Global gains in tuberculosis response endangered by funding challenges

Tuberculosis (TB) continues to be a major global health threat, claiming over 1.2 million lives and affecting an estimated 10.7 million people last year, according to the World Health Organization (WHO) Global Tuberculosis Report 2025. The report highlights that despite significant progress in diagnosis, treatment, and innovation, persistent funding challenges and unequal access to care are endangering the hard-won gains in the global fight against TB.

Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, acknowledged the progress made but emphasized that it is not enough. He stated, "The fact that TB continues to claim over a million lives each year, despite being preventable and curable, is simply unconscionable." WHO is committed to collaborating with countries to build on their progress and accelerate efforts to end TB by 2030.

Between 2023 and 2024, the global rate of people falling ill with TB declined by nearly 2%, while deaths from TB decreased by 3%. These improvements indicate a recovery of essential health services after disruptions caused by the COVID-19 pandemic.

Regional Progress

Certain regions and countries have demonstrated sustained progress through strong political commitment and investment. The WHO African Region achieved a 28% reduction in the TB incidence rate and a 46% reduction in deaths between 2015 and 2024. Similarly, the European Region experienced a 39% drop in incidence and a 49% reduction in deaths during the same period.

Over 100 countries have achieved at least a 20% reduction in TB incidence rates, and 65 countries have achieved reductions of 35% or more in TB-related deaths, reaching the first milestones of the WHO End TB Strategy.

Global Burden

Ending TB globally requires accelerated progress in countries with the highest burden. In 2024, 87% of global TB cases were concentrated in 30 countries. India (25%), Indonesia (10%), the Philippines (6.8%), China (6.5%), Pakistan (6.3%), Nigeria (4.8%), the Democratic Republic of the Congo (3.9%), and Bangladesh (3.6%) accounted for 67% of the global total.

Timely treatment for TB has saved an estimated 83 million lives since 2000. Progress in TB diagnosis, prevention, and treatment continued between 2023 and 2024, reflecting the impact of sustained efforts and innovation in countries.

• WHO has reported on progress toward the social protection target established at the second UN High-Level Meeting on TB in 2023.
• Among the 30 high TB burden countries, social protection coverage varies significantly, ranging from 3.1% in Uganda to 94% in Mongolia, with 19 countries reporting coverage rates below 50%.

The report also highlights that major risk factors such as undernutrition, HIV infection, diabetes, smoking, and alcohol use continue to drive the epidemic. Addressing these factors, along with structural determinants like poverty, requires coordinated multisectoral action.

Funding Challenges

Despite the gains, global progress is insufficient to meet the End TB Strategy targets. Global funding for TB has stagnated since 2020, with only US$5.9 billion available for prevention, diagnosis, and treatment in 2024, just over a quarter of the US$22 billion annual target set for 2027.

Cuts to international donor funding from 2025 onward pose a serious threat. Modeling studies suggest that long-term cuts could result in up to 2 million additional deaths and 10 million more people falling ill with TB between 2025 and 2035.

Global TB research funding also lags, reaching only US$1.2 billion in 2023 (24% of the target). As of August 2025, 63 diagnostic tests were in development and 29 drugs were in clinical trials, a significant increase from 2015. Additionally, 18 vaccine candidates are undergoing clinical trials, including 6 in Phase 3. WHO continues to lead global efforts to advance the TB vaccine agenda.

Dr. Tereza Kasaeva, Director of the WHO Department for HIV, TB, Hepatitis and STIs, emphasized the critical moment in the fight against TB. She stated, "Funding cuts and persistent drivers of the epidemic threaten to undo hard-won gains, but with political commitment, sustained investment, and global solidarity, we can turn the tide and end this ancient killer once and for all."

WHO is urging sustained political commitment, increased domestic investment, and intensified research to accelerate progress in combating tuberculosis.