Drug-resistant TB threatens to kill 75 million people by 2050


Dr Erlina Burhan speaks to a tuberculosis patient at the Persahabatan Hospital in Jakarta, Indonesia. [Henriette Jacobsen]

Over the next 35 years, multidrug-resistant tuberculosis will kill 75 million people and could cost the global economy a cumulative $16.7 trillion (€15.3 trillion) – the equivalent of the European Union’s annual output, a UK parliamentary group said on today (24 March).

If left untackled, the spread of drug-resistant TB superbugs threatens to shrink the world economy by 0.63% annually, the UK All Party Parliamentary Group on Global Tuberculosis (APPG TB) said, urging governments to do more to improve research and cooperation.

“The rising global burden of multidrug-resistant TB and other drug-resistant infections will come at a human and economic cost, which the global community simply cannot afford to ignore”, economist Jim O’Neill said in a statement.

O’Neill, a former chief at investment bank Goldman Sachs, was appointed last year by British Prime Minister David Cameron to head a review into antimicrobial resistance.

The bacteria that cause TB can develop resistance to drugs used to cure the disease. Multidrug-resistant TB fails to respond to at least isoniazid and rifampicin, the two most powerful anti-TB drugs, according to the World Health Organization (WHO).

The UK parliamentary group’s cost projections are based on a scenario in which an additional 40 percent of all TB cases are resistant to first-line drugs, leading to a doubling of the infection rate.

The WHO said last year multidrug-resistant TB was at “crisis levels”, with about 480,000 new cases in 2013.

It is a manmade problem caused by regular TB patients given the wrong medicines or doses, or failing to complete their treatment, which is highly toxic and can take up two years.

The group urged governments to set up a research and development fund, target investments into basic research and increase support for bilateral TB programmes.

“We need better tools to deal with this new threat, but since TB primarily affects the poorest and most vulnerable in society, there is little commercial incentive to develop new drugs,” said Nick Herbert, co-chairman of the APPG TB.

The fight against TB, the world’s second deadliest infectious disease after HIV, is also hampered by a lack of an effective vaccine, the APPG TB said.

The only TB vaccine, BCG, protects some children from severe forms of TB – including one that affects the brain – but is unreliable in preventing TB in the lung, which is the most common form of the disease.

TB, which spreads through the coughs and sneezes of an infected person, killed 1.5 million people worldwide in 2013, according to the WHO.

Tuberculosis is a widespread, and in many cases fatal, infectious disease which typically attacks the lungs, but which can also affect other parts of the body. It is spread through the air when people who have an active TB infection cough, sneeze, or otherwise transmit respiratory fluids through the air. 

But most people infected do not have symptoms, in which case it is referred to as latent tuberculosis. About one in ten latent infections eventually become active which, if left untreated, is fatal for more than 50% of those infected.

The World Health Organisation (WHO) has warned about a rise in drug-resistant tuberculosis in Eastern Europe and former Soviet states.

But the public health crisis is not receiving much attention, health experts say, especially when the disease is combined with HIV/AIDS.

Pharmaceutical companies say they have little incentive to produce the drugs that can combat the deadly but curable disease.

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