Health. Why such an upsurge in tuberculosis, unprecedented for 20 years

In 2021, no less than 1.6 million people died of tuberculosis worldwide.

That is significantly more, warns the World Health Organization (WHO), than in 2020 (1.5 million) or 2019 (1.4 million). Tuberculosis deaths were steadily declining between 2005 and 2019.

Contaminations and deaths on the rise

Unsurprisingly, these poor figures start first from an increase in contamination: 10.6 million worldwide in 2021, or 4.5% more than the previous year.

A serious infection

Tuberculosis is an infection caused by a mycobacterium, Koch’s bacillus. The disease mainly attacks the lungs of patients.

Tuberculosis is transmitted through the air. It is estimated that about a quarter of the world’s population has a latent infection – carrier but not sick and not contagious. They have a 5 to 10% risk of developing the disease, according to the WHO.

Among the main risk factors are malnutrition, then a deficient immune system, tobacco, alcohol. HIV-infected patients are particularly vulnerable.

Weak cough, chest pain, weakness, weight loss, fever and night sweats are among the most common symptoms of tuberculosis.

Tuberculosis can be treated and cured. For the active drug-sensitive form, a standard treatment of 6 months combining 4 anti-tuberculosis drugs is necessary. Without treatment, almost one out of two tuberculosis patients will die.

In contrast, current BCG vaccines do not provide sufficient protection, and the WHO has called for the development of more effective vaccines.

This is the first time in many years that an increase in the number of people falling ill with TB and drug-resistant TB has been reported.


The disease has progressed in 2021 on all continents – except Africa, where it remains at extremely high levels but still declining.

In Europe, after having been divided by three in 20 years, the number of cases has started to rise again since 2020. In the developed countries of the Old Continent or North America, tuberculosis remains at low levels, but on the increase sensitive.

The WHO puts forward several reasons likely to explain this worrying situation.

More drug resistant cases

The WHO has identified around 450,000 cases of “drug-resistant” tuberculosis to the antibiotic, rifampicin, in 2021. A figure also on the rise for the first time, and which worries health authorities.

The Covid-19 pandemic, which has been going on since the beginning of 2020, has seriously disrupted the fight against tuberculosis: isolation of populations, delays in diagnosis, but also a drop in funding for treatments and research.

In fact, the number of people actually diagnosed has decreased… while the number of contaminations has increased in 2020 and 2021. A situation leading to significant delays in treatment, and inevitable excess mortality.

Finally, the various conflicts of recent years, in Ukraine for Europe, but also in Africa and the Middle East further worsen the health situation among the most vulnerable populations.

The WHO aims to reduce deaths from the disease by 90% and the incidence rate of tuberculosis by 80% by 2030, compared to 2015. These objectives are now far from being achieved. reached. And the WHO anticipates another bad year in 2022.

Second leading cause of death from infectious disease

However, the fight against tuberculosis is making some progress: despite this difficult context, the number of people treated increased between 2018 and 2021.

In 2019, tuberculosis was the 13th cause of death but the first due to an infectious disease. It is today, and since 2020, the ninth cause of death and… the second by infectious disease, behind Covid-19.

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