TB deaths fell again in 2024 — and the money to keep them falling is not there

Tuberculosis killed more than 1.2 million people and made an estimated 10.7 million ill in 2024, according to the World Health Organization's Global Tuberculosis Report 2025, released on 12 November [s1]. Both numbers are lower than the year before — the global rate of people falling ill declined by nearly 2% between 2023 and 2024, and deaths fell by 3% [s1]. The report's own framing is that this is recovery from the service disruptions of the COVID-19 pandemic rather than acceleration toward the End TB targets, and that the funding to sustain it is not in place [s1].

What improved

The operational indicators moved in the right direction almost across the board. In 2024, 8.3 million people were newly diagnosed with TB and started on treatment — about 78% of everyone estimated to have fallen ill that year [s1]. Coverage of rapid molecular testing for diagnosis rose from 48% in 2023 to 54% in 2024 [s1]. Treatment for drug-susceptible TB stayed highly effective, with an 88% success rate [s1].

Drug-resistant TB, historically the hardest part of the response, also improved. The number of people developing drug-resistant TB each year has been declining, more than 164,000 people received treatment for it in 2024, and the treatment success rate rose to 71% from 68% the previous year [s1]. Preventive treatment reached 5.3 million people at high risk, up from 4.7 million in 2023 [s1].

Some regions have sustained decade-long declines. Between 2015 and 2024 the WHO African Region cut TB incidence by 28% and deaths by 46%; the European Region cut incidence by 39% and deaths by 49% [s1]. Over the same period more than 100 countries achieved at least a 20% reduction in incidence rates, and 65 countries cut TB deaths by 35% or more, meeting the first milestones of the End TB Strategy [s1]. WHO puts the cumulative number of lives saved by TB treatment since 2000 at an estimated 83 million [s1].

Where the disease still is

The burden remains extraordinarily concentrated. In 2024, 87% of everyone who developed TB disease lived in 30 countries, and just eight of those accounted for 67% of the global total: India (25%), Indonesia (10%), the Philippines (6.8%), China (6.5%), Pakistan (6.3%), Nigeria (4.8%), the Democratic Republic of the Congo (3.9%) and Bangladesh (3.6%) [s1].

For the first time, the report includes data on social protection coverage among the 30 high-burden countries, compiled with the International Labour Organization against a target set at the second UN High-Level Meeting on TB in 2023 [s1]. Coverage ranges from 3.1% in Uganda to 94% in Mongolia, with 19 of the 30 countries below 50% [s1]. That matters because TB is a disease whose drivers — undernutrition, HIV infection, diabetes, smoking, alcohol use, and poverty underneath all of them — sit largely outside the health sector [s1].

The financing problem

Global funding for TB prevention, diagnosis and treatment has been flat since 2020. In 2024 only US$5.9 billion was available — just over a quarter of the US$22 billion annual target set for 2027 [s1]. Research funding is further behind still, at US$1.2 billion in 2023, 24% of its target [s1].

The report is explicit that cuts to international donor funding from 2025 onward pose a serious challenge, and cites modelling warning that sustained long-term cuts could produce up to 2 million additional deaths and 10 million additional people falling ill with TB between 2025 and 2035 [s1]. Those are modelled projections over a decade, not observations, and they depend on assumptions about how deep and how durable the cuts turn out to be. But the direction is not in dispute.

Nine days before the TB report, WHO published separate guidance on the same underlying problem, titled "Responding to the health financing emergency: immediate measures and longer-term shifts" [s2]. That document projects external health aid falling 30% to 40% in 2025 compared with 2023 [s2]. WHO survey data collected from 108 low- and middle-income countries in March 2025 found funding cuts had reduced critical services — maternal care, vaccination, emergency preparedness, disease surveillance — by up to 70% in some countries, with more than 50 countries reporting job losses among health and care workers [s2].

What is being tried

The financing guidance leans on domestic mobilisation rather than replacement aid. Its policy recommendations are to prioritise services used by the poorest, protect health budgets outright, improve efficiency through procurement and strategic purchasing, integrate externally funded disease-specific programmes into primary care delivery, and use health technology assessment to choose what to buy [s2]. It names countries already acting: Nigeria increased its health budget by US$200 million with additional allocations for immunization and epidemic response; Ghana lifted the cap on the excise tax earmarked for its national health insurance agency, producing a 60% budget increase; Kenya and South Africa have allocated additional funds or await parliamentary approval; and Uganda has set out an agenda for integrating disease programmes into general service delivery [s2].

For TB specifically, the pipeline is the one area where the numbers are moving fast. As of August 2025, 63 diagnostic tests were in development and 29 drugs were in clinical trials, up from just eight drugs in 2015, with 18 vaccine candidates in clinical trials including six in Phase 3 [s1]. Whether any of that reaches the eight countries carrying two-thirds of the disease depends on the financing question, not the science one.

Sources

• [s1] Global gains in tuberculosis response endangered by funding challenges, World Health Organization, 12 November 2025. https://www.who.int/news/item/12-11-2025-global-gains-in-tuberculosis-response-endangered-by-funding-challenges
• [s2] WHO issues guidance to address drastic global health financing cuts, World Health Organization, 3 November 2025. https://www.who.int/news/item/03-11-2025-who-issues-guidance-to-address-drastic-global-health-financing-cuts