Study: Aggressive TB Control Can Yield Big Economic Gains

A new World Bank research report finds that 22 countries with the world’s highest numbers of TB cases could earn significantly more than they spend on TB diagnosis and treatment if they signed onto a global plan to sharply reduce the numbers of TB-related deaths.

Highly affected African countries could gain up to nine times their investments in TB control. The study also warns about the need to step up TB control worldwide with the growing emergence of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) in southern Africa, Eastern Europe and Central Asia.

The report says that despite recent gains in fighting TB, there were still 8.8 million new cases and 1.6 million deaths from the disease in 2005.

Without treatment, two thirds of smear-positive cases die within five to eight years, with most dying within 18 months of being infected.

According to the study — "The economic benefit of global investments in tuberculosis control" — the economic impact of TB deaths and the benefits of TB control among the 22 high-burden countries are greatest in China and India, where the combination of growing incomes and a relatively high number of TB deaths translates into a significant economic effect.

The study, which was commissioned by the World Bank on behalf of the Stop TB Partnership and funded by the Bill and Melinda Gates Foundation, has attracted considerable interest from international health and development agencies, along with research and civil society groups, which want more aggressive TB control worldwide. The disease is the leading infectious killer of adults after HIV/AIDS.

“This report set out to test whether the economic benefits of TB control are greater than the costs. It turns out that likely benefits are of impressive magnitude,” said Dr Jorge Sampaio, the UN Secretary-General’s Special Envoy to Stop TB, and former President of Portugal.

The study calls for urgently accelerated global TB control because of multiple factors: the extraordinary burden of TB on those afflicted by the disease, their families, and on government budgets; the dramatic growth of TB cases over more than a decade in Eastern Europe and Central Asia; and the emergence of MDR-TB and XDR-TB.

TB patients in Eastern Europe and Central Asia are 10 times more likely to have MDR-TB than in other regions of the world, and up to 15% of new cases are multi-drug resistant.

The report says the threat of MDR-TB underscores the urgency for all TB-affected countries and health and development agencies to push for the fullest possible adoption of the Global Plan to Stop TB; the plan calls for a shared investment by countries heavily affected by TB and donors.

"This report should wake up countries to the urgent need for a stronger financial commitment to TB control," said Michel Kazatchkine, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

"Effective TB control has a positive impact on the lives of the millions of people infected with TB, on whole communities and it reduces the burden of disease on national economies."

The 22 countries with a high burden of TB are: Afghanistan, Bangladesh, Brazil, Cambodia, China, the Democratic Republic of the Congo, Ethiopia, India, Indonesia, Kenya, Mozambique, Myanmar, Nigeria, Pakistan, Philippines, Russian Federation, South Africa, Thailand, Uganda, United Republic of Tanzania, Viet Nam and Zimbabwe.