According to a Global TB Report 2017 released by the World Health Organisation (WHO) on Monday, India tops the list of seven nations, accounting for 64 percent of the 10.4 million new tuberculosis (TB) cases worldwide in 2016. It is followed by Indonesia, China, Philippines, Pakistan, Nigeria and South Africa. One of the top ten causes of death worldwide, tuberculosis clocks up approximately 2.8 million cases and nearly half a million deaths on an annual basis in India. TB is an infectious, airborne disease mainly affecting the lungs and is caused by the bacterium Mycobacterium tuberculosis. “In 2016, there were an estimated 10.4 million new TB cases worldwide, 10 percent of which were people living with HIV. Seven countries accounted for 64 percent of the total burden, with India bearing the brunt,” it said. An estimated 1.7 million people died from TB, including nearly 400,000 co-infected with HIV, recording a drop by 4 per cent as compared to 2015. Also, India along with China and Russia accounted for almost half of the 490,000, multidrug-resistant TB (MDR-TB) cases registered in 2016. “Only one in five MDR-TB cases were started on treatment. India and China accounted for 39 percent of the global gap. Treatment success remains low, at 54 percent globally,” it said. Mario Raviglione, Director of the WHO Global TB Programme, said: “The sheer numbers of deaths and suffering speak for themselves – we are not accelerating fast enough.” “Prompt action towards universal health coverage and social protection, as well as breakthroughs in research and innovations – will be critical to enable access to patient-centered care of the highest standards for all, especially the poorest, most disadvantaged people everywhere.” According to the report, underreporting and under diagnosis of TB cases continues to be a challenge, especially in countries with large unregulated private sectors and weak health systems. “Of the estimated 10.4 million new cases, only 6.3 million were detected and officially notified in 2016, leaving a gap of 4.1 million. India, Indonesia and Nigeria accounted for almost half of this global gap,” said the report, which also says that some of the initiatives and efforts by the global bodies have yielded good results and saved an estimated 53 million lives since 2000 and reduced the TB mortality rate by 37 percent. However, it said that despite these achievements, the latest picture is grim. “TB remains the top infectious killer in 2016. TB is also the main cause of deaths related to antimicrobial resistance and the leading killer of people with HIV,” it said. For TB care and prevention, investments in low- and middle-income countries fall almost $2.3 billion short of the $9.2 billion needed in 2017. In addition, at least an extra $1.2 billion per year is required to accelerate the development of new vaccines, diagnostics, and medicines. “Shortfalls in TB funding are one of the main reasons why progress is not fast enough to be on track to reach the end TB targets,” said Dr Katherine Floyd, Coordinator of WHO’s Monitoring and Evaluation Unit at the Global TB Programme. “We have a double challenge. More domestic funding is needed in middle-income countries, and more international donor support is needed to support low-income countries.” The report for the first time presents results from a new multi sectoral monitoring framework that identifies linkages with the TB epidemic across seven Sustainable Development Goals (SDGs).