WHO: Investing in TB Prevention, Screening, Treatment Will Save Lives, Money
This year’s theme, “Yes! We can end TB," is intended to send a message of hope that ending the epidemic, which WHO says each year causes the deaths of some 1.3 million people, is possible.
While the disease is curable and preventable, heads of state at the 2023 U.N. high-level meeting on TB estimated that $13 billion was needed every year for prevention, diagnosis, treatment, and care to end the epidemic by 2030.
The heads of state, who pledged to accelerate progress to end TB and to turn these commitments “into tangible actions,” approved a series of global targets for moving this process forward.
“These include reaching 90% of people in need with TB prevention and care services, using WHO-recommended rapid tests and the first method of diagnosing TB, and providing a health and social benefit package to all people with tuberculosis,” said Dr. Tereza Kasaeva, director of WHO’s Global Tuberculosis Program.
“This is a watershed for the global fight to end tuberculosis. The next five years will be critical for ensuring that the political momentum we have now is translated into concrete action towards reaching global TB targets.”
Tuberculosis is the world’s second leading infectious killer after COVID-19, above HIV and AIDS. WHO reports 1.3 million people died from TB in 2022 and an estimated 10.6 million fell ill with the disease.
This is the highest number of new cases since the agency began monitoring the disease in 1995. WHO says the sharp rise may be linked to “delays in treatment caused by the COVID-19 pandemic.”
TB, an airborne disease, spreads when infected people cough, sneeze, or spit. It is present in all countries and age groups.
“Preventing TB infection and stopping progression from infection to disease are critical for reducing the incidence to the levels envisioned by the anti-TB strategy,” said Saskia Den Boon, technical officer, WHO Global TB Program.
“One of the key health care interventions to achieve this reduction is TB preventive treatment, which WHO recommends for people living with HIV, household contacts of people with TB and other risk groups.
“Strategies to provide preventive treatment are often linked to screening, to find and treat people earlier in the course of their disease and thus help to prevent transmission and improve outcomes,” she said.
In recent years, new tools developed and recommended by WHO are making TB screening more feasible. These include shorter preventive treatments of one or three months and a new antigen-based skin test for TB infection.
“For screening, WHO recommends the use of artificial intelligence or AI for the computer aided protection of tuberculosis abnormalities on chest x-ray among other tests,” said Den Boon.
WHO has released a modeling study that examines the costs and benefits of screening and preventive treatment in four countries — Brazil, Georgia, Kenya, and South Africa.
“The investment case studies showed that in all four countries, many TB episodes can be prevented, and lives saved by investing in TB screening,” Den Boon said.
“The modeling showed that relatively modest investments can achieve significant health and economic benefits in all four countries… From a societal perspective, the intervention package was cost-saving in all four countries. The return on investment varied between countries and was up to $39 gained for every dollar invested,” she said.
WHO scientists agree that early diagnosis is crucial to tackling, curing, and preventing the spread of tuberculosis. By the same token, they agree on the importance of developing new vaccines for prevention and eventual eradication.
Currently, only the BCG TB vaccine for children is available and it is 100 years old.
“Indeed, it is absolutely unacceptable that in the 21st century with a lot of innovations, we still do not have a new effective, TB vaccine,” said Kasaeva.
She said WHO’s director general, Tedros Adhanom Gebreyesus, launched a TB Vaccine Accelerator Council last year to bring attention to this problem and attract investments for research and development.
She said the U.N. high-level meeting is backing WHO’s initiative, adding, “This will make it possible to have new TB vaccines within the next five years.”
“We have more than 16 candidates in the pipeline, some of them in the later stages,” she said, “but we need more attention, more prioritization, more investments.”