The burden of TB, however, is expected to increase over the next two decades. Mathematical models predict 225 million cases and 80 million deaths from TB over the next three decades. During the recent resurgence of TB in New York City and in England, poverty again played a role, and the disease concentrated in minorities and the homeless. TB remains a familiar scourge in Africa and South Asia, where it is the leading cause of death, particularly amongst the poor. In South Africa, the risk of developing TB is 22 times greater for blacks than for whites.
Similar gradients are evident in most countries.
TB creates as many orphans as AIDS and more than any other infectious disease. It also kills more women than the direct complications of pregnancy and childbirth combined, with enormous negative impact on the social fabric of families. Widows and orphans lose not only loved ones but also breadwinners, and in many cases they are left with debts from the medical care of TB victims. TB patients lose three to four months of work and 20 to 35 percent of annual household income. In Asian countries, that translates to a 4 to 7 percent loss of gross domestic product.