Towards improving the quality and usefulness of GBD tuberculosis estimates

We, as co-chairs of the Panel of Experts of the Global Burden of Disease Independent Advisory Committee (GBD IAC)'s Deep Dive into the Institute for Health Metrics and Evaluation (IHME)'s tuberculosis estimates, welcome publication of GBD 2021 Tuberculosis Collaborators' study in The Lancet Infectious Diseases. 1 GBD 2021 Tuberculosis CollaboratorsGlobal, regional, and national age-specific progress towards the 2020 milestones of the WHO End TB Strategy: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Infect Dis. 2024; (published online March 19.)https://doi.org/10.1016/S1473-3099(24)00007-0 Google Scholar In the study, the authors estimated age-specific trends in tuberculosis incidence and mortality numbers and rates between 1990 and 2021 and assessed progress from 2015 towards the 2020 WHO End TB milestones. 1 GBD 2021 Tuberculosis CollaboratorsGlobal, regional, and national age-specific progress towards the 2020 milestones of the WHO End TB Strategy: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Infect Dis. 2024; (published online March 19.)https://doi.org/10.1016/S1473-3099(24)00007-0 Google Scholar Their analysis suggests rates of decline have been higher in younger individuals and that action on comorbidities could increase declines in tuberculosis in older individuals. The authors also carried out an elegant analysis of the potential impact of the COVID-19 pandemic on tuberculosis mortality in 41 of 204 countries and territories with available cause-specific mortality data in 2020–21. Interestingly, they found that in this subset of countries, overall there were fewer deaths due to tuberculosis than expected in 2020–21. This is in contrast to WHO estimates, which suggest that, globally, COVID-19 increased tuberculosis mortality in 2020–21. 2 WHOGlobal tuberculosis report 2023. https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2023Date: Nov 7, 2023 Date accessed: February 2, 2024 Google Scholar The contrast between GBD and WHO results is important to understand, and we fully support the GBD 2021 Tuberculosis Collaborators' call for more data and research, which should help to resolve some of these differences. Global, regional, and national age-specific progress towards the 2020 milestones of the WHO End TB Strategy: a systematic analysis for the Global Burden of Disease Study 2021Despite accelerated progress in reducing the global burden of tuberculosis in the past decade, the world did not attain the first interim milestones of the WHO End TB Strategy in 2020. The pace of decline has been unequal with respect to age, with older adults (ie, those aged >50 years) having the slowest progress. As countries refine their national tuberculosis programmes and recalibrate for achieving the 2035 targets, they could consider learning from the strategies of countries that achieved the 2020 milestones, as well as consider targeted interventions to improve outcomes in older age groups. Full-Text PDF Open Access