TB and Poverty

"TB is the child of poverty – and also its parent and provider.” Archbishop Desmond Tutu

Over 9 million people develop active TB infection each year - and an overwhelming 95% of these cases occur in the developing world.
Low-income populations often lack access to health-care facilities and treatment and prevention options, which delays the diagnosis of TB by several weeks or months. Poor nutrition and co-infection with other diseases, especially HIV/AIDS, can lead to the development of active TB.
Crowded living conditions, poor ventilation, and lack of access to clean water and sanitation all contribute to an increased susceptibility to TB.

TB's economic impact on families is devastating. Families often sell what few assets they have to secure even partial treatment.
TB most severely affects individuals between the ages of 15-54, the most economically productive years of a person's life, hampering their ability to break free of poverty.
Studies suggest TB patients, on average, lose 3-4 months of work time, resulting in lost wages for patients and their families. Cases of drug-resistant TB can take as long as two years to treat and may result in significantly longer absences from work.
20-30 percent of a family's household income can be lost as a result of a family member contracting active TB. If a patient dies the family loses about 15 years of income.
Children whose parents become sick with TB are often pulled out of school in order to support the family. This perpetuates the cycle of poverty by jeopardizing the child's basic education and future work opportunities.
In Africa, TB has ravaged the population to such a degree that in 2005, the WHO and Africa's Ministries of Health declared TB to be a continent-wide emergency.

A target for MDG 6 is to halt and begin to reverse the incidence of TB by 2015.
Global incidence rates have stabilized in all regions of the world except in Africa where the situation continues to worsen. High rates of HIV and drug-resistant forms of TB threaten to exacerbate the problem, making it unlikely that the region will meet the MDG target.

The Global Plan to Stop TB requires US$47 billion between 2011 and 2015 to control TB globally. Funding required to control MDR-TB is expected to rise from US$1 billion in 2011 to US$2 billion is 2015.[1]
According to a World Bank study released in 2007 (The Economic Benefit of Tuberculosis Control), implementing the Global Plan to Stop TB yields a 10-to-1 economic benefit globally. Highly affected African countries could gain up to nine times their investments in TB control; those outside Africa, a 15-fold return. For example, in India the benefits of fully implementing the Global Plan relative to sustaining current efforts exceed the costs by a factor of 21; in Indonesia, by a factor of 61.
Funding for TB control in 2012 is expected to reach US$3.3 billion in 22 high-burden countries that account for 80% of world’s TB cases. This is an increase from 2002, where the funding was at US$1.3 billion.[2]
In 97 countries where trends are measured, funding for 2012, from domestic and donor sources, is expected to reach US$4.4 billion, an increase from the US$3.5 billion in 2006[3]

[1] WHO, 2010, The Global Plan To Stop TB, 2011-2015

[2] WHO, 2011. WHO Report 2011: Global Tuberculosis Control

[3] Ibid.