Tuberculosis is now the world’s most deadly infectious disease. Global infection rates are falling, however, India holds the highest number of individuals harbouring the disease.
India accounts for 27 percent of the ten million people who developed TB in 2017 according to the World Health Organization’s (WHO’s) 2018 Global TB report.
Though the disease is a global problem, two thirds of disease cases were reported to be from eight countries. India leads this group of countries by a considerable margin, with the closest country being China, currently holding nine percent of disease cases.
TB, as well as other infectious diseases, have fallen down the global death toll list in recent years. Infectious diseases have been surpassed in death count by a number of non-communicable conditions such as heart disease (currently India’s biggest killer) as well as cancers and diabetes.
Though this may make TB seem like less of an issue, the concern regarding the disease cannot be dismissed. TB still takes tenth place in terms of death count, claiming the lives of around 4000 people globally on a daily basis.
“TB is an old disease that was once a death sentence,” wrote the authors of WHO’s 2018 Global Tuberculosis Report, “Effective drug treatments first became available in the 1940s, and in combination with social and economic development they allowed countries in western Europe, North America and some other parts of the world to reduce their burdens of TB disease to very low levels.”
Countries such as India are lagging behind in reducing TB burden however. India, along with a number of other low-to-middle income countries are currently acting as reservoirs of the disease. This is becoming an ever more dire situation as the threat of drug resistance is on the rise.
Data from the World Health Organization (WHO) indicates there were 6.3 million new cases of TB in 2016. Of these new cases, around 490,000 were drug-resistant, half of which were in India, China and the Russian Federation.
Drug resistant TB presents both India and the world with a situation where current first line treatments are no longer effective. This could lead to a considerable surge in disease cases which could go all but unchallenged in areas where the more expensive second like drugs are either unobtainable or too expensive.
Multi-drug resistant TB could eliminate all possibility for treatment options. This could result in TB effectively again becoming a death sentence. This threat looms on the horizon as according to a WHO report, the global TB burden is shrinking but not fast enough to reach milestones set by the End TB Strategy.