Prior to the COVID 19 pandemic many countries were making steady progress in tackling tuberculosis TB with a 9 reduction in incidence seen between 2015 and 2019 and a 14 drop in deaths in the same period High level political commitments at global and national levels were delivering results However a new report from WHO shows that access to TB services remains a challenge and that global targets for prevention and treatment will likely be missed without urgent action and investments Approximately 1 4 million people died from TB related illnesses in 2019 Of the estimated 10 million people who developed TB that year some 3 million were not diagnosed with the disease or were not officially reported to national authorities The situation is even more acute for people with drug resistant TB About 465 000 people were newly diagnosed with drug resistant TB in 2019 and of these less than 40 were able to access treatment There has also been limited progress in scaling up access to treatment to prevent TB Equitable access to quality and timely diagnosis prevention treatment and care remains a challenge said Dr Tedros Adhanom Ghebreyesus Director General of WHO Accelerated action is urgently needed worldwide if we are to meet our targets by 2022 About 14 million people were treated for TB in the period 2018 2019 just over one third of the way towards the 5 year target 2018 2022 of 40 million according to the report Some 6 3 million people started TB preventive treatment in 2018 2019 about one fifth of the way towards the 5 year target of 30 million Funding is a major issue In 2020 funding for TB prevention diagnosis treatment and care reached US 6 5 billion representing only half of the US 13 billion target agreed by world leaders in the UN Political Declaration on TB The COVID 19 pandemic and TB Disruptions in services caused by the COVID 19 pandemic have led to further setbacks In many countries human financial and other resources have been reallocated from TB to the COVID 19 response Data collection and reporting systems have also been negatively impacted According to the new report data collated from over 200 countries has shown significant reductions in TB case notifications with 25 30 drops reported in 3 high burden countries India Indonesia the Philippines between January and June 2020 compared to the same 6 month period in 2019 These reductions in case notifications could lead to a dramatic increase in additional TB deaths according to WHO modelling However in line with WHO guidance countries have taken measures to mitigate the impact of COVID 19 on essential TB services including by strengthening infection control A total of 108 countries including 21 countries with a high TB burden have expanded the use of digital technologies to provide remote advice and support To reduce the need for visits to health facilities many countries are encouraging home based treatment all oral treatments for people with drug resistant TB provision of TB preventive treatment and ensuring people with TB maintain an adequate supply of drugs In the face of the pandemic countries civil society and other partners have joined forces to ensure that essential services for both TB and COVID 19 are maintained for those in need said Dr Tereza Kaseva Director of WHO s Global TB Programme These efforts are vital to strengthen health systems ensure health for all and save lives A recent progress report from the UN Secretary General outlines 10 priority actions for Member States and other stakeholders to close gaps in TB care financing and research as well as advance multisectoral action and accountability including in the context of the COVID 19 pandemic Note for the editors Global targets In 2014 and 2015 all Member States of WHO and the UN adopted the UN Sustainable Development Goals SDGs and WHO s End TB Strategy The SDGs and End TB Strategy both include targets and milestones for large reductions in TB incidence TB deaths and costs faced by TB patients and their households TB is included under Goal 3 Target 3 3 of the SDGs which aims to end the epidemics of AIDS tuberculosis malaria and neglected tropical diseases by the year 2030 The WHO End TB Strategy aims for a 90 per cent reduction in TB deaths and an 80 per cent reduction in the TB incidence rate by 2030 compared to the 2015 baseline Milestones for 2020 include a 20 reduction in the TB incidence rate and a 35 reduction in TB deaths Efforts to step up political commitment in the fight against TB intensified in 2017 and 2018 culminating in September 2018 in the first ever high level meeting on TB at the UN General Assembly The outcome was a political declaration in which commitments to the SDGs and End TB Strategy were reaffirmed The UN Political Declaration on TB also included 4 new targets for the period 2018 2022 Treat 40 million people for TB disease Reach at least 30 million people with TB preventive treatment for a latent TB infection Mobilize at least US 13 billion annually for universal access to TB diagnosis treatment and care Mobilize at least US 2 billion annually for TB research Progress towards global targets According to the new report the WHO European Region is on track to achieve key 2020 targets of the WHO End TB Strategy with reductions in incidence and deaths of 19 and 31 respectively over the last 5 year period The African Region has also made impressive gains with corresponding reductions of 16 and 19 in the same timeframe On a global scale however the pace of progress has lagged and critical 2020 milestones of the End TB Strategy will be missed Financing As in previous years most available TB funding 85 in 2020 came from domestic sources with Brazil Russian Federation India China and South Africa providing 57 of the global total International donor funding increased from US 900 000 in 2019 to US 1 billion in 2020 The Global Fund to Fight AIDS Tuberculosis and Malaria was the single largest source of international TB financing in 2020 while the United States remains the biggest bilateral funder of efforts to end TB Research and innovation Reaching the 2030 global TB targets will require technological breakthroughs by 2025 The world needs affordable and accessible rapid point of care tests as well as new safer and more effective treatments and vaccines To meet these challenges Member States called on WHO in 2018 to develop a Global strategy for TB research and innovation that lays out key steps that governments and non state actors can undertake The strategy was adopted by the World Health Assembly in August 2020 Multisectoral action and accountability Further progress towards ending TB will depend on action across sectors underscoring the importance of the implementation of WHO s multisectoral accountability framework on TB In 2019 and 2020 WHO worked with high TB burden countries to ensure the inclusion of accountability mechanisms in national budget planning and pursuing assessment during high level missions and joint TB programme reviews with engagement of civil society representatives TB facts Tuberculosis TB the world s deadliest infectious killer is caused by bacteria Mycobacterium tuberculosis that most often affect the lungs It can spread when people who are sick with TB expel bacteria into the air for example by coughing Approximately 90 percent of those who fall sick with TB each year live in 30 countries Most people who develop the disease are adults and there are more cases among men than women TB is preventable and curable About 85 of people who develop TB disease can be successfully treated with a 6 month drug regimen treatment has the added benefit of curtailing onward transmission of infection Since 2000 TB treatment has averted more than 60 million deaths although with access to universal health coverage still falling short many millions have also missed out on diagnosis and care