A record low at home, ten million cases in the world

World TB Day is observed each year on 24 March.

The two sets of numbers it exists to hold together are very far apart.

In the United States

9,029 cases in 2018 — an incidence of 2.8 per 100,000 — down from
9,094 in 2017, and **the lowest number on record since reporting began in
1953.**

In the world

More than a thousand times the US case count, in a world about 25 times
the population. Tuberculosis is not a solved disease that lingers in a few
places; it is one of the largest infectious killers there is, and the United
States is an outlier rather than the norm.

Both figures are falling, and both are falling slowly — **1.8% and 3.9% in a
year.**

The same lever, at both scales

The US recommendation:

**Increased diagnosis and treatment of latent TB infection remains essential
to eliminating TB in the United States.**

And the global one:

**The implementation of effective strategies, including expansion of TB
preventive treatment — treatment for those who might be infected with TB and
are at risk of progressing to TB disease, including people living with HIV —
is necessary to reach global targets.**

They are the same idea in two vocabularies. Treating people who are infected
but not yet ill is what empties the reservoir, and it is the part that is hard
everywhere: it means finding, testing and medicating people who feel
completely well, for months.

Source: Centers for Disease Control and Prevention, MMWR.