New Delhi: India continues to have the highest number of tuberculosis (TB) cases in the world, the Global TB Report 2017 released by World Health Organization (WHO) on Monday revealed.

In 2016, there were an estimated 10.4 million new TB cases worldwide. Seven countries accounted for 64% of the total burden, with India having the maximum number of TB patients, followed by Indonesia, China, Philippines, Pakistan, Nigeria and South Africa, the report said.

According to the report, in India, an estimated 27.9 lakh patients were suffering from TB in 2016 and up to 4.23 lakh patients were estimated to have died during the year. 

According to the report, Multidrug-resistant TB (MDR-TB) remains a public health crisis and a health security threat. WHO estimates that worldwide, there were 600,000 new TB cases with resistance to rifampicin—the most effective first-line drug, of which 490,000 had MDR-TB. Almost half of these cases were in India, China and the Russian Federation.

The report highlighted that underreporting and underdiagnosis of TB cases continue to be a challenge, especially in countries with large unregulated private sectors and weak health systems, including India.

“Of the estimated 10.4 million new cases, only 6.3 million were detected and officially notified in 2016, leaving a gap of 4.1 million. India, Indonesia and Nigeria accounted for almost half of this global gap," the report stated.

“Only one in five MDR-TB cases was started on treatment. India and China accounted for 39% of the global gap. Treatment success remains low, at 54% globally," the report said.

Though the Indian government has made several announcements to eliminate TB by 2025, the WHO report showed that up to 27.9 lakh patients were estimated to be infected in the country in 2016. The infection burden in China, a more populous country, is one third of India at 8.95 lakh.

Out of the 27.9 lakh estimated patients, only 1,938,158 TB cases were notified in the public and private sector in India, which means over 8.5 lakh cases were missing the treatment options. 

The report said TB care and prevention investments in low- and middle-income countries fall almost $2.3 billion short of the $9.2 billion needed in 2017. In addition, at least an extra $ 1.2 billion per year is required to accelerate the development of new vaccines, diagnostics, and medicines.

“Shortfalls in TB funding are one of the main reasons why progress is not fast enough to be on track to reach the end TB targets," said Katherine Floyd, coordinator of WHO’s Monitoring and Evaluation Unit at the Global TB Programme.

“We have a double challenge. More domestic funding is needed in middle-income countries, and more international donor support is needed to support low-income countries," Floyd said.

At the global level, the report said that global efforts to combat TB have saved an estimated 53 million lives since 2000 and reduced TB mortality rate by 37%.

“Despite these achievements, the latest picture is grim. TB remains the top infectious killer in 2016. TB is also the main cause of deaths related to antimicrobial resistance and the leading killer of people with HIV. Progress in most countries is stalling and is not fast enough to reach global targets or close persistent gaps in TB care and prevention," the report said.

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