The TB Epidemic

Many people think tuberculosis (TB) is a disease of the past, but in reality, over 2 billion people are currently infected with TB bacteria - roughly one-third of the world's population. One in ten people will become sick with active TB. In 2010 alone, TB killed 1.5 million people, which amounted to approximately 3,800 deaths per day.[1]

TB preys on people with weak immune systems. Pregnant women, children, people with diabetes, smokers, and people living with HIV are at higher risk of contracting TB. The disease often affects people during their most economically and reproductively active years, causing a substantial burden on children and families. Nearly 10 million children have been orphaned because of TB.[2]

TB undermines years of progress against HIV/AIDS. TB is the leading infectious killer of people with HIV. Individuals are able to live with HIV but are dying from TB. Without proper treatment, 90% of those living with HIV die within months of contracting the disease.[3]

Keep in mind, the drugs to treat standard TB cost only $20 per patient in the developing world, and are very effective in curing a person of the disease when taken properly, even among people living with HIV.

However, if drugs are taken incorrectly or stopped prematurely, TB disease can reemerge and become resistant to medication. These strains can be difficult, and sometimes impossible, to cure. Cases of multidrug-resistant TB (MDR-TB) and extremely drug-resistant TB (XDR-TB) have been found in almost every country of the world. In 2010 there were an estimated 650,000 cases of MDR-TB.[4]   Recently, new forms of TB have emerged that are resistant to currently available drugs. 

A lack of political commitment and funding keeps TB a leading global killer. Resources available to adequately tackle the disease have long been insufficient.  Funding for TB control is expected to be at US$4.4 billion in 2012. The World Health Organization estimates a US$2 billion funding gap for 2012 alone. The funding gap for first line TB drugs will reach US $48 million in 2012.[5] This gap is costing millions of lives.

Another factor has been that TB programs have tended to be top down and centered on doctors and hospitals, with the result that many cases go undetected.  Now, many TB programs are moving towards a patient-centered approach.  A study in Pakistan showed that by working with the community and, using mobile phones and financial incentives, it was possible to find twice as many people with TB in 2011 compared to the previous year.[6]

What is TB, and how is it treated?

TB is an infectious disease caused by bacteria that often attack the lungs. It is spread through the air when an infected person coughs, sneezes, laughs, or even sings. When exposed to TB, most healthy people are able to fight the bacteria by sealing it off within a part of the body, usually the lungs. These people have a latent TB infection. They do not feel sick and they cannot spread the infection to others. Latent TB infection can be treated using only one drug, isoniazid, over the course of six to nine months.

In some cases, people are unable to fight the bacteria and they become sick with active TB disease. If not treated properly, active TB is often fatal. Active TB is treated with several different drugs taken over a six-to-twelve month period. It is crucial that patients take the medication exactly as prescribed and complete the full course of treatment. If the medication is taken incorrectly or stopped prematurely, TB can become resistant to medication. Drug-resistant strains of TB are much harder to cure and extremely expensive to treat.

For detailed data on the TB epidemic, please refer to the WHO Global Tuberculosis Control Report.


[1] World Health Organization. (2011). Global Tuberculosis Control 2011. Geneva: World Health Organization.

[2] Ibid, 2011.

[3] World Health Organization. (2011). Frequently asked questions about TB and HIV [website]. Geneva: World Health Organization. Retrieved from http://www.who.int/tb/challenges/hiv/faq/en/.

[4] World Health Organization. (2011). 2011-2012 Global Tuberculosis Facts [fact sheet]. Geneva: World Health Organization. Retrieved from http://www.who.int/tb/publications/2011/factsheet_tb_2011.pdf.

[5] Global Tuberculosis Control, 2011

[6] Khan, A.J. et al. (2012). Engaging the private sector to increase tuberculosis case detection: an impact evaluation study. Lancet Infectious Diseases 12(8): 608-616.