A global commitment to tackle TB, but more research needed urgently

Tuberculosis (TB) is an airborne infectious disease caused by Mycobacterium tuberculosis, mainly though not exclusively affecting the lungs. No country has managed to eradicate the disease, and efforts to do so face significant challenges, including the stigma attached to TB, increasing antimicrobial resistance (AMR), and the limited efficacy of the existing Bacillus Calmette-Guerin (BCG) vaccine. People affected by TB face months, sometimes years, of prolonged and painful treatment, which can include severe side-effects such as nausea and psychosis, including some that are permanent such as deafness.

Many people think that TB has been consigned to the history books, but this is very far from being the case. For the fourth year in a row, TB remains the world’s single biggest infectious killer, with 1.6 million deaths in 2017 – more than human immunodeficiency virus (HIV) and malaria combined. However, it is a neglected disease, largely ignored and under-funded, and treated using outdated drugs. It is estimated that if drug-resistance takes hold, TB could claim 75 million more lives by 2050, with a global economic cost of US$16.7 trillion.

The UK itself has one of the highest rates of TB in western Europe, with over 5,000 cases reported in England alone last year, including 68 cases of multidrug-resistant TB (MDR-TB). The Public Health England (PHE) and NHS England ‘Collaborative TB Strategy for England 2015–2020’ has driven the national response to TB, with incidence rates reduced by one-third since the 2011 peak.