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Tuberculosis

The Challenge

Tuberculosis (TB) is one of the world’s leading infectious disease killers. More than 1.6 million people died of TB in 2021, including people living with HIV. It is the leading killer of people living with HIV, causing 1 in 3 deaths. 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.

The COVID-19 pandemic has also had a devastating impact on the fight against TB, reversing years of progress. The number of people who died from the disease increased for the second consecutive year, and the number of people falling ill with TB increased to 10.6 million in 2021, an increase of 4.5% from 2020. At least 1 million children become ill with TB each year, representing about 10% of all people suffering from TB.

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$9.2 billion in programs to prevent and treat TB as of June 2023.

Prevention

  • 1.5 million people exposed to TB received preventive therapy in 2022.

Testing and Treatment

  • 6.7 million people treated for TB in 2022.
  • 118,000 people on treatment for multidrug-resistant TB in 2022.
  • 331,000 TB patients living with HIV on antiretroviral therapy during TB treatment in 2022.

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$9.2 billion in programs to prevent and treat TB and an additional US$1.5 billion in TB/HIV programs as of June 2023. In countries where the Global Fund invests, TB deaths have dropped by 16% between 2002 and 2021. Without these interventions, TB deaths would have increased by 143% in the same period.

Select:

With TB control (actual)
If there had been no TB control

Trends in TB deaths (excluding HIV-positive)

Trends in new TB cases (all forms)

TB burden estimates from WHO Global TB Report 2022. 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 where the Global Fund invests.

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 other people in a year. In 2021, many countries made enormous efforts to accelerate testing and treatment for TB, including those with drug-resistant TB; to improve access to quality diagnosis, treatment and care; and to scale up prevention and supporting “catch-up” activities to find and treat those who did not access care during the pandemic, and accelerate those recovery efforts.

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.

Between 2021 and 2022, the number of people treated for TB in the countries where the Global Fund invests rose by about 26%, with those treated for drug-resistant TB rising by 8.6%. 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, 1.5 million people exposed to TB received preventive therapy in 2022.

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 2022, 331,000 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 89% in 2021.

Our investments to mitigate the impacts of COVID-19 on the fight against TB has inspired multiple innovations in service delivery. Countries have accelerated the transition to all-oral treatment regimens for drug-resistant TB, they have used digital applications to support treatment adherence and have shifted to community- and home-based service delivery. The Global Fund partnership has also supported the rollout of integrated TB and COVID-19 screening and testing, a simple step that can stop onward transmission of both diseases – and ensure that people with TB are diagnosed and treated early.

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) is making funding available to 20 priority countries, 5 of which are in West and Central Africa.

Find out more

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

Learn More

Published: 24 March 2023

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