The Lancet Global Burden of Disease Report and tuberculosis

You may have seen the Gates Foundation-funded Global Burdens of Disease report...

There was some truly earth shaking stuff tucked away in it which hasn't been reported in the media but which we believe deserves much better publicity. We wonder if you agree..

1. The report estimated 1.3 million HIV deaths in 2013 (they believe that UNITAID have overestimated the numbers), and 1.4 million TB deaths in this same period (which is a little more than WHO's estimates). This is of huge significance since it means that HIV has passed back the title of ‘most lethal infectious disease’ to its previous title-holder, tuberculosis. This should surely be waking folk up more to the ongoing threat from TB, and should certainly be being highlighted (if these estimates are correct, and even these may be under-estimations).

2. Furthermore, if you care to wade through to 'fig 13' of the report (on page 27) you'll find something even more alarming. This graph shows that (contrary to all WHO estimates and reports) both prevalence and incidence rates for TB are actually still rising globally (though they do see mortality rates as slightly declining). As you may know, the Millennium Development Goal (MDG) for TB (which has long been recognised as being unambitious and which was superseded nearly ten years ago by other tougher goals) was simply to 'halt and reverse' it. According to this Lancet report even this meagre ‘halting and reducing’ hasn't yet been achieved 21 years into a global health emergency. If this is true, it represents an appalling and massive failure in public health which should be being talked about in the highest of places. In four simple words, it is a scandal.

3. Lastly, the Lancet piece unfortunately reveals itself to be guilty of the usual lack of clarity on MDR-TB, stating that it has “not separately examined the incidence, prevalence, and mortality related to multi-drug resistant tuberculosis (MDR-TB)”.

Given the scale of the current threat and the resource being awarded to this study, we ask “WHY ON EARTH NOT?”

DR-TB is hardly new, and yet there remains an abysmal response to monitoring it (let alone addressing the disease) even from an august (and enormous) team of experts like the ones who authored this report.

Ebola may be currently taking the headlines, but TB is still taking the lives - and DR-TB remains the biggest threat to the world's poor.