March 24 is global tuberculosis (TB) day. The World Health Organization (WHO) highlights that 74 million lives have been saved since 2000 through global efforts such as increased investments in resources such as vaccines, antibiotics, and screening tests to combat the spread of TB. Importantly, there were 10.6 million TB cases and 1.6 million TB-associated deaths in 2021. TB is a curable and preventable disease that is treated via long courses of antibiotics and the Bacille Calmette-Guérin (BCG) vaccine as the first line of defence. However, many low-income and middle-income countries such as China, India, South Africa, Pakistan, Philippines, and Nigeria lack the necessary healthcare infrastructures, education, and resources to combat TB. Additionally, TB day highlights the public health crisis of multidrug-resistant (MDR) TB, as only one in four MDR TB cases are detected and only one in two cases are cured, according to the WHO. The WHO has a TB strategy for 2035 to end the global TB epidemic. The strategy’s targets are to reduce the number of TB deaths compared to 2015 by 95% and the incidence of infection by 90%. The WHO stresses that to reach these goals, there needs to be increased surveillance globally with an emphasis on low-income and middle-income countries that have limited medical access.
GlobalData predicts that the TB tests market will be valued at $441.8m by 2030, with more than 18.7 million interferon-gamma release assays (IGRAs) and singleplex nucleic acid amplification tests (NAATs) sold. Moreover, the major players in the TB tests market are Qiagen, which holds 33.8% of the global TB market; and Oxford Immunotec, which holds 14.3%. However, these predictions do not include all of the regions that have the most cases of TB such as Nigeria, Pakistan, and the Philippines, where testing may be more prevalent.
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In regions where TB is epidemic, there needs to be heightened TB screening to not only prevent the spread of infection in communities and start treatment earlier but to also track individuals who have MDR TB with drug-susceptibility testing. Additionally, increased screening efforts need to be coupled with the BCG vaccine to insure long-term protection. In non-endemic regions, there needs to be screening for visitors and immigrants who are entering the country to ensure these countries can maintain their low TB case numbers. It is also important to stress the importance of getting the BCG vaccine and boosters every ten-15 years in non-endemic regions to further reduce TB incidence.
Notably, it is possible for people, especially children and infants, to still contract TB despite being vaccinated. Therefore, despite case numbers being low in countries such as the US, Canada, and Germany, continued vaccination and screening need to occur.
