Infection prevention
Only 34 million people of the intended 40 million people with TB were reached with treatment between 2018 and 2022. For TB preventive treatment, the situation was even more grim, with only 15.5 million of the 30 million people targeted to be reached with preventive treatment accessing it. Funding for TB services in low- and middle- income countries fell from US$ 6.4 billion in 2018 to US$ 5.8 billion in in 2022, representing a 50% financing gap in implementing the required TB programmes. Annual funding for TB research ranged from US$ 0.9 billion to US$ 1.0 billion between 2018 and 2022, which is just half of the target set in 2018. “Uniting around the TB response by world leaders, provides an opportunity to accelerate action and strengthen health systems capable of not only addressing the TB epidemic, but also protecting the broader health and wellbeing of communities, strengthening pandemic preparedness and building on lessons learnt during the COVID-19 pandemic,” said Dr. Tereza Kasaeva, Director of the WHO Global TB Programme. “Averting TB-related financial hardship and
preventing the development of the disease in vulnerable groups will help diminish inequities within and between countries, contributing to the achievement of the Sustainable Development Goals.”
Funding boost There was some good news in the fight against TB, announced by the UK, with the pledge of a £4 million boost for the TB REACH programme. This funding will help the programme to test new approaches to increase the number of people diagnosed and treated for the disease in low- and middle-income countries. It will also help to provide health services to 500,000 people; detect
TB remains one of the world’s top infectious killers: annually more than 10 million people fall sick, and over one million lose their lives to this preventable and curable disease.
cases of TB in 37,000 people; and save more than 15,000 lives. The Minister for Development and Africa,
Andrew Mitchell said: “TB is a devastating yet eminently preventable disease. The UK has been at the forefront of work to rid the world of it, alongside our partners, and TB REACH will help discover even better ways of detecting and treating the disease, so that people no longer suffer needlessly. It is possible to end TB in our lifetime – we must make every effort to do so. With this funding, TB REACH, part of the UK’s Global Fund Accelerator Programme, will be able to finance more organisations to test out innovative approaches that will also strengthen health systems and combat antimicrobial resistance.” Some of the projects the UK is currently supporting through TB REACH include: scaling up preventative treatment for TB in Brazil, Uganda, Vietnam, Zambia and Pakistan; integrating TB screening and services into maternal health services in Papua New Guinea and Afghanistan to tackle rising numbers of pregnant and post-partum women with the disease; and using portable x-ray machines and AI to diagnose TB in prisons in Mozambique.
TB cases rise in England The UK has good reason to be investing in efforts to end TB worldwide. The latest provisional annual data for 2024 from the UK Health Security Agency (UKHSA) shows that reported notifications of TB in England increased by 13%
compared to 2023 (from 4,850 to 5,480 people), continuing the upward trend over the last few years. England remains a low-incidence country for TB, but the TB notification rate in England rose from 8.5 per 100,000 population in 2023 to 9.5 per 100,000 in 2024. 81.5% of all TB notifications in 2024 were in people born outside the UK but there was an increase in both UK-born and non UK- born populations. Tuberculosis continues to be associated with deprivation and is more common in large urban areas. The largest increases in TB notifications in 2024 were recorded in London and West Midlands. Among UK-born individuals, TB is more common in those experiencing homelessness, drug or alcohol dependency, and contact with the criminal justice system. A TB test for infectious TB in the lungs is part
of the visa requirements for anyone coming to stay in the UK for six months or more if they are coming from certain countries where TB is common. However, the bacterium that causes TB can also lie dormant for many years – something known as latent TB. To detect people with latent TB infection, a testing and treatment programme is in place in higher incidence areas of England for new arrivals from higher incidence countries.
Finding ‘silent spreaders’ Identifying ‘silent spreaders’ could have a significant impact and UK scientists have taken a major step towards developing a blood test that could identify millions of people who spread tuberculosis unknowingly. A breakthrough study has discovered a group of biological markers that are found in high levels among infectious patients. The researchers hope the findings will pave the way for a simple test that can diagnose and stop the spread of the estimated 10 million cases annually. Scientists from the University of
Southampton, working with experts worldwide, carried out the most detailed analysis ever undertaken of blood markers for the bacterial infection. The study, published in the Journal of Clinical Investigation Insight, used a novel technique that identified a set of six proteins that are highly accurate in pinpointing TB.3,4 Lead author Dr. Hannah Schiff, a respiratory expert at Southampton, said as many as three million cases were missed last year, mostly in
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www.clinicalservicesjournal.com I March 2025
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