Tuberculosis passes HIV as No. 1 infectious disease

Promising New HIV Vaccine Begins Human Testing
Promising New HIV Vaccine Begins Human Testing

Tuberculosis surpassed HIV as the leading cause of death from infectious disease in the world in 2014, according to a report released Wednesday by the World Health Organization.

But it's not because more people are getting infected. Global health officials said on Wednesday that they are able to better track cases to report more accurate numbers. This year, 1 million new cases were reported in Indonesia, significantly revising data from last year, which showed half that number.

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Cases also were higher among children than previously thought – nearly double the number reported last year. Data show 140,000 children died from TB and 1 million were infected.

WHO estimates overall totals could be even higher, with nearly 40 percent of cases undiagnosed worldwide.

Still, global health efforts have greatly reduced the incidence of the disease since the 1990s, shows the report, the 20th annual Tuberculosis Report.

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TB mortality has fallen by nearly half since 1990, with nearly all improvement taking place since 2000, when the United Nations set Millennium Development Goals for reducing the incidence of the disease. From 2000 to 2014, about 43 million lives were saved because of better diagnosis and treatment.

"We can now begin to imagine the end of tuberculosis," said Dr. Ariel Pablos-Mendez, assistant administrator for global health at USAID, at a news conference Wednesday held in the District of Columbia at the National Press Club. "We never imagined we would be at this stage."

TB is caused by airborne bacteria that damage the lungs, resulting in fever and coughing up blood or mucus. It is curable through medication, but easily can be transmitted from one person to another.

Of the new TB cases in 2014, 58 percent were in the Southeast Asia and Western Pacific regions, with India having the largest percentage of cases at 23 percent. The African region had 28 percent of the world's cases in 2014, but the most severe burden relative to population: 281 cases for every 100,000 people – more than double the global average of 133. More than half of the world's TB cases (54 percent) occurred in China, India, Indonesia, Nigeria and Pakistan.

Despite advances, TB killed more than 1.5 million people in 2014.

This is slightly higher than HIV's death toll, estimated at 1.2 million, which included 400,000 deaths among people who had both TB and HIV, which is also treatable, through the use of antiretroviral drugs. People who are HIV-positive are more susceptible to TB because they have a weakened immune system. Worldwide, 9.6 million people contracted TB in 2014, 12 percent of whom were HIV positive.

Dr. Eric Goosby, United Nations special envoy on TB, called for more funding so that global health officials could reach their goals to reduce TB deaths by 90 percent and TB cases by 80 percent by 2030.

To do so, the report says, better detection systems need to be in place and tools developed to better diagnose people, and a vaccine should be developed. This will require more funding. WHO estimated a funding gap of $1.4 billion for interventions in 2015. For research, WHO estimates it is short $1.3 billion.

Dr. Mario Raviglione, director for WHO's global TB program, noted during the news conference that the U.S. had given the highest investment to combating TB. "Despite the gains, the progress is far from sufficient," he said.

Even with adequate investment, the world faces another looming threat: TB that has become resistant to the drugs used to treat it. The WHO report noted that about half of people who are infected with this type are effectively treated.

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