A Hidden Global Threat

Did you know that around 2 billion people—about a quarter of the world’s population—are unknowingly harboring dormant tuberculosis (TB) infections? Despite having treatments available since the 1950s, TB continues to claim the lives of one million individuals annually and infects an estimated 10 million people each year.

The COVID-19 Fallout

The World Health Organization (WHO) has set a bold target to reduce TB cases by 80% by 2030. However, the global fight against TB took a substantial hit during the COVID-19 pandemic, reversing years of progress as health resources shifted focus. Now, TB claims the grim title of the world’s deadliest infectious disease.

Wealthy Nations Aren't Exempt

While TB is more prevalent in lower-income countries, wealthier nations are not shielded. The United Kingdom witnessed a shocking 13% surge in TB cases in 2024, jeopardizing its 'low TB' status, with a third of patients facing delays in treatment. Meanwhile, the United States experienced its largest TB outbreak on record in January 2025.

A Disease with a Long History

TB has plagued humanity for thousands of years, with skeletal records dating back to 4,000 B.C. It spreads through airborne droplets from infected individuals and is caused by the bacterium Mycobacterium tuberculosis, first identified in the 1880s by German scientist Robert Koch. The alarming aspect is that TB can remain dormant in a person’s body for decades, only becoming active when immune defenses weaken.

The Problem of the 'Missing Millions'

Despite available diagnostics and treatment, TB remains notoriously challenging to control. Advocacy officer Jasmin Behrends from Doctors Without Borders stated, "The price of effective TB tests remains too high." WHO estimates reveal nearly 3 million TB cases each year go unreported, fostering ongoing transmission. Dr. Mohammed Yassin from the Global Fund emphasizes the need for proactive case finding, saying, "We must reach those at high risk in neglected communities, including homes, prisons, and urban slums."

The Rise of Drug-Resistant TB

Compounding the issue is the alarming emergence of drug-resistant TB, which develops when treatments are interrupted or incomplete. While standard TB treatment spans six months of multiple antibiotics, many patients struggle to complete it due to side effects and stigma. The WHO reported an estimated 400,000 new cases of drug-resistant TB in 2023 alone. Behrends advocates for shorter, less toxic treatment regimens to alleviate the burden on patients.

The Quest for New Vaccines

With the sole TB vaccine, BCG, developed over a century ago, researchers are urgently seeking better options. Funding disparities are staggering; COVID-19 vaccines received $90 billion for development, while TB vaccine research garnered a mere $1.1 billion over 11 years. As support wanes, concerns about the adequacy of resources in the fight against TB grow.

Hope Amidst Dwindling Support

Recent cuts in funding, particularly from the U.S. government, have raised red flags among healthcare activists. Behrends warns, "We are witnessing disruptions due to shortages of essential medical supplies and unpaid staff." Yassin emphasizes, "Sustained international funding is critical to combating TB, as reductions can have immediate and devastating effects on lives."

Towards Eradication: A Multi-Sector Approach

Fortunately, new molecular diagnostic tools now allow for speedy TB detection, enabling quicker treatment. Furthermore, several promising TB vaccine candidates are undergoing late-stage clinical trials. The Tuberculosis Vaccine Accelerator Council, established in 2023, aims to harness lessons from the COVID-19 response to expedite development.

A Call to Action

Ending TB requires a multi-faceted approach: improving healthcare systems, addressing poverty and malnutrition, enhancing housing conditions, and ensuring universal access to treatment. A UN high-level meeting in 2023 reaffirmed global commitments, but real action remains the ultimate challenge. Dr. Yassin says, "TB is no longer a silent epidemic. Advocates, survivors, scientists, and donors are uniting to demand change. The momentum from recent global meetings signifies an urgent window of opportunity to eradicate TB in our lifetime."