Global Tuberculosis Report 2020 – Reflections on the Global TB burden, treatment and prevention efforts

Jeremiah Chakaya*, Mishal Khan, Francine Ntoumi, Eleni Aklillu, Razia Fatima, Peter Mwaba, Nathan Kapata, Sayoki Mfinanga, Seyed Ehtesham Hasnain, Patrick D.M.C. Katoto, André N.H. Bulabula, Nadia A. Sam-Agudu, Jean B. Nachega, Simon Tiberi, Timothy D. McHugh, Ibrahim Abubakar, Alimuddin Zumla

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)


The October 2020 Global TB report reviews TB control strategies and United Nations (UN) targets set in the political declaration at the September 2018 UN General Assembly high-level meeting on TB held in New York. Progress in TB care and prevention has been very slow. In 2019, TB remained the most common cause of death from a single infectious pathogen. Globally, an estimated 10.0 million people developed TB disease in 2019, and there were an estimated 1.2 million TB deaths among HIV-negative people and an additional 208, 000 deaths among people living with HIV. Adults accounted for 88% and children for 12% of people with TB. The WHO regions of South-East Asia (44%), Africa (25%), and the Western Pacific (18%) had the most people with TB. Eight countries accounted for two thirds of the global total: India (26%), Indonesia (8.5%), China (8.4%), the Philippines (6.0%), Pakistan (5.7%), Nigeria (4.4%), Bangladesh (3.6%) and South Africa (3.6%). Only 30% of the 3.5 million five-year target for children treated for TB was met. Major advances have been development of new all oral regimens for MDRTB and new regimens for preventive therapy. In 2020, the COVID-19 pandemic dislodged TB from the top infectious disease cause of mortality globally. Notably, global TB control efforts were not on track even before the advent of the COVID-19 pandemic. Many challenges remain to improve sub-optimal TB treatment and prevention services. Tuberculosis screening and diagnostic test services need to be ramped up. The major drivers of TB remain undernutrition, poverty, diabetes, tobacco smoking, and household air pollution and these need be addressed to achieve the WHO 2035 TB care and prevention targets. National programs need to include interventions for post-tuberculosis holistic wellbeing. From first detection of COVID-19 global coordination and political will with huge financial investments have led to the development of effective vaccines against SARS-CoV2 infection. The world now needs to similarly focus on development of new vaccines for TB utilizing new technological methods.

Original languageEnglish
JournalInternational Journal of Infectious Diseases
Publication statusAccepted/In press - 2021
Externally publishedYes

Bibliographical note

Funding Information:
Professors Zumla, Francine Ntoumi, Peter Mwaba, Dorothy Yeboah-Manu, Sayoki Mfinanga,Timothy D McHugh, Ibrahim Abubakar, and Dr Kapata are members of the European and Developing Countries Clinical Trials Partnership the EU Horizon 2020 Framework Program, projects a) Pan-African Network on Emerging and Re-Emerging Infections (PANDORA-ID-NET, Grant Agreement RIA2016E-1609, ( ) and CANTAM-2 (EDCTP Grant No. RegNet2015-1045). Sir Prof Zumla is an AFREhealth Member and is in receipt of a UK-National Institutes of Health Research senior investigator award and is a 2020 Mahathir Science Award Laureate. Dr. Nachega is an infectious disease internist and epidemiologist supported by the NIH / Fogarty International Center (FIC) grant numbers 1R25TW011217-01 (African Association for Health Professions Education and Research); 1D43TW010937-01A1 (the University of Pittsburgh HIV-Comorbidities Research Training Program in South Africa—Pitt-HRTP-SA); and 1R21TW011706-01.

Funding Information:
Dr. Sam-Agudu is supported by NIH/ National Institute of Child Health and Human Development (NICHD) grant R01HD089866 , and by an NIH/FIC award through the Adolescent HIV Prevention and Treatment Implementation Science Alliance (AHISA), for(CAWISA). Dr. P.D.M.C Katoto is supported by Pitt-HRTP-SA and is a CAWISA Fellow.

Publisher Copyright:
© 2021 The Author(s)


  • Global TB Report 2020
  • Prevention
  • Treatment
  • Tuberculosis


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