TITLE: TB disease burden

Abstract

TB is the ninth leading cause of death worldwide and the leading cause from a single infectious agent, ranking above HIV/AIDS. In 2016, there were an estimated 1.3 million TB deaths among HIVnegative people (down from 1.7 million in 2000) and an additional 374 000 deaths among HIV-positive people.a An estimated 10.4 million people (90% adults; 65% male; 10% people living with HIV) fell ill with TB in 2016 (i.e. were incident cases). Most of the estimated number of incident cases in 2016 occurred in the WHO South-East Asia Region (45%), the WHO African Region (25%) and the WHO Western Pacific Region (17%); smaller proportions of cases occurred in the WHO Eastern Mediterranean Region (7%), the WHO European Region (3%) and the WHO Region of the Americas (3%). The top five countries, with 56% of estimated cases, were (in descending order) India, Indonesia, China, the Philippines and Pakistan. Globally, the TB mortality rate is falling at about 3% per year. TB incidence is falling at about 2% per year; this needs to improve to 4–5% per year by 2020 to reach the first milestones of the End TB Strategy. Regionally, the fastest decline in TB incidence is in the WHO European Region (4.6% from 2015 to 2016). The decline since 2010 has exceeded 4% per year in several high TB burden countries, including Ethiopia, Kenya, Lesotho, Namibia, the Russian Federation, the United Republic of Tanzania, Zambia and Zimbabwe. Regionally, the fastest declines in the TB mortality rate are in the WHO European Region and the WHO Western Pacific Region (6.0% and 4.6% per year, respectively, since 2010). High TB burden countries with rates of decline exceeding 6% per year since 2010 include Ethiopia, the Russian Federation, the United Republic of Tanzania, Viet Nam and Zimbabwe.