The known tally of people with tuberculosis rose last year but overall "major progress" is being made in rolling back the disease, the World Health Organization (WHO) said Wednesday.
"The 2015 Millennium Development Goal (MDG) of halting and reversing TB incidence has been achieved globally, in all six WHO regions and in most of the 22 high TB-burden countries," it said.
More effort is needed, though, it said: "The death toll from the disease is still unacceptably high."
In 2013, there were nine million new cases of tuberculosis and 1.5 million deaths worldwide, including 360,000 people co-infected with HIV, the agency said in an annual TB report.
The total marked an increase from 2012, but only because the first detailed figures were now available for Nigeria, the most populous nation in Africa, and some other countries.
In 2012, an estimated 8.6 million people worldwide were infected with TB and 1.3 million lives were lost, according to last year's report.
"These large numbers of TB cases and death notwithstanding, 21 years on from the... declaration of TB as a global public health emergency, major progress has been made," said the update.
"Globally, the TB mortality rate (deaths per 100,000 people per year) has fallen by 45 percent since 1990 and TB incidence (new cases per 100,000 people per year) are decreasing in most parts of the world."
The report added: "TB is slowly declining each year and it is estimated that 37 million lives were saved between 2000 and 2013 through effective diagnosis and treatment."
Good news includes new diagnostic tools to get patients on to treatment faster, and more investment in drug research and development.
"For the first time in four decades, new TB drugs are starting to emerge from the pipeline, and combination regimens that include new compounds are being tested in clinical trials," the report said.
"There are several TB vaccines in Phase I or Phase II trials. For the time being, however, a vaccine that is effective in preventing TB in adults remains elusive."
The report turned the spotlight on the campaign against multidrug-resistant (MDR) TB—strains that thwart frontline antibiotics and are extremely expensive to treat.
The proportion of new MDR TB cases was stable last year at 3.5 percent, though "much higher levels of resistance and poor treatment outcomes are of major concern in some parts of the world," it said.
Of last year's nine million new TB cases, India accounted for 24 percent and China for 11 percent.
A quarter were in African, which also had the highest death rates.
The MDG set by UN members in 2000 is a broad goal of reversing the disease by 2015.
The WHO later set a tougher target under its 2006-2015 "Stop TB" strategy: deaths and prevalence rates should be halved from 1990 levels by the end of 2015.
By the end of 2013, the fall was around 45 and 41 percent respectively, so "progress needs to accelerate," the WHO said.
To fight TB successfully, $8 billion (6.24 billion) is needed every year, it said. Funding in 2014 was $6.3 billion.
In 2013, treating a patient with conventional TB cost between $100 and $500, while MDR-TB cost an average $9,235 in poor countries but $48,553 in upper middle-income countries.
The MDGs will be supplanted by Sustainable Development Goals due to be finalised next September.
One proposed target is to "end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases."
© 2014 AFP