Measuring Global Tuberculosis Severity

Introduction

So… where is TB actually killing people?

The WHO splits the world into six regions. Let’s start there.

Q1: TB Cases Resulting in Mortalities in High Impact Regions

Of the six WHO regions, three carry the vast majority of the burden.

• Africa
• Western Pacific
• Southeast Asia

Which region saw the greatest case fatality rate?

Trends of Most Affected Regions

What’s going on in Africa?

Africa’s case fatality rate is consistently 2-3x higher than the other regions. What’s happening within the continent?

Central Africa Hit Hardest

Q2: What Is Driving Africa’s TB Death Toll?

HIV

The HIV-TB Syndemic in Africa

• HIV weakens the immune system, dramatically increasing chance of TB infection, reactivation, and mortality
• In 2000, nearly 60% of Africa’s TB deaths were HIV-driven
• By 2023, that dropped to ~28%, but Africa’s burden remains unique

HIV-Driven TB Deaths Have Plummeted

But is this progress enough?

HIV-TB deaths are falling in Africa, but how does the continent compare to the rest of the world today?

Africa’s HIV-TB Burden Is Unique

The bottom line

• TB mortality is declining globally, but Africa remains disproportionately affected
• The HIV-TB syndemic is one of the key driver of Africa’s outlier status
• ART programs have cut HIV-related TB deaths dramatically, but the gap with other regions persists
• Continued investment in co-infection treatment is critical