Trade, foreign policy, diplomacy and health

3. Tuberculosis control

Jim Yong Kim, Aaron Shakow, Arachu Castro, Chris Vande, Paul Farmer


The burden of tuberculosis: Population health burden

  • Leading infectious cause of adult mortality in the world: 1.5 - 2 million deaths per year
  • 1/3 of world's population (~2 billion) infected
  • Currently 8.4 million new cases each year
  • TB especially prevalent in regions of high HIV prevalence
  • Thus a large pool of patients with disease capable of spreading infection

TB, with AIDS, is the leading infectious cause of adult mortality in the world, causing between 1.5 and 2 million deaths per year. One-third of the world's population, almost 2 billion people, is infected, and the number of new TB cases each year climbed 6% between 1990 and 1997, from 7.5 million to 8 million cases, currently standing at 8.4 million.

Less than half of all TB cases world-wide are ever diagnosed, and fewer than 60% of those diagnosed are cured and TB is projected to remain one of the world's top 10 causes of adult mortality by the year 2020; HIV is the only other infectious pathogen to remain on this list. One estimate suggests 171 million new cases and 60 million deaths over this period in the 'best-case scenario', and 249 million new cases and 90 million deaths in the 'worse-case scenario'.

TB cases are especially high in regions of high HIV prevalence. While non-HIV infected persons with TB have a 5-10% -lifetime risk of developing TB disease, HIV infected persons with TB have a 5-10% annual risk of progressing to active disease. TB already accounts for approximately one-third of all AIDS deaths around the world, and in regions of sub-Saharan Africa up to 70% of people living with AIDS are infected with TB. The consequences of this dual burden are not just increased deaths due to TB, but a larger pool of patients with active disease capable of spreading infection

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