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Header photo The Global Fund/Vincent Becker
Published: 19 September 2024

Tuberculosis

The Challenge

Tuberculosis (TB) is a leading infectious disease killer and one of the most common causes of death among people living with HIV. In 2022, 10.6 million people fell ill with TB and approximately 1.3 million people died from the disease, including people living with HIV. Colliding crises – climate change, war and deepening inequities within and between countries – are causing more people to suffer and die from TB, a preventable, treatable and curable disease.

But we are fighting back. Thanks to interventions by the Global Fund partnership, TB programs are showing strong signs of recovery. We must continue to scale up adaptation and mitigation efforts to maintain these fragile gains against TB, and increase investments in the same tools, health workers and systems for health that are needed to fight TB and COVID-19 and to prepare for future airborne pandemics.

Tuberculosis by the Numbers

Funding

  • The Global Fund provides 76% of all international financing for TB.
  • We have invested US$9.9 billion in programs to prevent and treat TB as of June 2024.
  • We have invested an additional US$1.9 billion in TB/HIV programs as of June 2024.

Prevention

  • 2 million people exposed to TB received preventive therapy in 2023.

Testing and Treatment

  • 7.1 million people treated for TB in 2023.
  • 121,000 people on treatment for drug-resistant TB in 2023.
  • 353,000 TB patients living with HIV on antiretroviral therapy during TB treatment in 2023.

Read more about TB in our Results Report

See more TB Data on the Data Explorer

Our Response

The Global Fund provides 76% of all international financing for TB and has invested US$9.9 billion in programs to prevent and treat TB and an additional US$1.9 billion in TB/HIV programs as of June 2023.

In countries where the Global Fund invests, TB deaths have dropped by 36% between 2002 and 2022. Without these interventions, TB deaths would have increased by 129% in the same period.

Trends in TB deaths (excluding HIV-positive)

Trends in new TB cases (all forms)

TB burden estimates from WHO Global TB Report 2023. Estimation of “no TB control” trends for TB deaths from WHO and for new TB cases based on the assumption of constant trend in new TB cases since 2000. While major control efforts for malaria and HIV began with the launch of the Millennium Development Goals in 2000, TB control efforts began much earlier. The counter-factual and actual results therefore diverged from each other much earlier, making this graph look considerably different than its HIV and malaria counterparts. Global Fund portfolio indicates countries that have recently received Global Fund TB funding and have reported programmatic results over the past two cycles.

Testing and Treatment

The first step to ending TB is to screen, test and treat everyone falling ill with the disease. One person with active, untreated TB can spread the disease to as many as 15-20 other people in a year.

In 2023, TB programs supported by the Global Fund recorded a complete recovery from COVID-19-related disruption. More people with TB were found and treated than ever before. The significant recovery and acceleration in screening and testing from 2022 continued, and efforts to find undiagnosed people have progressed in many countries.

The Global Fund is working with the Stop TB Partnership and WHO to find “missing” people with TB – people who go undetected, untreated, or unreported – including those with drug-resistant TB.

Drug-resistant TB is part of the growing challenge of antimicrobial-resistant superbugs that do not respond to existing medications. The Global Fund is working with our partners to support the introduction of new drugs that provide better and faster treatment of drug-resistant TB, and the uptake of new, shorter TB preventive therapies.

In 2022, the percentage of people treated for TB in the countries where the Global Fund invests rose to 70%, with those treated for drug-resistant TB rising to 33%. We are also investing in rapid molecular diagnostics for both drug-sensitive and drug-resistant TB to support the latest guidance from WHO.

Care and Prevention

Preventing the spread of infection and the progression from infection to active disease is fundamental to winning the fight against TB. The Global Fund continues to invest in broadening access to better preventive treatment in low- and middle-income countries. In countries where the Global Fund invests, 2 million people exposed to TB received preventive therapy in 2023.

HIV and TB are a deadly combination, as each fuels the progress of the other in infected patients. Every person living with HIV should be screened and monitored for TB, and every person diagnosed with TB also needs to be tested for HIV. In 2023, 353,000 TB patients living with HIV were on antiretroviral therapy during TB treatment. Coverage of antiretroviral drugs in TB patients living with HIV increased from 45% in 2010 to in 91% in 2022.

Finding and treating “missing” people with TB, along with addressing social and other factors of the disease, remains essential in the global fight against TB. The TB Strategic Initiative, funded by the Global Fund and implemented by the Stop TB Partnership and WHO, has been working with national TB programs and other partners since 2018 to stop the spread of TB and reach the Sustainable Development Goal adopted by world leaders to end TB by 2030. The first phase of the Strategic Initiative ran from 2017-2019, and by the end of 2019 an additional 1,014,000 people with TB had been notified. Building on the successes and lessons learned from the first phase, the second phase (2021-2023) made funding available to 20 priority countries, 5 of which are in West and Central Africa.

Find out more

In 2023, approximately 1.3 million children and adolescents had TB, but only 700,000 were diagnosed with the disease. While TB diagnosis is often more challenging in children, countries have made progress to improve childhood TB prevention and care with support from the Global Fund and partners. Countries have been able to expand screening and diagnostic capacities, while prioritizing improved treatment options for children affected by TB. Global Fund investments are supporting the procurement of a short, 4-month drug-susceptible TB regimen for children with non-severe TB, pediatric fixed-dose combination drugs, and child-friendly formulations for drug-resistant TB.

Find out more [ download in English ]

The Global Fund works with governments and health providers to regularly review and improve the quality of TB programs in countries where we invest. This is done through conducting national surveys, developing toolkits tailored to specific needs and delivering training to health care practitioners and community health workers.

Read the case study [ download in English ]

The Global Fund is working with partners and countries to ensure that recent innovations in TB diagnostic and screening technologies, such as the use of digital chest x-rays to screen people at risk of TB and the use of artificial intelligence, are introduced and implemented so that people with and at risk of TB have access to good quality care. Innovations in TB care do not always involve new drugs or tools. They can be new ways of offering care or including other sectors, particularly the private sector, in the fight against TB. The Global Fund supports countries to incorporate innovation in models of care, such as using TB data to improve care or implementing quality improvement strategies to ensure that people at risk of or with TB are able receive a diagnosis, access care and successfully complete their treatment.

Read the case study

Our new Strategy reiterates our commitment to accelerating progress toward the 2030 TB targets and recovering ground lost due to COVID-19. It outlines how we must tackle the vulnerabilities, barriers and gaps that limit equitable access to quality TB prevention and treatment programs and scale up efforts to find and treat all people with TB, tailoring services to meet the needs of the most vulnerable communities. It also shows how we will support countries to adapt their TB programming to respond to changing situations and expand the deployment of innovations, whether these are medical tools or new service approaches.

Learn more about the Global Fund Strategy

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Read the Latest Results Report

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