In the wake of massive cuts in US funding, the World Health Organization (WHO) today called on global health leaders, donors, and policymakers to protect and maintain tuberculosis (TB) care and support services around the world.
In a statement issued ahead of World Tuberculosis Day (March 24), the WHO said the “drastic and abrupt” cuts to global health funding threaten to reverse gains made in global efforts to combat TB, which remains the world’s deadliest infectious disease. Those efforts have saved an estimated 79 million lives worldwide since 2000, the organization said.
“The huge gains the world has made against TB over the past 20 years are now at risk as cuts to funding start to disrupt access to services for prevention, screening, and treatment for people with TB,” said WHO Director-General Tedros Adhanom Ghebreyesus, PhD. “But we cannot give up on the concrete commitments that world leaders made at the UN General Assembly just 18 months ago to accelerate work to end TB. WHO is committed to working with all donors, partners and affected countries to mitigate the impact of funding cuts and find innovative solutions.”
USAID cuts have crippled TB control efforts
While the statement does not specifically mention the US Agency for International Development (USAID), the Trump administration’s freeze of USAID funding, and the subsequent canceling of thousands of contracts issued by the agency, have left a gaping hole in funding for TB prevention, screening, and treatment services. The US government has been the leading bilateral donor to global TB control efforts, contributing $200 million to $250 million annually—roughly one quarter of international donor funding for the disease.
The WHO said 27 countries are facing crippling breakdowns in their TB response, with the biggest impact seen in high-TB burden countries in Africa, Southeast Asia, and the Western Pacific. Among the services that have been disrupted are diagnosis, active case finding, screening, and contact tracing, and those disruptions are resulting in delayed detection and treatment and increased transmission risk. Drug supply chains, laboratory services, and data and surveillance systems have also been undermined.
A recent update from StopTB Partnership, which works on TB response with more than 2,000 partners in 100 countries, provides some detail on the services affected by the USAID funding cuts. In Cambodia, active case finding has halted in half the country, resulting in 100,000 people missing TB screening and 10,000 cases of drug-susceptible (DS)-TB going undetected. In Kenya, sputum sample transport once supported by USAID has halted, affecting the diagnosis of DS- and drug-resistant (DR)-TB. In India, USAID-funded TB screening projects in vulnerable groups have stopped.
The huge gains the world has made against TB over the past 20 years are now at risk as cuts to funding start to disrupt access to services for prevention, screening, and treatment for people with TB.
Those are just three of dozens of examples. In a news release today, StopTB Partnership Executive Director Lucica Ditiu, MD, echoed Tedros’s call for action.
“People with TB need us,” Ditiu said. “We have to remain strong, and we can never ever give up the fight. Through innovative, global and national efforts and standing together, we will be able to achieve these targets of ensuring TB prevention, treatment, and care are accessible to all.”
TB was responsible for an estimated 1.25 million deaths in 2023, according to the WHO’s most recent annual report. An estimated 8.2 million people were newly diagnosed with the disease—the most cases in a year recorded by the WHO since it began global TB monitoring in 1995. High-burden TB countries have only recently begun to recover from the disruptions caused by the COVID-19 pandemic, which the WHO estimates resulted in 700,000 excess TB deaths.
Cuts exacerbate funding shortfalls
As the WHO notes, the funding cuts come amid what was already a shortfall in funding for global TB control efforts. In 2023, $5.7 billion was available for TB prevention, diagnostic, and treatment services in low- and middle-income countries, but that’s only 26% of the 2027 target goal of $22 billion. TB research is receiving just one fifth of its 2022 target of $5 billion. Cuts to US funding are only going to exacerbate the problem.
In a joint statement issued earlier this week, Tedros and the Civil Society Task Force on Tuberculosis called on countries to take urgent action to prevent any disruption to TB services, ensure domestic resources to sustain equitable and essential TB care, and safeguard essential TB drugs, diagnostics, care, and social protection coverage for TB patients. They also urged the establishment of national partner platforms that would bring together public and private sectors, civil society, nongovernmental organizations, professional societies, and donors to maintain momentum against TB in affected countries.
“This urgent call is timely and underscores the necessity of swift, decisive action to sustain global TB progress and prevent setbacks that could cost lives,” said Tereza Kasaeva, PhD, director of WHO’s Global Programme on TB and Lung Health, in today’s WHO news release.