TUBERCULOSISGlobal Tuberculosis
Report 2016
1.8 MILLION
TB DEATHS

US$ 2BILLIONGAPINCLUDING 0.4 MILLION
TB DEATHS AMONGPEOPLE WITH HIV*49 million lives saved
between 2000-2015

TB was one of the top ten
causes of death worldwide

MDR-TB crisis with gaps
in detection and treatment

Funding shortfall for
TB implementation

TB deaths fell by 22%
in the same period

TB was responsible for moredeaths than HIV and malaria

Only 1 in 5 needing MDR-TB
treatment were enrolled on it

Gap of over US$1 billion
per year for TB research

DESPITE PROGRESS AND MILLIONS OF LIVES SAVED,GLOBAL ACTIONS AND INVESTMENTS FALL FAR SHORT OF THOSE NEEDED.
TO END THE GLOBAL TB EPIDEMICTB SITUATION AND RESPONSE
Tuberculosis (TB) is contagious and airborne.
TB was one of the top 10 causes of death worldwide
in 2015, and was responsible for more deaths than
HIV and malaria.
THE BURDEN
In 2015, there were an estimated 10.4 million new(incident) TB cases worldwide, of which 5.9 million
were men, 3.5 million were women and 1 million werechildren. People living with HIV accounted for 11% ofthe total.
Six countries accounted for 60% of the new cases:
India, Indonesia, China, Nigeria, Pakistan and South
Africa.
In 2015, 1.8 million people died from TB*, including
0.4 million among people with HIV. The total includes
1.1 million men, 0.5 million women and 0.2 million
children.
Globally, the number of TB deaths fell by 22%
between 2000 and 2015.
The case fatality ratio (the global proportion of people
with TB who die from the disease) varied from under
5% in a few countries to more than 20% in mostcountries in the WHO African Region. This shows
considerable inequalities among countries in access toTB diagnosis and treatment that need to be addressed.
*When an HIV-positive person dies from TB disease, the underlying cause is classified as HIV in the International Classificationof Diseases system (ICD-10).
#MDR-TB is defined as resistance to rifampicin and isoniazid. WHO recommends that all patients with rifampicin-resistant TB(RR-TB) are treated with a second-line MDR-TB regimen.

TB CARE AND PREVENTION
TB treatment saved 49 million lives globally between
2000 and 2015.
In 2015, 6.1 million new TB cases were notified tonational authorities and reported to WHO. This
reflects a 4.3 million gap between incident andnotified cases, with India, Indonesia and Nigeria
accounting for almost half of this gap.
Globally, the treatment success rate for people
newly diagnosed with TB was 83% in 2014.
DRUG-RESISTANT TB
Globally in 2015, there were an estimated 480 000
new cases of multidrug-resistant TB (MDR-TB) andan additional 100 000 people with rifampicin-resistant
TB (RR-TB) who were also newly eligible for MDR-TBtreatment.#
A total of 125 000 patients (20% of those newlyeligible for treatment) were enrolled and started on
MDR-TB treatment, an increase of 13% compared to2015.
Globally, data show an average cure rate of only
52% for treated MDR-TB patients.
In 2015, an estimated 9.5% of people with MDR-TB
had extensively drug resistant TB (XDR-TB). XDRTB patients had a treatment success rate of 28% in
2013.
© World Health Organization 2016

ADDRESSING THE CO-EPIDEMICS OF TB AND HIV
In 2015, 55% of TB patients globally had adocumented HIV test result. In the African region,that has the highest TB/HIV burden, 81% of TB
patients knew their HIV status.
Globally, 78% of HIV-positive TB patients in 2015
were started on antiretroviral therapy. Nevertheless,only a third of the 1.2 million people living with HIV
estimated to have developed TB in 2015 had beenplaced on antiretroviral therapy.
TB PREVENTIVE TREATMENT
A total of 910 000 people who were newly enrolled inHIV care were started on TB preventive treatment in2015. In addition, 87 000 children under five (7% ofthe 1.2 million children eligible) were known to beprovided with it.
UPTAKE OF DIAGNOSTICS, NEW DRUGS ANDREGIMENS
By the end of 2015, at least 15 countries with a highburden of TB, MDR-TB and TB/HIV had adopted
national algorithms positioning Xpert MTB/RIF as theinitial diagnostic test for all people with signs andsymptoms of pulmonary TB.
At least 23 countries in Africa and Asia haveintroduced shorter MDR-TB regimens, which haveachieved high treatment success rates (87‒90%)
under operational research conditions.
At least 70 countries had imported or started using
bedaquiline and 39 countries had used delamanidby the end of 2015 for the treatment of M/XDR-TB
patients.

RESEARCH AND DEVELOPMENT

UNIVERSAL HEALTH COVERAGE AND
SOCIAL PROTECTION
Government expenditures on health in 2014 wereless than the WHO benchmark of at least 6% ofgross domestic product (GDP) in 150 countries.
Out-of-pocket expenditures exceeded 45% of total
health expenditures in 46 countries, including 11 of
the 30 high TB burden countries.
In some of the highest TB burden countries, emerging
national health insurance and social protection
schemes need to be scaled-up to reduce medical
and other costs for patients.

TB FINANCING
The funding required for a full response to the global
TB epidemic in low- and middle-income countries is
estimated at US$ 8.3 billion in 2016, excluding
research and development.
Based on reporting by countries, US$ 6.6 billion wasavailable for TB prevention, diagnosis and treatment
in 2016, leaving a funding gap of almost
US$ 2 billion.
Overall, 84% of the US$ 6.6 billion available in 2016 isfrom domestic sources.
International donor funding dominates in the group of
25 high-burden countries outside the BRICS countries,
accounting for 85% of total funding. Low-incomecountries continue to rely on international donors
for more than 90% of their financing.
For research and development, at least an extra
US$ 1 billion per year is needed to accelerate thedevelopment of new tools. ̴̴̴In 2016, four new diagnostic tests were reviewed
and recommended by WHO: one for TB and three for
MDR-TB. A next-generation cartridge called Xpert
Ultra and a new diagnostic platform called GeneXpertOmni are in development. Assessment of both by
WHO is expected in 2017.

BILLION

US$ REQUIREDPER YEAR FOR
TB IMPLEMENTATION

Nine new or repurposed anti-TB drugs are inadvanced phases of clinical development.

BILLIONThirteen vaccine candidates are in clinical trials,
including candidates for prevention of TB infection
and candidates for prevention of TB disease in people
with latent TB infection.
New diagnostics, drugs and vaccines arenecessary to achieve the ambitious targets set inthe End TB Strategy.
The WHO GLOBAL TB PROGRAMME together with WHOregional and country offices: develops policies, strategies
and standards; supports the efforts of WHO Member States;
measures progress towards TB targets and assesses
national programme performance, financing and impact;
promotes research; and facilitates partnerships, advocacy
and communication. More information: www.who.int/tb

BILLION

US$ REPORTED TO
BE AVAILABLE IN
COUNTRIES FOR
THE TB RESPONSE
IN 2016

84%

16%

DOMESTIC INTERNATIONALFINANCING DONORFINANCING

BILLIONBILLION
US$FUNDING
GAPIN 2016

US$ FUNDING GAPFOR TB RESEARCH IN 2016