WHO Report: Top 10 countries with most tuberculosis cases

The World Health Organisation’s (WHO) Global Tuberculosis Report 2024 highlights the ongoing challenges in the fight against tuberculosis (TB). Although the rise in TB cases during the COVID-19 pandemic has slowed and stabilised, the numbers remain concerning. An estimated 10.8 million people received a TB diagnosis in 2023, a rise from 2022 and a testament to the challenge of controlling the disease's spread.

In 2023, tuberculosis (TB) killed 1.25 million people, including 161,000 with HIV, making it the world’s leading cause of death from a single infectious agent, surpassing COVID-19 after three years. It remained the top killer of people with HIV and a significant contributor to antimicrobial resistance-related deaths. An estimated 10.8 million people fell ill with TB globally, comprising 6 million men, 3.6 million women, and 1.3 million children, with cases recorded across all countries and age groups.

The report reveals a concentration of TB in a few countries. India leads with 26% of global TB cases, followed by Indonesia (10%), China (6.8%), the Philippines (6.8%), and Pakistan (6.3%). Together, these five nations account for 56% of all TB cases, reflecting the need for targeted interventions in high-burden regions.

Top 10 countries with highest TB burden

Here’s a breakdown of the top 10 countries with the highest TB burden according to the report:

1. India: 26% of global cases

2. Indonesia: 10%

3. China: 6.8%

4. Philippines: 6.8%

5. Pakistan: 6.3%

6. South Africa: 4.2%

7. Nigeria: 3.9%

8. Bangladesh: 3.7%

9. Myanmar: 3.6%

10. Vietnam: 2.9%

These countries face challenges, including inadequate healthcare infrastructure, social and economic barriers, and high rates of asymptomatic TB. The report calls for enhanced international collaboration to address these issues.

India's TB burden reduced significantly

India, home to the world’s largest TB burden, has made remarkable progress under Prime Minister Narendra Modi. His vision for eliminating TB has led to innovative measures, acknowledged by the WHO. Between 2015 and 2023, TB incidence in India declined by 17.7%, double the global average. Treatment coverage rose from 59% in 2015 to 85% in 2023, with 25.1 lakh patients diagnosed last year.

The introduction of advanced drugs like Bedaquiline and Delamanid, which improve treatment outcomes, particularly for drug-resistant TB, has bolstered India's fight against TB. The adoption of the BPaLM regimen, a six-month course, has streamlined the treatment process, offering a more efficient alternative to the traditional 19–20-month regimens.

Diagnostics have significantly improved. From a few hundred molecular diagnostic machines in 2014–15, India now has 8,293 machines nationwide, reducing testing time and cost. Indigenous WHO-endorsed molecular tests have reinforced India’s position as a global leader in TB care.

The Global TB Report 2024 highlighted global challenges. Rein Houben, Professor of Infectious Disease Epidemiology at the London School of Hygiene & Tropical Medicine, emphasized the need for a paradigm shift in TB care,

“Tuberculosis remains a huge problem, and this WHO announcement highlights the challenge and opportunities ahead. Current TB policies are passive and wait for symptomatic individuals to seek healthcare. We need new strategies, including early detection to prevent transmission and an effective vaccine.”

The persistence of asymptomatic TB, which contributes to ongoing transmission, further hinders the global TB response. Addressing this will require a proactive approach, significant investments in research, and new tools to combat the disease.

The WHO report highlights the urgent need to prioritise global TB control efforts. It emphasizes the importance of multisectoral action, addressing social health determinants, improving access to quality healthcare, and investing in research and development of new tools. We can only achieve the goal of ending the TB epidemic by 2030 through a concerted global effort.

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