African countries feature prominently in WHO’s new global lists of high-burden countries for TB

AFRICA – African countries have been cited in the new WHO lists of high burden countries for tuberculosis (TB), HIV-associated TB and multidrug/rifampicin-resistant TB.

Zimbabwe transitioned out of the list of the 30 high TB burden countries while Gabon and Uganda joined the list.

Angola, Chad, Ghana and Papua New Guinea have transitioned out of the 30 high TB/HIV burden countries whilst Gabon and Guinea have joined the list.

The 30 high MDR/RR-TB burden countries list saw Ethiopia and Kenya transition out while Zambia joined.

WHO officially communicated with the ministry of health of Zimbabwe, to inform them about the country’s transition out of the list of 30 high TB burden countries and to recognize their success in reducing the burden of TB disease in recent years.

Between 2015 and 2019, incidence (per 100 000 population per year) fell by an estimated 22%, 25% and 18% in the Zimbabwe, Cambodia and the Russian Federation.

According to WHO, in 2016, 2.5 million people fell ill with TB in the African region, accounting for a quarter of new TB cases worldwide.

An estimated 417,000 people died from the disease in the African region (1.7 million globally) in 2016. Over 25% of TB deaths occur in the African Region.

The new lists replace those previously used between 2016 and 2020 to illustrate the top 20 countries in terms of their estimated absolute number of new (incident) cases in 2019.

Each list accounts for 86-90% of the estimated global incidence.

The lists provide a focus for global action on TB, HIV-associated TB and drug-resistant TB in the countries where progress is most needed to achieve the targets set in WHO’s End TB Strategy, the political declaration of the United Nations (UN) high-level meeting on TB held in 2018 and the UN Sustainable Development Goals (SDGs).

They will also help to build and sustain national political commitment and funding in the countries with the highest burden in terms of absolute numbers or severity and promote global monitoring of progress in a well-defined set of countries.

The new lists which have been defined using the same criteria as those used for the previous 2016-2020 lists, will facilitate the WHO global TB watchlist.

This will consist of the countries transitioning out the global list of 30 high TB burden countries, since they still warrant continued attention and will remain a priority in terms of support from WHO.

In future, other countries may be considered for inclusion on this watchlist, for example, based on evidence about the impact of the COVID-19 pandemic on TB services and disease burden.

WHO also considered the COVID-19 pandemic prior to finalizing the updated global high-burden country lists to asses whether the impact of the pandemic on TB incidence could plausibly affect the countries included in each list.

It was concluded that it was unlikely that the COVID-19 pandemic would change the countries included in each list.

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