Background

The tuberculosis targets for the UN Sustainable Development Goals (SDGs) call for a 90% reduction in tuberculosis deaths by 2030, compared with 2015, but meeting this target now seems highly improbable. To assess the economic impact of not meeting the target until 2045, we estimated full-income losses in 120 countries, including those due to excess deaths resulting from COVID-19-related disruptions to tuberculosis services, for the period 2020–50.

Methods

Annual mortality risk changes at each age in each year from 2020 to 2050 were estimated for 120 countries. This risk change was then converted to full-income risk by calculating a population-level mortality risk change and multiplying it by the value of a statistical life-year in each country and year. As a comparator, we assumed that current rates of tuberculosis continue to decline through the period of analysis. We calculated the full-income losses, and mean life expectancy losses per person, at birth and at age 35 years, under scenarios in which the SDG targets are met in 2030 and in 2045. We defined the cost of inaction as the difference in full-income losses and tuberculosis mortality between these two scenarios.

Findings

From 2020 to 2050, based on the current annual decrease in tuberculosis deaths of 2%, 31·8 million tuberculosis deaths (95% uncertainty interval 25·2 million–39·5 million) are estimated to occur, corresponding to an economic loss of US$17·5 trillion (14·9 trillion–20·4 trillion). If the SDG tuberculosis mortality target is met in 2030, 23·8 million tuberculosis deaths (18·9 million–29·5 million) and $13·1 trillion (11·2 trillion–15·3 trillion) in economic losses can be avoided. If the target is met in 2045, 18·1 million tuberculosis deaths (14·3 million–22·4 million) and $10·2 trillion (8·7 trillion–11·8 trillion) can be avoided. The cost of inaction of not meeting the SDG tuberculosis mortality target until 2045 (vs 2030) is, therefore, 5·7 million tuberculosis deaths (5·1 million–8·1 million) and $3·0 trillion (2·5 trillion–3·5 trillion) in economic losses. COVID-19-related disruptions add $290·3 billion (260·2 billion–570·1 billion) to this cost.

Interpretation

Failure to achieve the SDG tuberculosis mortality target by 2030 will lead to profound economic and health losses. The effects of delay will be greatest in sub-Saharan Africa. Affected countries, donor nations, and the private sector should redouble efforts to finance tuberculosis programmes and research because the economic dividend of such strategies is likely to be substantial.

Funding

None.

中文翻译：

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结核病死亡率对 120 个国家的经济影响以及未实现可持续发展目标结核病指标的代价：全收入分析

背景

联合国可持续发展目标 (SDG) 的结核病目标要求到 2030 年将结核病死亡人数比 2015 年减少 90%，但现在看来实现这一目标的可能性很小。为了评估 2045 年之前无法实现目标的经济影响，我们估计了 120 个国家在 2020-50 年期间的全部收入损失，包括因 COVID-19 相关结核病服务中断导致的额外死亡。

方法

估计了 120 个国家从 2020 年到 2050 年每年每个年龄段的年度死亡风险变化。然后通过计算人口水平的死亡率风险变化并将其乘以每个国家和年份的统计生命年值，将这种风险变化转化为全收入风险。作为比较，我们假设目前的结核病发病率在整个分析期间继续下降。我们计算了在 2030 年和 2045 年实现可持续发展目标的情况下，每人在出生时和 35 岁时的全部收入损失和平均预期寿命损失。我们将不作为的成本定义为完全不采取行动的差异-这两种情景之间的收入损失和结核病死亡率。

发现

从 2020 年到 2050 年，根据目前每年 2% 的结核病死亡人数下降，估计将发生 31·800 万结核病死亡（95% 不确定区间 25·200 万–39·500 万），相当于经济损失17·5 万亿美元（14·9 万亿–20·4 万亿）。如果在 2030 年实现 SDG 结核病死亡率目标，则可以避免 23·800 万例结核病死亡（18·900 万–29·500 万）和 13·1 万亿美元（11·2 万亿–15·3 万亿）的经济损失. 如果在 2045 年实现该目标，则可以避免 18·100 万例结核病死亡（14·3 百万–22·4 百万）和 10·2 万亿美元（8·7 万亿–11·8 万亿）。到 2045 年才达到 SDG 结核病死亡率目标而不采取行动的代价（vs因此，2030 年）是 5·7 百万例结核病死亡（5·1 百万–8·1 百万）和 3·0 万亿美元（2·5 万亿–3·5 万亿）的经济损失。与 COVID-19 相关的中断为此成本增加了 290·30 亿美元（260·20 亿–570·10 亿美元）。

解释

到 2030 年未能实现可持续发展目标结核病死亡率目标将导致严重的经济和健康损失。延迟的影响将在撒哈拉以南非洲地区最为严重。受影响的国家、捐助国和私营部门应加倍努力资助结核病规划和研究，因为此类战略的经济红利可能是巨大的。

资金

没有任何。