Hopes to eradicate tuberculosis — the world’s second biggest killer disease after HIV/AIDS — received a blow on Wednesday as the World Health Organization revealed that there were nearly half a million more cases worldwide last year than previously estimated. The upward correction coincides with a perceived shortfall in funding to fight the disease.
While public health efforts have resulted in lower mortality and incidence rates, a “staggering” number of people still die from the curable disease each year, the UN’s health agency said in a statement accompanying a new report on tuberculosis (TB).
In 2013, more than 9 million people contracted TB, and 1.5 million died because treatment wasn’t available or their cases were not detected in time.
"There are severe [TB] epidemics in some regions, particularly in Eastern Europe and Central Asia," the agency said in its statement, adding that the treatment success rate in many places is "alarmingly low."
Once known as the "white plague" for its ability to render its victims skinny, pale and feverish, TB causes night sweats, persistent coughing, weight loss and blood in the phlegm or spit. It is spread through close contact with infected people. Some TB treatment regimens can cause permanent deafness and severe discomfort for the patient.
Health advocates point to insufficient private and public funds for putting cities at risk of renewed outbreaks, halting growth in developing countries, and causing unnecessary deaths.
The World Health Organization (WHO) reports that an estimated $8 billion is needed each year to keep the disease at bay. However, a steady decline in funding has hampered the development of new prevention methods, diagnostic tools, research pipelines and treatment options, according to Treatment Action Group (TAG), a U.S.-based advocacy group.
In 2013, the world spent $677 million on research and development related to TB, an amount equal to just one third of the budget experts estimate the world needs to invest each year to find a cure. Sixty percent of that funding came from public agencies, according to TAG.
In the United States, for example, TB research funding at the Department of Defense (DoD) — the nation's biggest global health investor — only amounted to $1.6 million in 2013, TAG found — a minute fraction of the department's total global public health estimated budget of about $500 million.
Private investment has also been insufficient. Since 2012, three major pharmaceutical companies — Pfizer, AstraZeneca and Novartis — have abandoned TB research entirely. The public sector now gives four times more money to TB research than the private industry does, and philanthropic institutions give twice as much, according to a TAG statement.
“Pharmaceutical companies spent less than $100 million on TB research in 2013 —which is lower than what they did in 2009 at the peak of the economic crisis,” said Mark Harrington, executive director of TAG.
The decline in funding for TB eradication has resulted in the growing threat of multi-drug resistant tuberculosis (MDR-TB), a powerful strain with a mortality rate of up to 80 percent that was cultivated by the wrong medications, incorrect doses and failure to complete treatment.
The impact of MDR-T is particularly felt in Africa, due to the high rate of HIV-positive patients and others with compromised immune systems. In 2013, nearly half a million people were infected by the strain. More than two-thirds of them did not receive treatment, according to WHO.
"Access to proper treatment is drastically low: only one in five people with multidrug-resistant TB receives treatment; the rest are left to die, increasing the risk to their families and communities and fuelling the epidemic," said Grania Brigden of Doctors Without Borders (MSF).
About 1.5 million people died from TB last year, up from 1.3 million in 2012.