Donald Trump’s quotes from global health programs will be fatal in the fight against tuberculosis, the infectious disease that causes more deaths in the world, but despite this, it is preventable. The World Health Organization, in projections published in the World TB Report 2025, calculates that this million is prevalent, and that if US government funding for USAID and the Global Fund is not replaced, millions of people who should not die prematurely will die from here until 2035. Moreover, 10 million unexpected new cases will be produced.
For Teresa Kasayeva, director of the WHO’s HIV and TB division, the results from 2025 represent a “serious challenge.” “It is essential that there is strong political leadership that will promote increased national investment in the countries that bear the highest burden (of TB). The decisions that will be taken today will determine whether we accelerate progress or whether we merely make some progress,” he stressed in a virtual press release this month.
The cuttings ease the timid recovery in the fight against the disease after the ravages of the epidemic. The World Health Organization estimates that interruptions in the diagnosis and treatment of tuberculosis amid Covid-19 and the crisis in health systems will kill an additional 700,000 people between 2020 and 2023.
In 2024, 10.7 million people will become ill and 1.23 million will die. Although it is the first time since 2020 that infection and death rates have decreased by 1% and 3% compared to 2023, the data is still higher than those recorded before the emergence of Covid-19.
The decisions we make today will determine whether we accelerate progress or make little progress
Teresa Kasaeva, Director of the Department of HIV, Tuberculosis, Hepatitis and Sexually Transmitted Infections at the World Health Organization.
The toll on international aid to global health will be more damaging than the pandemic. In August this year, according to the World Health Organization, the reduction in aid affected groups of community workers carrying out prevention tasks, laboratory and diagnostic activities, preventive treatments, data management and transport of samples to laboratories.
Africa was able to reduce TB infection rates by 28% and deaths by 46%. Other good news, which is now at risk, is the progress made in developing new vaccines and pharmaceuticals. The World Health Organization highlighted in its report that there are 18 vaccines against tuberculosis in the clinical development stage, and six of them are in the third phase of trials. 63 new diagnostic tests and 29 drugs are also being developed. The problem, the organization warned in its report, is that “several grants from the National Institutes of Health (a US agency) for health-related research have been canceled, and a 40% reduction in the NIH assumptions for 2024 is proposed.”
One of the affected vaccines is now being detected in Spain. Carlos Martin, a microbiologist at the University of Zaragoza and one of the researchers behind the vaccine, explained to EL PAÍS in May that one of the trials in South Africa was halted due to decisions of the EE UU government.
The scraps from 2025 exacerbated an already critical financial situation. The global response to tuberculosis has remained stagnant since 2020. In 2024, funding in low- and middle-income countries reached $5,900 million, representing only 27% of the $22,000 million that must be invested annually, according to the goals set by the United Nations, until 2027 to confront the disease.
While 82% of resources generally come from national donors, there are countries that rely more on international donors. For example, 26 countries with a high burden of TB depend on 54% of external resources. In low-income countries, the dependency ratio rises to 63%.
EE UU is now the largest contributor to TB care programs in the world. Between 2015 and 2024, it contributed approximately 50% of resources through USAID and the Global Fund. Countries such as Zambia, Cambodia, Malawi, Ethiopia, and the Philippines are among those most dependent on USAID funds to address the disease.
Peter Sands, executive director of the Fondo Mundial Foundation, warns that the world cannot allow “another setback” like what happened during the pandemic. He stressed through a statement issued this month after reviewing data from the World Health Organization report that “the larger financial deficit now poses a risk of reversing the achievements that helped us achieve so much, especially in the most vulnerable communities.” The Global Fund will celebrate the reallocation of its resources for the 2027-2029 cycle next week. More than 70% of global funds allocated to fight tuberculosis depend on this organization.
In this scenario, the World Health Organization called on countries to increase national funding to try to fill funding gaps. The report highlights that countries such as Nigeria and South Africa have increased their assumptions for this purpose.
We must ensure that new tools arrive more quickly, are achievable and that countries adopt them before this is possible
Yogan Pillai, director of HIV and TB programs at the Gates Foundation
Yogan Pillay, director of HIV and TB programs at the Gates Fund, announced during the press conference that innovations also played a key role. For example, Pillay highlighted a study that advances the foundations of asymptomatic TB, which affects up to 50% of people with TB.
The expert also celebrates progress in developing low-cost molecular tests to detect the parasite that causes disease and prevention through digital means to reduce the effects of stigma and aid artificial intelligence in diagnosis. “We need to change the way we do things so that we can maintain the achievements we have seen in 2024,” Pillay emphasized. “We must ensure that new tools arrive more quickly, which is essential, and that countries adopt them before that is possible.”
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