The Cost of Complacency: Economist Intelligence Unit Report Underscores Major Gaps in World’s Response to Drug-Resistant Tuberculosis
Report estimates DR-TB deaths in a single year cost the global economy at least US$17.8 billion and calls for commitment and action to end the epidemic
Urgent action needed for hundreds of thousands who go undiagnosed and untreated for DR-TB – the leading contributor to deaths from antimicrobial resistance
NEW BRUNSWICK, N.J., MAY 7, 2019 — A new report published today by The Economist Intelligence Unit (EIU), and 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]
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]
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]
“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.
About TB and DR-TB
TB is the world’s deadliest infectious disease. Nearly one-quarter of the world’s population — 1.7 billion people — are infected with Mycobacterium tuberculosis, the bacterium that causes tuberculosis. In most of them, the infection is in a dormant state. But every year, 10 million people develop active tuberculosis and approximately 1.6 million people die from the disease. In the past 200 years alone, TB has killed more than one billion people – more deaths than from malaria, influenza, smallpox, HIV/AIDS, cholera and plague combined.[vii]
DR-TB is a particularly complicated form of the bacterial infection and is characterized by resistance to at least one of the most powerful drugs in the first-line treatment regimen. Globally, DR-TB is a growing threat. In 2017, an estimated 3.5% of new and 18% of previously treated TB cases were drug resistant, and DR-TB now accounts for approximately one-third of all deaths from AMR.
Johnson & Johnson’s TB Commitment
Johnson & Johnson has long been committed to the fight against DR-TB, including by developing Janssen’s SIRTURO® (bedaquiline), the first novel TB medicine in more than 40 years and one of the last lines of defense against DR-TB. Since its approval, the company has delivered more than 90,000 courses of bedaquiline to 118 countries, including the 30 highest-burden countries.
In support of global efforts to end TB by 2030, Johnson & Johnson announced a comprehensive 10-year commitment in September 2018. Through innovative partnerships and collaborations, Johnson & Johnson is working to broaden access to bedaquiline; support efforts to properly diagnose the millions of TB cases that currently go undetected – and thus untreated – every year; and accelerate the development of next-generation TB treatments and regimens. These efforts are intended to save an estimated 1.8 million lives and prevent 12 million new TB infections over the next decade.
About Johnson & Johnson
At Johnson & Johnson, we believe good health is the foundation of vibrant lives, thriving communities and forward progress. That’s why for more than 130 years, we have aimed to keep people well at every age and every stage of life. Today, as the world’s largest and most broadly-based healthcare company, we are committed to using our reach and size for good. We strive to improve access and affordability, create healthier communities, and put a healthy mind, body and environment within reach of everyone, everywhere. We are blending our heart, science and ingenuity to profoundly change the trajectory of health for humanity. Learn more at www.jnj.com. Follow us at @jnjglobalhealth.
About The Economist Intelligence Unit
The EIU is the thought leadership, research and analysis division of The Economist Group and the world leader in global business intelligence for executives. We uncover novel and forward-looking perspectives with access to over 650 expert analysts and editors across 200 countries worldwide. More information can be found on www.eiu.com, www.eiu.com/healthcare and www.eiuperspectives.economist.com
[i] WHO. Multidrug-Resistant Tuberculosis (MDR-TB) Fact Sheet (2018 Update). Available from: https://www.who.int/tb/areas-of-work/drug-resistant-tb/MDR-RR_TB_factsheet_2018_Apr2019.pdf?ua=1
[ii] WHO. Tuberculosis: Key facts. Available from: https://www.who.int/news-room/fact-sheets/detail/tuberculosis
[iii] EIU. It’s Time to End Drug-Resistant Tuberculosis: The Case for Action. Available from: http://www.eiu.com/drug-resistant-tb
[iv] EIU. It’s Time to End Drug-Resistant Tuberculosis: The Case for Action. Available from: http://www.eiu.com/drug-resistant-tb
[v] Stop TB Partnership. The Paradigm Shift 2016-2020: Global Plan to End TB. Available from: http://www.stoptb.org/assets/documents/global/plan/globalplantoendtb_theparadigmshift_2016-2020_stoptbpartnership.pdf
[vi] The Global Fund to Fight AIDS, Tuberculosis and Malaria. Results report 2018. Available from: https://www.theglobalfund.org/media/7741/corporate_2018resultsreport_report_en.pdf
[vii] NIH. Tuberculosis. Available from: https://www.niaid.nih.gov/diseases-conditions/tuberculosis-tb