The Cost of Complacency

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The FINANCIAL — A new report published  by The Economist Intelligence Unit (EIU), and made possible with support from Johnson & Johnson, emphasizes the urgent need for focused global action to address the growing threat of drug-resistant tuberculosis (DR-TB). DR-TB is the leading contributor to deaths from antimicrobial resistance (AMR).

DR-TB is an airborne infectious disease that does not respond to the most commonly used TB medicines. In 2017 alone, DR-TB infected more than 550,000 people — with cases in nearly every country globally — and claimed 230,000 lives.[i] In comparison, the devastating Ebola outbreak in West Africa — which attracted significant international attention and investment — had a similar mortality rate and took the lives of approximately 11,000 people over a three-year period (2014–2016).

To address DR-TB, proper diagnosis and linkage to care are essential. This can be a particular challenge in low-resource settings where the majority of cases occur. Though effective treatment options now exist, three out of every four people with DR-TB go undiagnosed and untreated and, as a result, can each infect up to 15 additional people over the course of a year.[ii]

Economist Intelligence Unit Report Underscores Major Gaps in World’s Response to Drug-Resistant Tuberculosis

Beyond its devastating impact on human lives and the global health security threat it poses, DR-TB takes a tremendous economic toll. The EIU analysis published today shows that, based on current incidence and prevalence rates, DR-TB deaths in a single year are estimated to cost the global economy at least US$17.8 billion.[iii] This represents a loss of future gross domestic product — in purchasing power parity (PPP) terms — due to deaths from DR-TB globally (i.e., 230,000 in 2017). In addition, in a single year, DR-TB causes a loss of at least US$3 billion in PPP terms due to work absences in the approximately 100 countries for which data were available.[iv]

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Alarmingly, the report states that these are conservative estimates that do not include the economic impacts of work absences among the approximately 400,000 people annually with DR-TB who are not diagnosed and treated, or the nearly 70,000 estimated undocumented deaths from DR-TB. Without urgent action and a robust policy response to reverse these trends, these costs will only grow.

“The EIU report sounds the alarm on DR-TB. If the disease continues to be left unchecked the damage to people’s lives and entire economies could be devastating,” said Jaak Peeters, Global Head, Johnson & Johnson Global Public Health, Janssen-Cilag GmbH. “Turning the tide on this disease requires that we act immediately. By working together in new ways and with a real sense of urgency, we can end this deadly airborne threat.”

The global response, resources and preparedness are not keeping pace with the increasing spread of DR-TB. According to the Stop TB Partnership, there is currently an estimated funding gap of US$3.5 billion in 2018-2020 for TB prevention, diagnosis and treatment programs – a gap that is expected to increase considerably by 2022. An additional $9 billion is needed for research and development (R&D) by 2020 to develop new drugs, diagnostics and vaccines.

Importantly, the EIU reports that addressing TB provides good value for money. The benefit-to-cost ratio for investing in diagnosis and treatment of DR-TB specifically has been estimated at up to US$23 for every dollar invested. Additionally, if TB R&D is fully funded, the world could see an estimated 8.4 million fewer TB cases and US$181 billion in productivity gains by 2030.[v]

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“If we really want to achieve the Sustainable Development Goal ambition of ending the TB epidemic by 2030, we have to step up the fight. We have to do more, better. That’s innovation, it’s collaboration, it’s better execution, it’s better use of data. But it also takes more money,” said Peter Sands, Executive Director, The Global Fund to Fight AIDS, TB and Malaria.

In October 2019, governments and other donors will have an important opportunity to take strides toward this goal by pledging to replenish the Global Fund to Fight AIDS, TB and Malaria. The Global fund provides approximately $200 million per year to support the fight against DR-TB. In 2017 alone, in countries and regions where the Global Fund invests, more than 100,000 people with DR-TB were on treatment.[vi] Replenishment of the Global Fund in 2019 is a prerequisite for sustained international funding of the response to DR-TB.

A copy of the EIU report, titled It’s Time to End Drug-Resistant Tuberculosis: The Case for Action, is available here. A summary version of the report and an infographic on DR-TB are also available.

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