Tuberculosis

The Challenge

Tuberculosis (TB) is one of the world’s leading infectious disease killers. More than 1.5 million people died of TB in 2020, including people living with HIV. It is the leading killer of people living with HIV, causing one in three deaths.

The COVID-19 pandemic has had a devastating impact on the fight against TB. Deaths from the disease rose for the first time in more than a decade, driven by a surge in undiagnosed and untreated cases. For the first time in the Global Fund’s history, there have been significant declines in key TB programmatic results compared to the previous year. Between 2019 and 2020, nearly 1 million fewer people were treated for TB in the countries where the Global Fund invests. The number of people treated for drug-resistant TB fell by 19%, and for extensively drug-resistant TB by 37%.

To address the severe disruptions caused by COVID-19, and end both COVID-19 and TB as global health threats, both diseases need to be fought at the same time. We must urgently scale up adaptation and mitigation efforts to regain lost progress 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.

This year, with the Global Fund’s Seventh Replenishment conference, the world has an opportunity to invest more to protect our hard-won gains and get back on track in our fight against TB. If we do not increase investment in fighting TB, we must accept that we are effectively abandoning the 2030 goals to end the disease as a public health threat.

Trends in new TB cases (all forms)
In countries where the Global Fund invests

Tuberculosis by the Numbers:

Funding

The Global Fund provides 76% of all international financing for TB.
We have invested US$8.5 billion in programs to prevent and treat TB as of June 2022.

Prevention

395,000 people exposed to TB received preventive therapy in 2021.

Testing and Treatment

5.3 million people treated for TB in 2021.
110,000 people on treatment for drug-resistant TB in 2021.
283,000 TB patients living with HIV on antiretroviral therapy during TB treatment in 2021.

See more TB Data on the Data Explorer

Our Response

The Global Fund provides 76% of all international financing for TB (12% of total available resources) and has invested US$8.5 billion in programs to prevent and treat TB and an additional US$5 billion in TB/HIV programs as of June 2022. In countries where the Global Fund invests, TB deaths have dropped by 21% since the Global Fund was founded in 2002. Without these interventions, TB deaths would have increased by 121% in the same period.

Trends in TB deaths (excluding HIV-positive)
In 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. 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 2020 and 2021, the number of people treated for TB in the countries where the Global Fund invests rose by about 12%, with those treated for drug-resistant TB rising by 9%. 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, 395,000 people exposed to TB received preventive therapy in 2021.

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 2021, 283,000 TB patients living with HIV were on antiretroviral (ARV) therapy during TB treatment. Coverage of ARVs in TB patients living with HIV doubled from 45% in 2010 to in 90% in 2020.

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/Atul Loke/Panos

The Global Fund/Vincent Becker

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 ]

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