New Delhi: An estimated 1 crore people contracted tuberculosis in 2019, and over a quarter of them were in India, says the just released Global Tuberculosis Report 2020.
India, which had 26 per cent of the cases, and seven other countries accounted for two thirds of the global total. They include Indonesia (8.5%), China (8.4%), the Philippines (6%), Pakistan (5.7%), Nigeria (4.4%), Bangladesh (3.6%) and South Africa (3.6%).
According to the report, there were an estimated 12 lakh TB deaths among HIV-negative people in 2019 (a reduction from 17 lakh in 2000), and an additional 2,08,000 deaths among HIV-positive people (a reduction from 6,78,000 in 2000).
Males aged over 15 years accounted for 56 per cent of those who developed TB in 2019, while women accounted for 32 per cent and children (aged <15 years) the remaining 12 per cent. Among all those affected, 8.2 per cent were people living with HIV.
The report says the TB incidence rate is falling, but adds that the target of achieving a 20 per cent reduction in the rate, between 2015 and 2020, may be missed. From 2015 to 2019, there was a total reduction of nine per cent — from 142 to 130 new cases per 1 lakh population. Between 2018 and 2019, there was a 2.3 per cent reduction.
India has highest burden of drug-resistant TB
The estimated rate of TB incidence in India is 193 per 1 lakh population, with the total number of cases estimated at 26,40,000. Of these, 2.8 per cent are new cases.
On a more positive note, the report says that 82 per cent of these patients are under treatment. The case fatality ratio stands at 17 per cent.
The report further says that India has the highest burden of drug-resistant TB.
“Drug-resistant TB continues to be a public health threat. Worldwide in 2019, close to half a million people developed rifampicin-resistant TB (RR-TB), of which 78% had multidrug-resistant TB (MDR-TB),” it points out.
“The three countries with the largest share of the global burden were India (27%), China (14%) and the Russian Federation (8%). Globally in 2019, 3.3% of new TB cases and 17.7% of previously treated cases had MDR/RR-TB. The high- est proportions (>50% in previously treated cases) were in countries of the former Soviet Union.”
Effect of Covid-19 pandemic
The report estimates that the global TB deaths could increase by around 0.2–0.4 million in 2020 alone. “In India, Indonesia, the Philippines and South Africa, four countries that account for 44% of global TB cases, there were large drops in the reported number of people diagnosed with TB between January and June 2020. Compared with the same six-month period in 2019, overall reductions in India, Indonesia and the Philippines were in the range 25–30%,” the report says.
The impact on livelihoods such as job losses etc could also increase the percentage of people with TB and their households facing catastrophic costs, it adds.
The Narendra Modi government estimates that the disruption of health services because of Covid-19 could result in an estimated 5 lakh additional TB cases and 1 lakh more deaths in the next five years. India has reported a 60 per cent decline in tuberculosis notifications because of the lockdown imposed to control Covid-19.