The World Has A New Leading Infectious Killer – And It’s Not COVID-19

COVID-19 has been overtaken as the deadliest infectious disease on the planet. According to a new report from the World Health Organization (WHO), tuberculosis (TB) is now once again the biggest killer among infectious pathogens, having previously held the top spot before being surpassed by the virus in 2020.

Collating data from 193 countries, WHO found that 1.25 million people died from TB worldwide in 2023, dwarfing the global COVID-19 death toll of 320,000 during the same period. Overall, 10.8 million people fell ill with TB last year, representing a modest increase on the 10.7 million cases in 2022 and a significant rise in comparison to the 10.4 million and 10.1 million infections reported in 2021 and 2020 respectively.

In 2023, 87 percent of infections occurred in just 30 countries, with India, Indonesia, China, the Philippines, and Pakistan collectively accounting for 56 percent of the burden.

Caused by the pathogenic bacterium Mycobacterium tuberculosis, TB is curable in around 85 percent of cases but kills nearly 50 percent of sufferers who don’t receive treatment.

“Tuberculosis (TB) is a preventable and usually curable disease,” reads the WHO report. “Yet in 2023, TB probably returned to being the world’s leading cause of death from a single infectious agent, following 3 years in which it was replaced by coronavirus disease (COVID-19), and caused almost twice as many deaths as HIV/AIDS.”

“Urgent action is required to end the global TB epidemic by 2030, a goal that has been adopted by all Member States of the United Nations (UN) and the World Health Organization,” write the authors.

Despite describing this objective as a “distant goal”, WHO does go on to identify “several positive trends”. For instance, despite the disease returning to the summit of global killers, the number of TB-related deaths has in fact been falling for a number of years – with the exception of 2020 and 2021 – with the 2023 figure considerably lower than the 1.32 million deaths reported in 2022.

In 2021, the death toll peaked at 1.42 million, while current numbers remain well below the pre-pandemic level of 1.34 million deaths in 2019. There are also six new vaccines currently in Phase III clinical trials, leading to hope that a new treatment may be available within the next five years. 

Overall though, TB funding remains way off target. Last year, for instance, only $5.7 billion (USD) was made available for prevention, diagnostic, and treatment services, compared to the WHO’s target of $22 billion per year by 2027. 

Similarly, the $1 billion spent on funding TB research in 2023 is considerably lower than the $5 billion annual target.

“The fact that TB still kills and sickens so many people is an outrage, when we have the tools to prevent it, detect it and treat it,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus in a statement. “WHO urges all countries to make good on the concrete commitments they have made to expand the use of those tools, and to end TB.”