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Tuberculosis Emerges as Leading Infectious Disease, Affecting 10.8 Million People Worldwide

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Tuberculosis Emerges as Leading Infectious Disease, Affecting 10.8 Million People Worldwide

In a resurgence that has health officials alarmed, tuberculosis (TB) has once again claimed the title of the world’s deadliest infectious disease, with new cases reaching a record high of 10.8 million in 2023, according to the World Health Organization (WHO). This represents a stark increase from the 10.1 million cases recorded in 2020, illustrating the ongoing challenge in managing this ancient but persistent disease.

TB, a highly contagious airborne infection primarily targeting the lungs, is fueled by factors like undernutrition, HIV, diabetes, smoking, and alcohol abuse. Despite a drop in TB-related deaths, the toll remains high, with 1.25 million fatalities recorded last year, placing TB above COVID-19 as the leading infectious cause of death for the first time in three years.

The global distribution of TB cases highlights significant regional and national disparities. India accounts for 26% of all new cases, followed by Indonesia at 10%, with China, the Philippines, and Pakistan each contributing over 6%. Southeast Asia, Africa, and the Western Pacific emerged as the hardest-hit regions, collectively representing 86% of cases.

“TB occurs in every part of the world,” said Dr. Tereza Kasaeva, head of WHO’s global TB program, during a recent press briefing. “But we are not on track to eliminate it.”

Challenges in Containment

Despite advances in TB treatments, rapid diagnostics, and ongoing vaccine research, Kasaeva expressed concern that global efforts are falling short of the United Nations General Assembly (UNGA) targets set for 2027. These targets aim to provide rapid diagnostic testing and preventive treatment to those at risk, yet only 48% of newly diagnosed TB patients received a rapid test last year. Among high-risk groups, 56% of individuals with HIV and 21% of household contacts of TB patients received preventive care.

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Drug-resistant TB remains a significant hurdle. In 2023, an estimated 400,000 people developed multi-drug-resistant TB, though only 44% of these patients were accurately diagnosed and treated. This lack of treatment access is particularly troubling, as drug-resistant TB requires more costly and complicated care. “Drug-resistant TB continues to pose a major public health threat,” Kasaeva warned, underscoring the need for timely access to effective treatments.

Funding Shortfalls Impede Progress

The UNGA has set a funding target of $22 billion to combat TB through prevention, diagnostics, and treatment. However, as of last year, only 26% of this goal had been met, with $5.7 billion allocated worldwide. Research funding is similarly limited, with only $1 billion allocated toward the $5 billion target in 2022. Kasaeva highlighted the pressing need for increased investment, noting that low- and middle-income countries are especially constrained by the current funding gap.

Despite these financial challenges, there are promising developments in TB vaccine research. Six vaccine candidates are in late-stage clinical trials, with the WHO optimistic that a new TB vaccine could become available within the next few years. “We’re seeing clinical trials in the hardest-hit countries, and preparations for vaccine distribution should begin now,” Kasaeva noted, expressing hope for future breakthroughs.

With cases of drug-resistant TB rising and funding for prevention and care lagging, health officials are calling for urgent international support to bridge financial and logistical gaps. The resurgence of TB underscores the need for a comprehensive, well-funded approach to contain what remains a leading cause of death worldwide.

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More Europeans Take Up Sport, but Major Gaps Remain Across Countries

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More Europeans are exercising regularly than they were four years ago, but participation continues to vary sharply depending on where people live, their age, education and financial circumstances, according to a new European Commission survey.

The latest Eurobarometer survey on sport and physical activity found that 39% of respondents said they never exercise or play sport, down from 45% in 2022. Nearly half of the 26,508 people surveyed said they exercise or play sport every day or several times a week.

The results also showed wide differences between countries. Finland recorded the highest share of people exercising daily, at 21%, followed by Denmark at 20%. In both countries, another 59% of respondents said they exercise several times a week.

At the other end of the scale, 68% of respondents in Portugal said they never exercise or play sport. Greece and Romania followed, with 66% in each country reporting that they never take part in sport or exercise.

Time was the most commonly cited barrier among people who wanted to exercise more, with 37% identifying it as an obstacle. A lack of motivation or interest was mentioned by 26%, while 15% pointed to health problems or injury. Cost was cited by 12%.

Education and household finances were also closely linked to participation. Some 59% of people who continued their education until at least the age of 20 said they exercise or play sport several times a week. That compared with 23% among those who left education at 15 or younger.

Financial circumstances showed a similar divide. People who said they had the greatest difficulty paying their bills were twice as likely to report never exercising as those who rarely or never faced financial difficulties, at 54% compared with 26%.

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“More Europeans are getting active, but the opportunity to take part still depends too much on income, age and education,” said Roxana Mînzatu, Executive Vice-President for Social Rights and Skills, Quality Jobs and Preparedness.

The survey also highlighted a significant age gap. Nearly three-quarters of people aged 15 to 24 exercise or play sport at least several times a week, compared with 25% of those aged 75 and over. Health problems or injury were the main barrier for older respondents, while younger and middle-aged people were more likely to cite a lack of time.

Physical activity linked to everyday life also increased. Active commuting rose from 24% in 2022 to 37%, while 72% of respondents said they now walk for at least 10 minutes at a time.

The survey found, however, that some Europeans do not consider their neighbourhoods suitable for walking or cycling, potentially restricting opportunities for active travel.

Mînzatu said affordable sport and safe places to exercise should be available close to where people live, including for children from families unable to afford club fees, older people and those with disabilities.

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Congenital Infections Linked to Higher Risks of Autism and Intellectual Disability

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Children born with certain infections acquired during pregnancy face substantially higher risks of autism and intellectual disability later in life, according to a study of more than 3.7 million people in Sweden.

Researchers found that children with congenital infections were about three times more likely to be diagnosed with autism and more than seven times more likely to receive a diagnosis of intellectual disability than those without such infections.

The findings suggest that infections transmitted from a pregnant woman to her foetus may have lasting effects on brain development, although the study identifies an association rather than proving that the infections directly cause autism or intellectual disability.

The research focused on TORCH infections, a group that includes syphilis, rubella, toxoplasmosis, cytomegalovirus and herpesvirus. These infections can cross the placenta and affect the developing foetus, potentially increasing the risk of miscarriage, stillbirth and other pregnancy complications.

“Although these congenital infections are rare, some of them can be prevented, which makes them important from a public health perspective,” said Reneé Gardner of the Department of Global Public Health at Karolinska Institutet, who contributed to the study.

The researchers examined people born in Sweden between 1987 and 2021 and followed them for up to 30 years. Among the 3.7 million participants, 975 had been diagnosed with a congenital TORCH infection.

Although congenital infections accounted for only a small proportion of autism cases across the population, the risk among affected children was considerably higher. The researchers estimated that about one in five children born with a TORCH infection could later develop autism.

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The study also found elevated risks of intellectual disability across different levels of severity. The risk of severe to profound intellectual disability was as much as 30 times higher among children with a congenital infection than among those without one.

The researchers found evidence of an impact on educational outcomes even among people who were not diagnosed with autism or intellectual disability. A total of 420 participants with a TORCH infection showed poor school performance without receiving either diagnosis.

Congenital cytomegalovirus, or CMV, is the most common of these infections globally and affects roughly one in 150 newborns. Its burden is substantially greater in low- and middle-income countries.

The researchers said the findings highlight the importance of prevention, particularly in regions where these infections are more common. They pointed to vaccination programmes and other preventive measures as important tools for reducing congenital infections.

They also called for improved identification of affected newborns. Current screening systems, including those used in Sweden, may miss asymptomatic infections because universal screening for TORCH infections is not routinely carried out.

The authors said stronger screening and prevention strategies could help identify children at risk earlier and improve long-term support and care.

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AI Chatbots Make Faster, Less Nuanced Kidney Transplant Decisions Than Doctors

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Artificial intelligence chatbots may make faster and more confident decisions than human doctors when determining which patient should receive a life-saving kidney transplant, but a new study found that the systems often rely on fewer factors and show less sensitivity to the ethical complexity of such choices.

Researchers from Penn State University in the United States compared decisions made by large language models (LLMs) with choices made by people in earlier studies on kidney allocation. The researchers presented AI models with hypothetical cases based on existing datasets in which human participants had previously chosen between two patients competing for a single available kidney.

The patients were described using characteristics including age, health and drinking habits. Both were considered eligible for the transplant, requiring the decision maker to determine which patient should receive the available organ.

The researchers tested the AI systems in several ways. Some scenarios focused on individual characteristics, while others combined several traits to examine how the models handled competing considerations. In some tests, participants and AI systems were also given the option of flipping a coin, allowing researchers to assess indecision as part of moral decision-making.

Human participants generally placed greater importance on age, often favouring younger patients over older patients. Many of the AI models, however, placed greater weight on lower alcohol consumption.

Hadi Hosseini, the study’s lead researcher at Penn State University, said the findings showed that AI chatbots can diverge from human values when weighing characteristics of patients.

The researchers found that human decisions tended to consider several factors together and were more sensitive to context. LLMs, by contrast, frequently focused on a single characteristic when making their choices.

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Another difference involved uncertainty. Human participants were more likely to recognise that organ allocation can involve competing ethical considerations and that there may not be one objectively correct answer. AI models generally showed little hesitation and committed to one choice.

John Dickerson, chief executive officer of Mozilla.ai and a collaborator on the study, said humans recognise ambiguity when allocating scarce resources and use debate to shape how such decisions are made.

The findings come as AI systems are increasingly being used in healthcare for clinical workflows, diagnosis, treatment planning and decisions involving limited medical resources.

The researchers said kidney allocation presents a particularly important test because decisions over deceased-donor and living-donor organs involve medical, ethical and moral considerations.

Hosseini said the ethical stakes are high because decisions involving organ allocation can directly affect patients’ lives. He stressed that the study was not intended to encourage replacing professional medical judgment with AI.

Instead, the researchers said understanding how AI systems behave in high-stakes situations is becoming increasingly important as individuals, organisations and businesses use AI to make decisions or provide recommendations.

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