Global, regional, and national economic value of reducing amenable tuberculosis mortality

Progress in reducing Tuberculosis (TB) mortality falls short of one-third of the End TB Strategy target, partly due to a high proportion of amenable deaths, most of which occur among individuals aged 15-64 years. The loss of this working-age population has a deterrent effect on human capital and economic growth. Our objective was to estimate the global, regional, and national economic value of reducing amenable TB mortality at the macroeconomic level.

We utilized TB burden data from the 2021 Global Burden of Disease (GBD) to estimate amenable TB mortality across countries and regions, stratified by sex, age, and drug-resistance type. Economic data were obtained from the World Bank. We estimated the economic losses due to amenable TB mortality using the Value of Lost Welfare (VLW) approach, which integrates the Value of Statistical Life (VSL), Years of Life Lost (YLL) and Gross Domestic Product (GDP). The age-specific percentage of economic losses relative to GDP was calculated.

The global number of amenable TB deaths in 2021 was 616,736, accounting for 53.04% of total TB mortality. The global economic losses due to amenable TB mortality in 2021 were estimated at $480.75 billion, accounting for 0.31% of global GDP. Losses among individuals aged 15-49 and 50-64 accounted for 48.73% and 34.12%, respectively., respectively. Lower-middle-income countries had the largest economic losses at $376.77 billion, corresponding to 1.30% of their GDP, while the percentage of economic losses relative to GDP was highest in low-income countries at 1.73%, with losses of $24.79 billion.

Amenable TB mortality can lead to disproportionate economic losses, especially among deaths in people aged 15-49 years and in lower-middle-income countries. As these deaths and economic losses can be avoidable, investments in improving healthcare services will bring huge economic value.