community-based case finding are highlighted as critical interventions—especially in countries with high MDR-TB burdens like India.
• Social Protection & Equity:
  Equitable access to care, especially for marginalized populations, must be prioritized. Without reducing barriers, gains in detection and treatment may not translate to lasting impact.

Risks & Challenges Ahead

• Funding Risks: The funding gap remains the most existential threat to TB control. Without bridging this, modeling suggests potential reversal of recent gains.
• Donor Instability: The report explicitly calls out the withdrawal or reduction of major donor support, which could undermine global TB infrastructure.
• Meeting 2030 Targets:
  Under WHO’s “End TB Strategy,” the target was to reduce TB incidence and mortality sharply by 2030. However:
  • By 2025, so far only a 12% global reduction in incidence has been achieved, falling far short of the 50% reduction goal from 2015.
  • TB deaths declined by 29% since 2015, but WHO’s 2025 milestone was much steeper.
    

Conclusion & Call to Action

The WHO Global Tuberculosis Report 2025 offers a cautiously optimistic narrative: after years of pandemic-related disruption, we’re seeing a reversal in the rising trend of TB cases. But optimism alone isn’t enough. The world must treat these early gains as fragile.

• Governments — especially in high-burden countries — must double down on investment, scale up early detection, and strengthen drug-resistance programs.
• International donors need to recommit, especially in the face of shrinking budgets, to prevent a resurgence.
• Civil society and public health advocates should amplify the call for equitable access, ensuring even the most marginalized communities are not left behind.

Prelims Questions: