10 Chapter 1 Global Tuberculosis Burden and Risk Factors Despite investments in tuberculosis (TB) control, 10.6 million people were ill with TB in 2022, with 1.3 million TB-related deaths [1]. Country programs were on track to end TB in line with the United Nations Sustainable Development Goals (SDG) 2030 targets, but the measures aimed at contending the COVID-19 pandemic halted these gains [2,3]. Recent global TB reports indicate a surge in TB-related deaths in 2020 and 2021 back to the 2017 levels, with a gap in the number of people with TB disease accessing treatment and reduced spending on TB-related prevention and treatment activities [4]. Consequently, ending TB by 2030 is presently out of reach, except innovative approaches are developed to increase TB prevention services, TB active case finding, and treatment of new and relapse TB cases to match and supersede pre-COVID-19 pandemic levels. Although TB is present in all countries, the incidence is highest in Southeast Asia, followed by Africa and the Western Pacific (Figure 1). Eight countries contribute to 68% of new global TB cases, while 30 contribute to 85% of all new global TB cases [4,5]. Seventeen of the thirty high-burden TB countries are from Sub-Saharan Africa. This high incidence has been attributed to the high HIV prevalence, undernourishment, alcohol use, smoking, diabetes, overcrowding, and poor housing infrastructure in Sub-Saharan Africa [1,6,7]. Figure 1: Estimated TB incidence rates per 100,000 population in 2022. Countries in the WHO African region had the highest TB incidence rates (WHO 2023 Global Tuberculosis Report - https://www.who.int/teams/ global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2023)
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