What is tuberculosis and why are deaths rising?

(Credit: Unsplash)

This article is brought to you thanks to the collaboration of The European Sting with the World Economic Forum.

Author: Kate Whiting, Senior Writer, Formative Content


  • Deaths from tuberculosis (TB) have risen for the first time in a decade, due to the COVID-19 pandemic.
  • The World Health Organization estimates the number of people developing TB and dying from the disease could be much higher in 2021 and 2022.
  • Dr. Tereze Kasaeva, Director of the WHO’s Global Tuberculosis Programme, explains what TB is and how to stay safe.

“The struggle to end TB is not just a struggle against a single disease. It’s also the struggle to end poverty, inequity, unsafe housing, discrimination and stigma, and to extend social protection and universal health coverage.”

So says World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus in the WHO’s Global Tuberculosis report 2021.

“If the pandemic has taught us anything, it’s that health is a human right, not a luxury for those who can afford it.”

Deaths from TB have risen during the COVID-19 pandemic – and for the first time in a decade, according to the WHO, with 1.5 million people dying from TB in 2020 (of which 214,000 were HIV positive).

If the pandemic has taught us anything, it’s that health is a human right, not a luxury for those who can afford it.—Dr Tedros Adhanom Ghebreyesus, Director-General, World Health Organization

What is tuberculosis?

Until COVID-19, TB was the main cause of death from a single infectious agent, higher even than HIV/AIDS. Unlike COVID-19, it’s a bacterial rather than virus-caused illness.

TB’s been around for thousands of years, but the bacteria that causes it – Mycobacterium tuberculosis – was only discovered in 1882. It’s spread when people who are ill expel the bacteria into the air, through coughing or sneezing.

“Both TB and COVID-19 primarily affect the lungs,” says Dr. Tereze Kasaeva, Director of the WHO’s Global Tuberculosis Programme in the latest WHO Science in 5 video.

“Patients with TB, in cases where they’ve got COVID-19, will have more severe COVID-19 and the risk of less successful treatment is higher.”

Symptoms can be similar to COVID-19 and include coughing (sometimes with blood), fever, night sweats, or weight loss.

Who does TB affect?

One in four people in the world is infected with the bacteria, meaning a higher risk of developing disease, according to the WHO, but not everyone with it becomes ill.

Most cases (90%) of TB occur in adults – and those with compromised immune systems, such as people with HIV, diabetes, or malnutrition, have a higher risk of becoming ill.

It occurs in all parts of world, but some places have a higher burden of disease. In 2020, two-thirds of new cases were in just eight countries: India, China, Indonesia, the Philippines, Pakistan, Nigeria, Bangladesh and South Africa.

According to the WHO, the burden of HIV-associated TB is highest in Africa, where 85% of TB patients in 2020 had a documented HIV test result.

Global trends in the estimated number of deaths caused by TB and HIV, 2000-2020.
How TB deaths have risen in the past year. Image: WHO

Why are TB deaths rising and what can be done?

It can be successfully treated with a 6-month course of drugs, but diagnosis has dropped due to the healthcare disruption of the pandemic, says Dr. Kasaeva.

“We can see significant drops in TB diagnosis notification and it means that access is limited… People are not receiving timely life-saving treatment and the transmission of the infection is continued.”

The only licensed vaccine for prevention of TB disease – the bacille Calmette-Guérin or BCG – was developed 100 years ago, and prevents severe forms of TB in children, says the WHO.

As yet, there is no vaccine effective in preventing TB disease in adults, but results from a Phase II trial of the M72/AS01E candidate have shown promise. Vaccines, Health and healthcare, Gavi

What is the World Economic Forum doing about access to vaccines?

In 2000, Gavi, the Vaccine Alliance was launched at the World Economic Forum’s Annual Meeting in Davos, with an initial pledge of $750 million from the Bill and Melinda Gates Foundation.

The aim of Gavi is to make vaccines more accessible and affordable for all – wherever people live in the world.

Along with saving an estimated 10 million lives worldwide in less than 20 years,through the vaccination of nearly 700 million children, – Gavi has most recently ensured a life-saving vaccine for Ebola.

At Davos 2016, we announced Gavi’s partnership with Merck to make the life-saving Ebola vaccine a reality.

The Ebola vaccine is the result of years of energy and commitment from Merck; the generosity of Canada’s federal government; leadership by WHO; strong support to test the vaccine from both NGOs such as MSF and the countries affected by the West Africa outbreak; and the rapid response and dedication of the DRC Minister of Health. Without these efforts, it is unlikely this vaccine would be available for several years, if at all.

Read more about the Vaccine Alliance, and how you can contribute to the improvement of access to vaccines globally – in our Impact Story.

Dr. Kasaeva encourages those with TB to follow their doctor’s advice during the pandemic, as well as the principles of good hygiene, ventilation, mask wearing and cough etiquette.

“Get yourself tested for both TB and COVID-19 if you have symptoms like coughing, high fever, and difficulties in breathing… You should be tested for TB if you have history in your family or close contacts with TB and you’ve been tested with a TB infection.”

Watch the WHO’s Science in 5: Tuberculosis and COVID-19 here: https://www.youtube.com/embed/WxrNDLbFGUA?enablejsapi=1&wmode=transparent Share


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