WHO declares Pakistan among five high-burden countries as TB resurges

• "TB remains a global health threat," says WHO director general.
• Newly diagnosed cases rose to 8.2mn in 2023, WHO reports says.
• In 2023, only 44% of MDR/RR-TB cases were diagnosed, treated.

ISLAMABAD: The World Health Organisation (WHO) has declared Pakistan as one of the top five high-burden countries where tuberculosis (TB) cases reached record high in 2023, The News reported on Wednesday.

According to the global health body, the country — alongside India, Indonesia, China and the Philippines — accounted for over half of 10.8 million cases of the disease worldwide, shedding light on an ongoing public health challenge despite the availability of treatment and prevention tools.

The WHO's Global Tuberculosis Report 2024 stated that the newly diagnosed TB cases rose to 8.2 million in 2023, up from 7.5 million in 2022 — highest number since global monitoring began in 1995.

TB claimed 1.25 million lives, making it the leading infectious disease killer in 2023 and surpassing COVID-19.

"TB remains a global health threat, particularly in high-burden countries like Pakistan," said WHO Director-General Dr Tedros Adhanom Ghebreyesus. "We urge all nations to fulfil commitments to expand tools for TB prevention, detection, and treatment to end TB once and for all," DG said.

While TB-related deaths saw a modest decrease — down from 1.32 million in 2022, the disease continues to spread rapidly in resource-constrained settings, with high undernutrition, diabetes, smoking and HIV infection acting as major risk factors. Nearly 56% of global TB burden in 2023 was concentrated in Pakistan and its neighbouring high-burden countries.

Further complicating TB’s eradication is the rising incidence of multidrug-resistant TB (MDR-TB), a severe form that resists common treatments and is closely linked with antimicrobial resistance.

In 2023, only 44% of MDR/RR-TB cases were diagnosed and treated, with a treatment success rate of 68%, illustrating challenges faced by health systems in tracking and managing this resistant strain.

Despite national and international efforts to counter TB, funding shortages persist. In 2023, low-and middle-income countries (LMICs) required $22 billion to effectively combat TB, but only managed to secure $5.7 billion (26% of this target). The WHO’s report underscores a significant number of TB-affected households face catastrophic costs, exceeding 20% of their annual income, to access necessary TB care and treatment.

Dr Tereza Kasaeva, Director of WHO’s Global Tuberculosis Programme, called for urgent, multisectoral action, emphasizing, “Funding shortfalls, financial burdens on patients, conflict, climate change and drug-resistant strains are hampering progress in controlling TB”.

Addressing TB, she noted, requires united efforts to tackle these barriers, as well as increased funding and research into diagnostics, treatments and vaccine development.

The WHO’s push for TB vaccine research highlights unmet need, with only 20% of $5 billion annual target for TB research reached in 2022. TB Vaccine Accelerator Council is actively working on advancing this agenda.

WHO also calls for action on commitments made at 2023 UN High-Level Meeting on TB, urging governments, donors and global partners to translate pledges into effective strategies.

The targets set for 2027 remain off-track, with further progress needed to reduce TB cases and deaths globally.

Dr Ghebreyesus emphasised fight against TB requires immediate, concerted efforts to meet global milestones and ensure effective, accessible TB care reaches those most in need.