The TB incidence rate increased for the second consecutive year in three of the six WHO regions, reflecting the estimated impact of shortfalls in TB case detection in 2020 and incomplete recovery in 2021 and 2022. An upward trend between 2020 and 2021 was reversed in 2022 in two regions: the Eastern Mediterranean Region (back to the level of 2020) and the European Region (almost back to the level of 2020). In the African Region, the decline that has been sustained for many years was maintained in 2022, consistent with evidence that disruptions related to the COVID-19 pandemic had little impact on the number of people diagnosed and officially notified with TB in either 2020 or 2021 (Section 2.1).
The biggest reduction compared with the baseline year of 2015 has been in the European Region, with a net reduction of 25% by 2022. A similar reduction has been achieved in the African Region, with a 23% decline by 2022. The net decline by 2022 compared with 2015 was relatively small in three of the remaining WHO regions: the Eastern Mediterranean Region (7.4%), South-East Asia (6.6%) and the Western Pacific (3.7%). The most concerning trend is in the Region of the Americas, where there was a net increase of 14% between 2015 and 2022.
Progress in reducing the TB incidence rate at country level is highly variable (Fig. 1.1.8). A total of 83 countries, mostly in the WHO African and European regions, achieved estimated reductions of at least 20% between 2015 and 2022, thus reaching or surpassing the first (2020) milestone of the End TB Strategy. A total of 21 countries are estimated to he achieved reductions of at least 50% between 2015 and 2022, including one high TB burden country (South Africa). At the other extreme, there are countries where TB incidence in 2022 was more than 5% higher than in 2015. These countries are most noticeably in the Region of the Americas but also include four high TB burden countries in Asia: Indonesia, Mongolia, Myanmar and the Philippines.