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The key findings of the Global Tuberculosis Report 2022 (released in October 2022) by World Health Organization are as follows (please click here and here to access): 

India-specific findings

• The case notifications of people newly diagnosed with TB in India were 16,67,136 in 2015, 17,63,876 in 2016, 16,49,694 in 2017, 19,08,683 in 2018, 21,62,323 in 2019, 16,29,301 in 2020, and 19,65,444 in 2021. Please click here to access the data.  

• Between 2019 and 2020, India witnessed a reduction of 24.65 percent in case notifications of people newly diagnosed with TB. Please click here to access the data.

• Between 2019 and 2021, India faced a reduction of 9.1 percent in case notifications of people newly diagnosed with TB. Please click here to access the data.

• Almost all (90 percent) of the global drop in the number of people newly diagnosed with TB and reported (notified) between 2019 and 2020 was accounted for by 10 countries; the top three, India, Indonesia and the Philippines, accounted for 67 percent. In 2021, 90 percent of the reduction compared with 2019 was accounted for by only five countries. Please click here to access the data.

• Among the 30 high TB burden and 3 global TB watchlist countries, the largest relative reductions in annual notifications between 2019 and 2020 were (ordered according to the size of the relative reduction) in Philippines, Lesotho, Indonesia, Zimbabwe, India, Myanmar and Bangladesh (all >20 percent). In 2021, there was considerable recovery in India, Indonesia and the Philippines, although not to 2019 levels. Please click here to access the data.

• In 2021, eight countries accounted for more than two thirds of global TB cases: India (28 percent), Indonesia (9.2 percent), China (7.4 percent), the Philippines (7.0 percent), Pakistan (5.8 percent), Nigeria (4.4 percent), Bangladesh (3.6 percent) and Democratic Republic of the Congo (2.9 percent). Please click here to access data.

• Trends in the TB incidence rate in the 30 high TB burden countries are mixed. Between 2020 and 2021, there were estimated increases in countries with major shortfalls in TB notifications in 2020 and 2021 (e.g. India, Indonesia, Myanmar, Philippines), while in others the previous decline in the TB incidence rate has slowed or stabilized. Please click here to access data.

• TB incidence rates for India were 341 per lakh population in 2000, 340 per lakh population in 2001, 339 per lakh population in 2002, 337 per lakh population in 2003, 334 per lakh population in 2004, 329 per lakh population in 2005, 323 per lakh population in 2006, 316 per lakh population in 2007, 309 per lakh population in 2008, 300 per lakh population in 2009, 292 per lakh population in 2010, 284 per lakh population in 2011, 277 per lakh population in 2012, 270 per lakh population in 2013, 263 per lakh population in 2014, 256 per lakh population in 2015, 249 per lakh population in 2016, 234 per lakh population in 2017, 224 per lakh population in 2018, 214 per lakh population in 2019, 204 per lakh population in 2020, and 210 per lakh population in 2021. Please click here to access data.

• TB case notification rates (of new and relapse cases) for India were 105 per lakh population in 2000, 101 per lakh population in 2001, 97 per lakh population in 2002, 96 per lakh population in 2003, 100 per lakh population in 2004, 100 per lakh population in 2005, 105 per lakh population in 2006, 109 per lakh population in 2007, 110 per lakh population in 2008, 110 per lakh population in 2009, 108 per lakh population in 2010, 105 per lakh population in 2011, 101 per lakh population in 2012, 96 per lakh population in 2013, 123 per lakh population in 2014, 126 per lakh population in 2015, 132 per lakh population in 2016, 122 per lakh population in 2017, 139 per lakh population in 2018, 156 per lakh population in 2019, 117 per lakh population in 2020, and 140 per lakh population in 2021. Please click here to access data.          

• In 2021, 82 percent of global TB deaths among HIV-negative people occurred in the WHO African and South-East Asia regions; India alone accounted for 36 percent. The African and South-East Asia regions accounted for 82 percent of the combined total of TB deaths in HIV-negative and HIV-positive people; India accounted for 32 percent. Please click here to access the data.

• Trends in the number of TB deaths in the 30 high TB burden countries are mixed. Between 2019 and 2021, striking increases are estimated to have occurred in countries with major shortfalls in TB notifications in 2020 and 2021 (e.g. India, Indonesia, Myanmar, Philippines), while in others previous declines have slowed or stabilized. Please click here to access the data.

• The estimated absolute numbers of TB deaths (HIV-positive and HIV-negative) in India were 7,10,000 in 2000, 7,00,000 in 2001, 6,90,000 in 2002, 6,70,000 in 2003, 6,50,000 in 2004, 6,40,000 in 2005, 6,30,000 in 2006, 6,30,000 in 2007, 5,90,000 in 2008, 5,80,000 in 2009, 5,50,000 in 2010, 5,40,000 in 2011, 5,30,000 in 2012, 5,20,000 in 2013, 4,90,000 in 2014, 4,70,000 in 2015, 4,60,000 in 2016, 4,60,000 in 2017, 4,60,000 in 2018, 4,50,000 in 2019, 4,80,000 in 2020, and 5,10,000 in 2021. Please click here to access the data.
       
• The estimated numbers of incident cases of Multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB) were 1,49,000 in 2015, 1,44,000 in 2016, 1,35,000 in 2017, 129,000 in 2018, 123,000 in 2019, 1,17,000 in 2020, and 1,19,000 in 2021. Please click here to access the data.

• The countries with the largest share of incident cases of MDR/RR-TB in 2021 were India (26 percent of global cases), the Russian Federation (8.5 percent of global cases) and Pakistan (7.9 percent of global cases). Please click here to access the data.

• In 2019–2021, the first-ever national survey was completed in India; this was one of the largest surveys to date, with a sample size of about 3,20,000 people. Please click here to access the data.

• In 2020, the first full year of the COVID-19 pandemic, there were particularly large absolute and relative reductions in India, Indonesia and Philippines, followed by some recovery in 2021. 

• The number of notifications of people newly diagnosed with TB (new and relapse cases, all forms) was 11,15,718 in 2000, 10,85,075 in 2001, 10,60,951 in 2002, 10,73,282 in 2003, 11,36,182 in 2004, 11,56,248 in 2005, 12,28,827 in 2006, 12,95,943 in 2007, 13,32,267 in 2008, 13,51,913 in 2009, 13,39,866 in 2010, 13,23,949 in 2011, 12,89,836 in 2012, 12,43,905 in 2013, 16,09,547 in 2014, 16,67,136 in 2015, 17,63,876 in 2016, 16,49,694 in 2017, 19,08,683 in 2018, 21,62,323 in 2019, 16,29,301 in 2020, and 19,65,444 in 2021. Please click here to access the data.  

• The number of estimated TB incident cases in India was 36,10,000 in 2000, 36,70,000 in 2001, 37,20,000 in 2002, 37,60,000 in 2003, 37,90,000 in 2004, 38,00,000 in 2005, 37,90,000 in 2006, 37,60,000 in 2007, 37,20,000 in 2008, 36,80,000 in 2009, 36,30,000 in 2010, 35,70,000 in 2011, 35,30,000 in 2012, 34,80,000 in 2013, 34,40,000 in 2014, 33,90,000 in 2015, 33,30,000 in 2016, 31,60,000 in 2017, 30,60,000 in 2018, 29,60,000 in 2019, 28,50,000 in 2020, and 29,50,000 in 2021. Please click here to access the data.

• The contribution of public-private mix (PPM) initiatives to total notifications was 2.3 percent in 2010, 0.26 percent in 2011, 0.24 percent in 2012, 6.0 percent in 2013, 12.0 percent in 2014, 11.0 percent in 2015, 17.0 percent in 2016, 23.0 percent in 2017, 26.0 percent in 2018, 28.0 percent in 2019, 31.0 percent in 2020, and 33.0 percent in 2021. Please click here to access the data.

• The percentage of people in India newly diagnosed with pulmonary TB who were bacteriologically confirmed was 35 percent in 2000, 41 percent in 2001, 44 percent in 2002, 49 percent in 2003, 53 percent in 2004, 56 percent in 2005, 58 percent in 2006, 60 percent in 2007, 61 percent in 2008, 62 percent in 2009, 63 percent in 2010, 65 percent in 2011, 66 percent in 2012, 71 percent in 2013, 66 percent in 2014, 64 percent in 2015, 63 percent in 2016, 71 percent in 2017, 57 percent in 2018, 57 percent in 2019, 54 percent in 2020, and 66 percent in 2021. Please click here to access the data

• The number of WHO-recommended rapid tests used per 1,00,000 population in the case of India was 258 in 2021. Please click here to access the data.

• The percentage of people in India initially tested for TB with a WHO-recommended rapid test who had a positive test was 24 percent in 2021. Please click here to access the data.

• The number of WHO-recommended rapid diagnostic tests per person notified as a TB case (new and relapse cases, all forms) in India was 1.8 in 2021. Please click here to access the data.

• The estimated TB treatment coverage for India was 67 percent in 2021. The estimated TB treatment coverage among children aged 0–14 years for India was 32 percent in 2021. The estimated TB treatment coverage among children aged >= 15 years for India was 71 percent in 2021. Please click here to access the data.

• In 2021, ten countries accounted for 75 percent of the global gap between the estimated number of people who developed TB (incident TB cases) and the number of people who were detected with TB and officially reported. About 60 percent of the global gap was accounted for by five countries: India (24 percent), Indonesia (13 percent), the Philippines (10 percent), Pakistan (6.6 percent) and Nigeria (6.3 percent). Please click here to access the data.

• The estimated coverage of antiretroviral therapy for people living with HIV who developed TB for India 59 percent in 2021. Please click here to access the data.

• The number of Indian people diagnosed with MDR/RR-TB was 3,288 in 2010, 4,297 in 2011, 17,253 in 2012, 18,888 in 2013, 25,748 in 2014, 28,876 in 2015, 37,258 in 2016, 39,009 in 2017, 58,347 in 2018, 66,255 in 2019, 49,679 in 2020, and 58,837 in 2021. Please click here to access the data.

• The number of Indian people enrolled on MDR/RR-TB was 2,182 in 2010, 3,378 in 2011, 14,117 in 2012, 21,093 in 2013, 24,073 in 2014, 26,966 in 2015, 32,914 in 2016, 35,950 in 2017, 47,284 in 2018, 60,858 in 2019, 42,505 in 2020, and 53,037 in 2021. Please click here to access the data.

• The number of Indian people enrolled on MDR/RR-TB was 2,182 in 2010, 3,378 in 2011, 14,117 in 2012, 21,093 in 2013, 24,073 in 2014, 26,966 in 2015, 32,914 in 2016, 35,950 in 2017, 47,284 in 2018, 60,858 in 2019, 42,505 in 2020, and 53,037 in 2021. Please click here to access the data.

• The WHO regions with the best treatment coverage are the European Region and the Region of the Americas. Among the 30 high MDR/RR-TB burden countries, those with the best treatment coverage are 2021: Peru, the Russian Federation, Azerbaijan, the Republic of Moldova, India and Kazakhstan. Please click here to access the data.

• The estimated treatment coverage for MDR/RR-TB for India was 45 percent in 2021. Please click here to access the data.

• Seven countries (India, Nigeria, South Africa, Uganda, United Republic of Tanzania, Zambia and Zimbabwe) each reported initiating over 200 000 people with HIV on TB preventive treatment in 2021, accounting collectively for 82 percent of the 2.8 million reported globally. Please click here to access the data.

• Since 2014, spending on the diagnosis and treatment of drug-susceptible TB has fallen slightly. Spending on treatment of multidrug and rifampicin-resistant TB (MDR/RR-TB) has increased steadily since 2010: this growth is largely explained by trends in the BRICS group of countries (i.e., Brazil, Russian Federation, India, China and South Africa). Please click here to access the data.  

• Bangladesh, Cambodia, China and Zambia are examples of high TB burden countries that have steadily increased domestic funding specifically allocated to NTPs (as opposed to funding allocated more generally for inpatient and outpatient care, including for people with TB) in recent years. There was a considerable reduction in domestic spending in India between 2020 and 2021; one explanation for this was less need for spending on second-line anti-TB drugs in 2021, given stocks that still existed from 2020. Please click here to access the data.

• The international funding (at constant 2021 US$) for national TB programmes on TB prevention, diagnostic and treatment services was 37 million in 2010, 65 million in 2011, 61 million in 2012, 143 million in 2013, 92 million in 2014, 142 million in 2015, 135 million in 2016, 187 million in 2017, 170 million in 2018, 91 million in 2019, 85 million in 2020, and 154 million in 2021. Please click here to access the data.

• The domestic funding (at constant 2021 US$) for national TB programmes on TB prevention, diagnostic and treatment services was 56 million in 2010, 60 million in 2011, 44 million in 2012, 85 million in 2013, 162 million in 2014, 132 million in 2015, 139 million in 2016, 305 million in 2017, 348 million in 2018, 365 million in 2019, 326 million in 2020, and 183 million in 2021. Please click here to access the data.

• In the case of India, the sources of funding and funding gaps reported for the TB-specific budgets included in national strategic plans for TB were domestic funding: 66 percent, Global Fund: 29 percent, and international funding (excluding Global Fund): 4.9 percent in 2021. Please click here to access the data.

• The distribution of the two UHC indicators in the 30 high TB burden countries and three global TB watchlist countries shows that, in general, values improve with income level; this is especially evident for the SCI. Nonetheless, the risk of catastrophic health expenditures is high (15 or above) in several middle-income countries, including Angola, Bangladesh, Cambodia, China, India, and Nigeria. Please click here to access the data.

• To achieve Universal Health Coverage (UHC), substantial increases in investment in health are critical. From 2000 to 2019 there was a striking increase in health expenditure (from all sources) per capita in a few high TB burden countries, especially the upper-middle-income countries of Brazil, China, South Africa and Thailand. A steady upward trend was evident in Bangladesh, Ethiopia, India, Indonesia, Lesotho, Mongolia, Mozambique, the Philippines and Viet Nam, and there was a noticeable rise from 2012 to 2017 in Myanmar. Elsewhere, however, levels of spending have been relatively stable, and at generally much lower levels. Please click here to access the data.

• The current health expenditures per capita were US$ 86 in 2000, US$ 96 in 2001, US$ 99 in 2002, US$ 101 in 2003, US$ 109 in 2004, US$ 114 in 2005, US$ 119 in 2006, US$ 126 in 2007, US$ 131 in 2008, US$ 139 in 2009, US$ 141 in 2010, US$ 146 in 2011, US$ 162 in 2012, US$ 190 in 2013, US$ 189 in 2014, US$ 197 in 2015, US$ 205 in 2016, US$ 182 in 2017, US$ 196 in 2018, and US$ 211 in 2019. Kindly click here to access the data.

• The estimated number of TB cases attributable to alcohol use disorders was 2,58,000, diabetes was 1,05,000, HIV was 93,000, smoking was 1,10,000 and undernourishment was 7,38,000 in 2021. Kindly click here to access the data.

• Based on the latest available data in the World Bank database, some upper-middle-income and lower-middle-income countries (e.g. Brazil, China, India, Indonesia, Mongolia, South Africa, Thailand, and Viet Nam) appear to be performing relatively well. Please click here to access the data.

• Three new antigen-based skin tests for TB infection that perform better than tuberculin skin tests (particularly in terms of specificity) were evaluated and recommended by WHO in 2022; these are the Cy-Tb skin test, Serum Institute of India, India; C-TST, Anhui Zhifei Longcom Biopharmaceutical Co. Ltd, China; and Diaskintest, JSC Generium, Russian Federation. WHO plans to evaluate the following tests in the coming year: culture-free, targeted-sequencing solutions to test for drug resistance directly from sputum specimens; broth microdilution methods for drug-susceptibility testing (DST); and new IGRAs to test for TB infection. Please click here to access the information.

• In India, the Ministry of Health & Family Welfare launched the 21-day TB Mukt Bharat Campaign at Ayushman Bharat Health and Wellness Centres (AB-HWCs), from 24 March to 14 April 2022. The campaign aimed to meaningfully engage community and civil society to build a people’s movement to end TB. It was celebrated across 75 228 AB-HWCs; a total of 6 801 956 people were screened for TB, and 38 328 community awareness activities took place using 21 479 trained TB champions. Linked to this initiative, primary health care teams led by the newly introduced cadre of community health officers (CHOs) provide people-centred TB services to people’s doorsteps. AB-HWCs are playing an important role in improving awareness, identifying TB symptoms at an early stage, offering treatment adherence and psychosocial support to individuals and families with TB, and creating a strong network of TB survivors to strengthen the TB response. Please click here to access the more information.

• WHO has been advancing MAF-TB efforts to strengthen the engagement of the private sector and other public care providers not linked to national TB programmes (NTPs) through a new initiative with the Bill & Melinda Gates Foundation. The initiative promotes the development of enhanced PPM data dashboards in seven priority countries: Bangladesh, India, Indonesia, Kenya, Nigeria, Pakistan and the Philippines. Please click here to get more information.

• India has developed a national multisectoral action framework for TB; this strategic document makes a strong case for transforming India’s TB elimination efforts from a health sector struggle to a whole-of-society responsibility. The framework is a guide for policy-makers and a call to action for communities, civil society, the private sector, and other partners and stakeholders. The overarching goal is to strengthen the country’s capacity for a multisectoral response that facilitates TB elimination by 2025, with the key objective being to achieve policy convergence and adopt a health-in-all approach. The framework highlights the six key strategic areas for integrated action: integrated health care service delivery; TB-free workplaces; socioeconomic support for patients; awareness generation and infection control; corporate social responsibility and investment in TB; and targeted intervention for key affected populations. It defines the list of government ministries and other stakeholders, and the strategic scope of collaboration with each of them. Also, the framework acknowledges the importance of resources for defined strategic areas (e.g. financing, capacity-building, technical resources and research), and calls on partners and governments to mobilize resources for its implementation. Please click here to get more information.
 

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