With 97% of Tuberculosis (TB) cases occurring in low- and middle-income countries, those least equipped to fight the disease are the most affected.

The Challenge

With 97% of Tuberculosis (TB) cases occurring in low- and middle-income countries, those least equipped to fight the disease are the most affected.

Tuberculosis (TB) is an airborne, bacterial, infectious disease mainly affecting the lungs. Those with the bacteria in their lungs can infect others when they cough, which makes the disease highly contagious. On average, one person is newly infected with TB bacilli (the bacteria that causes tuberculosis) every three seconds.

TB is the leading infectious killer globally and one of the top 10 causes of death worldwide, surpassing HIV and malaria. Tuberculosis caused 1.7 million deaths in 2016. Because HIV/AIDS weakens the immune system, people who are HIV-positive are 21 times more likely to develop the disease than someone without HIV. Indeed, TB is a leading cause of death for AIDS patients. Of the 10.4 million individuals newly infected with TB in 2016, 10% were also HIV-positive.

The evolution of the disease, along with misuse of the drugs used to treat it, has led to the development of drug-resistant forms of TB. Drug-resistant TB, including multidrug-resistant TB (MDR-TB), is difficult and expensive to treat, often failing to respond to standard first-line drugs. Drug-resistant TB infected about 600,000 people and killed 240,000 people in 2016. More recently, an even more deadly strain of the disease called Extensively Drug-Resistant Tuberculosis (XDR-TB) has emerged, which responds to even fewer available medicines, including the most effective second-line anti-TB drugs.

TB is completely treatable, but poor health systems often hinder efforts to stop the spread of TB and to treat those already infected. A successful adult TB vaccine has not yet been deployed, but 12 TB vaccines are currently in clinical trials.

The Opportunity

TB is treatable and curable. In many endemic countries, $20 will buy a full six-month drug course of TB treatments; when administered properly, treatment success rates are high.

The global response to TB has made significant inroads against the disease. Since 2000, the TB mortality has fallen by 37%, and the world saved an estimated 53 million lives through TB diagnosis and treatment, with treatment success improving each year.

The Global Fund to Fight AIDS, Tuberculosis and Malaria has supported the detection and treatment of 17.4 million cases of TB, providing over half of the world’s external funding for TB. Despite this progress, much more remains to be done. While funding for TB control has increased, funding for TB in 2016 amounted to $6.9 billion, which leaves a $2.3 billion gap of the $9.2 billion needed in 2017 to reach the Global Plan targets by 2020. The gap will widen to $5.4 billion in 2020 if current funding levels do not increase.

Looking ahead, the world has a plan to end TB by 2030 called the End TB Strategy that provides a framework for countries to reduce the number of TB deaths by 90% by 2030, cut new cases by 80% and ensure that no family is burdened with catastrophic costs due to TB.

ONE’s Policy Position

ONE advocates for sustained financing for TB treatment and prevention through proven and effective programs. ONE calls on governments to increase their domestic financing for health and ensure there are systems in place to support TB programming from the clinic level to the community level, including a strong healthcare workforce. ONE calls on donor countries to provide strong support for malaria through official development assistance (ODA) channeled through effective bilateral programs and international organizations like the Global Fund to Fight AIDS, TB & Malaria.

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