In 2021, WHO estimated that the tuberculosis (TB) incidence rate was 112 per 100 000 population in the WHO Eastern Mediterranean Region, which was lower than the global estimated incidence of 134 per 100 000 population and the third highest among all WHO regions. TB incidence varies greatly in the Region – ranging from less than 1 per 100 000 per year in the West Bank and Gaza Strip and United Arab Emirates to above 250 per 100 000 in Pakistan and Somalia.
The Region accounts for almost 8% of all global TB cases and experienced a marked drop in the number of people diagnosed with TB between 2019 and 2020, as an impact of COVID-related disruptions on essential TB services. This was followed by an almost complete recovery in 2021, and a total of 498 000 people were diagnosed with TB. Two countries account for the highest proportions of regional TB incidence: Pakistan (71%) and Afghanistan (9%). TB incidence estimates disaggregated by age and sex indicate that people in all age groups are affected. Men accounted for 47% of all TB cases in the Region in 2021, compared with 40% of cases in women and 13% in children.
In 2021, WHO estimated that there were 86 000 deaths in the Region among TB patients who were negative for human immunodeficiency virus (HIV) (11 per 100 000 population) and 2800 deaths among HIV-positive TB patients (0.37 per 100 000 population).
Detection
The number of people newly diagnosed with TB and reported in the Region dropped by 15% in 2020 compared with 2019 as a consequence of the COVID-19 pandemic. This drop was almost completely restored in 2021. TB treatment coverage is slowly recovering from 52% in 2020 to 58% in 2021 – but lower than 60% in 2019. It ranged from 41% in Somalia to 87% in Lebanon and member countries of the Gulf Cooperation Council (Bahrain, Kuwait, Saudi Arabia, United Arab Emirates, Qatar and Oman)
Multidrug resistant or rifampicin-resistant TB (MDR/RR-TB)
The Region accounts for almost 8% of the global MDR/RR-TB burden. In 2021, only an estimated 8% of people in the Region affected by drug-resistant TB were treated – below the global average of 30% and ranging from 10% in Afghanistan to 50% in Oman.
Treatment success rates
TB treatment success rates in the Region are the highest of all 6 WHO regions. Regional figures of 92% success among new and relapse cases (in 2020) and 72% among drug-resistant cases (in 2019) exceeded the corresponding global averages of 86% and 60% respectively. Treatment success rates ranged from 56% in Oman to 95% in Afghanistan for drug-susceptible TB, and from 25% in Lebanon and Libya to 100% in Jordan for drug-resistant TB.
Progress toward the End TB Strategy targets
Between 2015 and 2020, the decline in estimated TB incidence (4.9%) and TB deaths (6.2%) in the WHO Eastern Mediterranean Region fell short of the End TB Strategy 2020 milestones of 20% and 35%, respectively.
Related links
Global tuberculosis report 2021. Geneva: World Health Organization; 2021.