Tuberculosis (TB) – World Health Organization (WHO)

Global Impact of Tuberculosis and its Relation to Sustainable Development Goals

Mortality and Morbidity Statistics (SDG 3.3)

Tuberculosis (TB) remains a significant barrier to achieving Sustainable Development Goal 3 (Good Health and Well-being), particularly Target 3.3, which aims to end the epidemic by 2030. The disease continues to be a leading cause of death globally from a single infectious agent.

• Fatalities: In 2024, a total of 1.23 million people died from TB, including 150,000 individuals co-infected with HIV. This mortality rate underscores the urgent need for intensified global health interventions.
• Incidence: An estimated 10.7 million people contracted TB in 2024, comprising 5.8 million men, 3.7 million women, and 1.2 million children, highlighting the disease’s wide-reaching impact across all demographics.
• Progress: Despite the ongoing challenges, global efforts to combat TB have averted an estimated 83 million deaths since 2000, demonstrating the effectiveness of concerted public health strategies.

Demographic and Geographic Distribution (SDG 10)

The burden of TB is not evenly distributed, reflecting and exacerbating global inequalities, a core concern of SDG 10 (Reduced Inequalities). Over 80% of cases and deaths occur in low- and middle-income countries.

• Regional Concentration: In 2024, the highest number of new TB cases were reported in the WHO South-East Asia Region (34%), the Western Pacific Region (27%), and the African Region (25%).
• High-Burden Countries: Approximately 87% of new cases were concentrated in 30 high-burden countries. India, Indonesia, the Philippines, China, Pakistan, Nigeria, the Democratic Republic of the Congo, and Bangladesh collectively accounted for two-thirds of the global total.

Disease Characteristics and Risk Factors

Overview and Transmission

Tuberculosis is a preventable and curable infectious disease caused by bacteria, primarily affecting the lungs. It is transmitted through the air when an infected person coughs, sneezes, or spits. While an estimated quarter of the global population has a latent TB infection, only 5-10% will develop active TB disease.

Key Risk Factors Linked to SDGs

Several risk factors for developing active TB disease are directly linked to broader development challenges addressed by the SDGs.

• Undernutrition (SDG 2 – Zero Hunger): In 2024, an estimated 0.97 million new TB cases were attributable to undernutrition.
• Weakened Immune Systems (SDG 3 – Good Health and Well-being): Conditions such as HIV infection, diabetes, tobacco use, and harmful alcohol consumption significantly increase the risk of developing TB. An estimated 0.57 million new cases were linked to HIV infection.
• Poverty and Social Determinants (SDG 1 – No Poverty): The disease disproportionately affects vulnerable populations, creating a vicious cycle of poverty and ill-health.

Strategic Interventions for TB Control in Line with SDG 3

Prevention and Diagnosis

Effective prevention and early diagnosis are critical for breaking the chain of transmission and meeting SDG targets.

• Prevention: Measures include seeking early medical attention for symptoms, screening high-risk groups, completing TB preventive treatment (TPT), and practicing good respiratory hygiene. The Bacille Calmette-Guérin (BCG) vaccine is administered to infants in certain countries to prevent severe forms of TB.
• Diagnosis: WHO recommends rapid molecular diagnostic tests, which can provide accurate results within 48 hours, enabling prompt treatment decisions and improving early detection of both TB and drug-resistant TB.

Treatment Protocols

TB is curable with a standard 4-6 month course of antibiotics, including rifampicin, isoniazid, pyrazinamide, and ethambutol. Adherence to the full treatment regimen is essential to prevent the development of drug resistance.

Critical Challenges to Achieving SDG Target 3.3

Multidrug-Resistant Tuberculosis (MDR-TB)

MDR-TB, a form of TB resistant to the two most potent first-line drugs, poses a major public health and health security threat, complicating efforts to end the epidemic.

• Treatment Gap: In 2024, only about two in five people with drug-resistant TB accessed treatment, a significant gap that fuels further transmission.
• Advanced Resistance: Extensively drug-resistant TB (XDR-TB) presents even greater treatment challenges.
• New Regimens: WHO is promoting shorter, all-oral regimens (e.g., BPaLM/BPaL) which have higher efficacy and lower pill burdens, aiming to improve treatment outcomes and expand access.

The TB and HIV Co-epidemic

The convergence of TB and HIV creates a lethal synergy, undermining progress on SDG 3. People living with HIV are 12 times more likely to develop active TB.

• Mortality: TB is the leading cause of death among people with HIV, responsible for 150,000 deaths in 2024.
• Treatment Integration: Collaborative TB/HIV activities, including bidirectional screening and integrated treatment, are crucial. However, in 2024, only 61% of people living with HIV who developed TB received antiretroviral therapy (ART).

Socioeconomic Burden and Investment Gaps

Economic Impact on Households (SDG 1)

The financial burden of TB pushes families further into poverty, directly contravening SDG 1 (No Poverty). Globally, approximately 50% of TB patients and their households face catastrophic costs, defined as exceeding 20% of their total household income. This is far from the End TB Strategy’s target of zero.

Funding Requirements and Current Investment Levels

A significant funding gap impedes the global TB response. Achieving the targets set at the 2023 UN high-level meeting requires an annual investment of US$ 22 billion for TB prevention, diagnosis, and care. Current funding falls far short of this goal, with international donor funding remaining stagnant and domestic funding concentrated in a few countries.

Global Response and Strategic Framework

WHO’s Role in Advancing the End TB Strategy

The World Health Organization (WHO) collaborates with countries, partners, and civil society to accelerate the TB response. WHO’s efforts are focused on six core functions designed to achieve the targets outlined in the WHO End TB Strategy, the Sustainable Development Goals, and the 2023 UN High-level Meeting political declaration.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The article on Tuberculosis (TB) primarily addresses several Sustainable Development Goals (SDGs), reflecting the multifaceted nature of the disease as a public health, social, and economic issue.

• SDG 3: Good Health and Well-being

  This is the most central SDG discussed. The entire article focuses on TB as a major global health threat, detailing its causes, symptoms, prevention, and treatment. It highlights mortality rates, incidence, and the impact on vulnerable populations, directly aligning with the goal of ensuring healthy lives and promoting well-being for all at all ages.

• SDG 1: No Poverty

  The article establishes a clear link between TB and poverty. It states that “over 80% of cases and deaths are in low- and middle-income countries.” Furthermore, it highlights the economic burden of the disease, mentioning that “about 50% of people treated for TB and their households face total costs… that are catastrophic,” which can push families into poverty.

• SDG 2: Zero Hunger

  The connection to this goal is made through the identification of undernutrition as a significant risk factor for TB. The article specifies that in 2024, an “estimated 0.97 million new TB cases that were attributable to undernutrition,” linking poor nutrition directly to the incidence of the disease.

• SDG 17: Partnerships for the Goals

  The article implicitly and explicitly addresses this goal by discussing the global effort to combat TB. It mentions the “WHO response,” “global efforts to combat TB,” and the significant funding gap between what is needed (“US$ 22 billion… annually”) and what is available from domestic sources and “international donor funding,” underscoring the need for global partnerships and financial mobilization.

2. What specific targets under those SDGs can be identified based on the article’s content?

Based on the issues discussed, several specific SDG targets can be identified:

• Target 3.3: End the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases

  This target is the primary focus of the article. The text is entirely dedicated to the global TB epidemic, providing key facts on mortality (“1.23 million people died from tuberculosis (TB) in 2024”), incidence (“an estimated 10.7 million people fell ill with TB”), and the specific challenges of HIV-associated TB and multidrug-resistant TB (MDR-TB).

• Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all

  The article highlights significant gaps in universal health coverage. The statement that “Only about 2 in 5 people with drug-resistant TB accessed treatment in 2024” points to a lack of access to essential health services. The mention of “catastrophic” costs for 50% of households demonstrates a failure in financial risk protection.

• Target 3.b: Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries

  This target is addressed in the section on investments, where the article notes that “Financing for TB research and innovation, at US$ 1.2 billion in 2023, also continues to fall far short of the global target of US$ 5 billion per year,” indicating a critical need to support R&D for diseases like TB that disproportionately affect low- and middle-income countries.

• Target 1.2: By 2030, reduce at least by half the proportion of men, women and children of all ages living in poverty in all its dimensions according to national definitions

  The article’s data on the “catastrophic” economic impact of TB directly relates to this target. The high costs associated with treatment (direct medical, non-medical, and income losses) are a major driver of poverty for affected households, making the fight against TB a crucial component of poverty reduction strategies.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article provides several quantitative and qualitative data points that serve as or imply official SDG indicators.

• Indicator 3.3.2: Tuberculosis incidence per 100,000 population

  The article provides the absolute number of new cases: “an estimated 10.7 million people fell ill with TB worldwide” in 2024. This figure is the numerator used to calculate the incidence rate, a key metric for tracking progress against Target 3.3.

• Indicator for TB Mortality (related to Target 3.3)

  The article explicitly states the number of deaths: “A total of 1.23 million people died from tuberculosis (TB) in 2024 (including 150,000 among people with HIV).” This is a direct measure of the burden of the disease and progress in preventing deaths.

• Indicator 3.8.1: Coverage of essential health services

  Progress towards this indicator is implied by the treatment access data. The fact that “Only about 2 in 5 people with drug-resistant TB accessed treatment in 2024” is a direct measure of the coverage gap for a specific, essential health service.

• Indicator 3.8.2: Proportion of population with large household expenditures on health as a share of total household expenditure or income

  The article provides a direct measurement related to this indicator: “Globally, about 50% of people treated for TB and their households face total costs… that are catastrophic (>20% of total household income).” This statistic precisely measures the financial burden of TB, which is a key component of universal health coverage.

• Indicator for Funding and Partnerships (related to Target 17.2)

  The article quantifies the financial resources available for the TB response, mentioning that “international donor funding amounted to US$ 1.1 billion” and that total spending falls far short of the “US$ 22 billion… needed annually.” These figures serve as indicators of the level of global partnership and financial commitment to ending TB.

4. Create a table with three columns titled ‘SDGs, Targets and Indicators” to present the findings from analyzing the article.

Source: who.int