WHO releases an investment case for TB screening and preventive treatment

Ahead of World Tuberculosis (TB) Day, which is marked on 24 March, WHO has released an investment case for TB screening and preventive treatment. A modeling study developed with Governments of four countries - Brazil, Georgia, Kenya and South Africa - highlights the impact to be achieved from expanding TB screening and preventive treatment.

The analysis shows that modest investments could lead to significant health and economic benefits in all four countries, with a return on investment up to US$ 39 gained for every dollar invested. The investment case has been released to support countries in advocating for and allocating increased resources to scale-up TB screening and preventive treatment towards reaching new targets committed by Heads of State at the 2023 UN High-Level Meeting on TB.

While global efforts to combat TB have saved an estimated 75 million lives since the year 2000, TB causes 1.3 million deaths each year and affects millions more, with enormous impacts on families and communities.

The investment case outlines the health and economic rationale for investing in evidence-based, WHO-recommended interventions on TB screening and prevention that can contribute to advancing universal health coverage. Today, we have the knowledge, tools and political commitment that can end this millennia-old disease that remains one of the world's top infectious killers".

Dr. Tedros Adhanom Ghebreyesus, WHO Director-General

According to the investment report, implementing TB screening plus preventive treatment can substantially reduce TB incidence and mortality. It argues that these crucial public health investments are essential for addressing the needs of vulnerable populations and achieving the End TB targets.

In 2022, WHO reported a significant worldwide recovery in the scale-up of access to TB diagnosis and treatment services, with the highest figure recorded since WHO began global TB monitoring in 1995.

However, the scale-up of access to TB preventive treatment has been slow. Preventing TB infection and stopping progression from infection to disease are critical for reducing TB incidence to the levels envisaged by the WHO's End TB Strategy. To do this, it is vital to offer TB preventive treatment to those with HIV, household contacts of TB patients, and other high-risk groups.

The global number of people living with HIV and household contacts of people with TB who were provided with TB preventive treatment increased to 3.8 million in 2022 or about 60% of those targeted that year in line with the commitments made at the UN High-Level Meeting of 2018.

Multidrug-resistant TB (MDR-TB) remains a public health crisis. While an estimated 410 000 people developed multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB) in 2022, only about 2 in 5 people accessed treatment. Progress in the development of new TB diagnostics, drugs and vaccines remains constrained by the overall level of investment in these areas. It is clear much more efforts are needed to combat TB, which remains one of the world's leading infectious killers.

2024 World Tuberculosis Day is being commemorated under the theme 'Yes! We can end TB!' conveying a message of hope that getting back-on-track to turn the tide against the TB epidemic is possible through high level leadership, increased investments and faster uptake of new WHO recommendations.

Following the commitments made by Heads of State at the UN High-Level Meeting in 2023 to accelerate progress to end TB, this year's focus shifts to turning these commitments into tangible actions. This includes implementing the WHO Director-General's flagship initiative on TB for 2023-2027.

"The next five years will be critical for ensuring that the political momentum we have now is translated into concrete actions towards reaching global TB targets," said Dr Tereza Kasaeva, Director of WHO's Global Tuberculosis Programme. "WHO will continue to provide global leadership for the TB response, working with all stakeholders until we reach and save every person, family and community impacted by this deadly disease".

The global targets approved at the 2023 UN High-Level Meeting on TB include: reaching 90% of people in need with TB prevention and care services; using a WHO-recommended rapid test as the first method of diagnosing TB; providing a health and social benefit package to all people with TB; ensuring the availability of at least one new TB vaccine that is safe and effective; and closing funding gaps for TB implementation and research by 2027.