A new report by the World Health Organization (WHO) noted that multidrug-resistant tuberculosis (MDR-TB), epidemics of TB and HIV, and under-funding of research are major challenges in the world’s fight against TB, the second biggest killer disease from a single infectious agent.

After increased focus on data collection regarding TB, the Global Tuberculosis Report 2014 says there are nearly half a million more cases of the disease than estimated previously. The report released by WHO on Monday says that 9 million people developed TB in 2013, and 1.5 million died, including 360,000 people who were HIV positive.

On the other hand, the report reveals that mortality rate from TB is falling and has dropped by 45% since 1990, as the number of people developing the disease is declining by an average 1.5% a year.

India and China accounted for 37% of the 5.7 million new and relapse cases of TB that were notified in 2013 (22% and 15%, respectively).

The report further revealed that around three million people who fall ill from TB are still being “missed" by health systems each year, either because they are not diagnosed or because they are diagnosed but not reported. India accounts for 27% of the missed cases in the world.

There were an estimated 480,000 new cases of MDR-TB in 2013. Worldwide, about 3.5% of all people who developed TB in 2013 had this form of the disease, which is much harder to treat and has significantly poorer cure rates. Severe epidemics of MDR-TB have been reported, especially in Eastern Europe and Central Asia. Furthermore, extensively drug-resistant TB, which is harder to treat than MDR-TB, has now been reported in 100 countries.

The report noted that the co-epidemic of TB and HIV is a major challenge. An estimated 1.1 million (13%) of the 9 million people who developed TB in 2013 were HIV-positive, with four out of five cases and deaths occurring in the African region.

“In addition to the serious under funding for research, $8 billion a year is required for TB and MDR-TB prevention, diagnosis and treatment. Domestic and international financing needs to step up to prevent millions of unnecessary deaths," says Katherine Floyd, WHO coordinator for TB monitoring and evaluation. The report estimated that there is currently an annual shortfall of $2 billion which must be addressed. ​