WHO revises lower estimates for global tuberculosis mortality based on India data

The World Health Organization (WHO) has revised lower its estimates for worldwide tuberculosis mortality based on cause-of-death statistics and calculations from India, which show that the country has lost fewer people to the disease each year than previously thought.

Based on data from the Sample Registration Survey (SRS), which included a sample population of over eight million individuals nationally, the estimates for India's yearly tuberculosis fatalities since 2015 have been between 400,000 and 300,000, less than the over 500,000 previously predicted.

The World Health Organization's 2023 World TB Report, which was made public on Tuesday, revised lower estimates of the number of TB-related fatalities globally since 2010 to 1.3 million deaths worldwide. The WHO said that the primary cause of these reduced estimates is changes made to estimates for India based on cause-of-death data from SRS for 2014–19 that were made public earlier this year by the Indian government.

An previous Global Burden of Disease (GBD) research conducted by the US-based Institute of Health Metrics and Evaluation served as the foundation for the WHO's estimations of the number of tuberculosis (TB) fatalities in India between 2000 and 2019. The WHO explained its revised figures by saying, "Estimates of the percentage of total deaths in India that were caused by TB in the official SRS reports are lower than those in GBD 2019."

The SRS gives information regarding the percentage of TB-related fatalities among all deaths in the sample population surveyed, according to an Indian public health specialist who was not involved in the WHO TB report or the India calculations.

The expert, who asked to remain anonymous, said, "One problem with relying on the proportion of deaths is that increases in other causes of deaths — such as heart disease or something else — might lower the proportion from TB." "However, for estimates of annual TB deaths, other data could be combined with the SRS data."

In contrast to the WHO 2021 TB study, which anticipated 1.5 million worldwide TB fatalities, 34% (510,000) of which occurred in India, the WHO 2022 TB report estimated 1.6 million global TB deaths in 2021, with 32% (512,000) occurring in India.

The WHO reported that the net reduction in TB-related mortality from 2015 to 2019 was 19%, far short of the WHO End TB Strategy milestone of a 75% reduction by 2025, notwithstanding the revised forecasts in the 2023 report.

According to the survey, over 50% of TB patients and their families experience catastrophic financial expenditures as a result of the disease. These costs are categorized as direct medical expenses as well as indirect costs like lost income that surpass 20% of family income.