China has made significant progress in reducing its tuberculosis burden and related deaths, but health experts say achieving global elimination targets will require major advances in scientific innovation, including novel vaccines, faster diagnostics and broader access to new tools.

Data from the World Health Organization shows an estimated 696,000 people in China contracted TB in 2024, a decrease of 6.1 percent from 2023.

The country's TB incidence rate dropped 5.8 percent year-on-year to 49 cases per 100,000 people in 2024, marking the first time China was classified as having moderate-to-low TB prevalence, according to a report released by WHO in November.

Zhang Hui, deputy head of the Chinese Center for Disease Control and Prevention's National Center for Tuberculosis Control and Prevention, said the number of people with rifampicin resistance declined by 50.9 percent — or about 29,000 fewer cases — from 2015 to 2024.

Compared with global averages, both the decline in TB-related deaths and the reduction in incidence have been more pronounced in China, she said.

However, China still had the fourth-highest number of TB cases in 2024, accounting for 6.5 percent of the global total.

It remains among the eight highest-burden countries, which together account for about two-thirds of worldwide infections.

"There remains a gap between the current situation and the WHO's End TB Strategy, which aims to reduce the TB incidence rate by 80 percent by 2030 and by 90 percent by 2035, compared with a 2015 baseline," Zhang said at a seminar held by Peking University's Center for Social Media Research and the Global Health Drug Discovery Institute in Beijing ahead of World TB Day on Tuesday.

To meet these goals, she stressed the need to strengthen conventional control measures, including proactive case detection and early intervention.

"Existing tools alone are insufficient to meet the objectives. Scientific innovation — in the form of more effective vaccines, lower-cost and more efficient technologies, and improved approaches for screening, diagnosis and treatment — is essential," she said.

Zhang added that intervention priorities should vary by region and align with local conditions.

Chen Zhongdan, a technical officer at the WHO Representative Office in China, said that while a variety of novel TB control tools have emerged in recent years, their accessibility remains far below the level required.

Globally, only 54 percent of people with TB were tested with a WHO-recommended rapid diagnostic test as an initial test, he said. The proportion of patients diagnosed through bacteriological confirmation — a more accurate method — has stagnated at about 58 to 64 percent over the past decade.

In addition, the number of people receiving treatment for multi-drug-resistant TB has remained stable since 2015, but is still far below the estimated number in need.

"More efforts are needed to develop novel tools, including better diagnostic technologies, safer, more accessible and affordable, shorter treatment regimens, and effective vaccines," Chen said.

"It is particularly important to drive innovation in funding, management and service models to ensure the population level coverage of novel tools," he added.

Chinese researchers say several innovations are in development.

Hu Ye, dean at Tsinghua University's School of Biomedical Engineering, said his team has developed a fast, portable TB test that can analyze blood, saliva and sputum samples using a handheld device.

The technology could be especially useful in resource-limited settings such as rural townships and mountainous regions.

Zhang Rumin, chief scientist at the Global Health Drug Discovery Institute, said artificial intelligence could help accelerate the development of therapies that precisely target TB bacteria, as well as combination drugs capable of tackling drug-resistant or dormant strains simultaneously.

"It would be ideal to have a single shot that works, rather than having to take pills every day," he said.

Gao Lei, vice-chairman of the Chinese Antituberculosis Association, said the WHO has already recommended AI-powered imaging diagnostics to screen and triage active TB cases.

He added that AI could also play a broader role, including identifying individuals at high risk of developing the disease.

wangxiaoyu@chinadaily.com.cn