Income-Related Disparity in Country TB Rates
19 December 2024
A new analysis of global TB data reveals that lower income countries are disproportionately affected by TB.
The International Union Against Tuberculosis and Lung Disease (The Union) found that low-income, lower-middle income, and upper-middle income countries consistently reported higher TB rates from 1995 to 2022, compared to high-income countries.
Dr Kobto Ghislain Koura, Director of TB at The Union and study co-author, said: “These striking findings reaffirm the need for the public health community to recognise that our current efforts to end TB are not achieving the results we require.
“We need greater equity for low- and middle-income countries in the investment made in holistic approaches, which incorporate evidence-based interventions (like active case-finding), strengthening health systems and addressing social determinants that drive TB transmission and progression.
“High-income countries have demonstrated the effectiveness of this holistic approach in reducing TB rates.”
The Union analysed data from 208 countries and islands from 1995 to 2022, and at a global level the study found the TB case notification rates (per 100,000 population) were between:
- 100 and 120 in low-income countries
- 120 and 150 in lower-middle income countries
- 50 and 100 in upper-middle income countries
- 25 or lower in high-income countries
Dr Koura continued: “The persistent high TB rates in low-income countries suggest that current strategies are insufficient and need to be bolstered with greater resources and tailored interventions that address the specific challenges of these regions.”
Across all country regions, the impact of the COVID-19 pandemic on TB rates was evident, with dips in 2020 followed by subsequent rises.
Prof Anthony Harries, Senior Advisor at The Union and co-author, explained: “This pattern during COVID-19 underscores the vulnerability of TB control programs to global health emergencies and highlights the importance of building resilient health systems that can maintain essential services during crises.”
The paper was recently published in the Tropical Medicine and Infectious Disease journal and was the cover story of the issue.
Dr Koura concluded: “Adopting a holistic approach would be highly beneficial in tackling TB, particularly in low- and middle-income countries.
“This would involve not only strengthening health care systems to ensure universal health coverage and high-quality TB care, but also addressing broader social determinants of health. These include tackling poverty, improving nutrition, reducing smoking and alcohol abuse, managing co-morbidities like HIV and diabetes, and enhancing public health education.
“By focusing on these interconnected factors, countries can create a sustainable framework for reducing TB incidence and improving overall public health outcomes.”
Source: The Union
