Global Tuberculosis (TB) Control Shows Cautious Progress; Gains Remain Fragile and Uneven

Globally, new TB cases declined slightly in 2024, from 10.8 million in 2023 to 10.7 million. This is the first reduction in new TB cases since 2020, following three consecutive years (2021-2023) of increases due to COVID-related disruptions in diagnosis and treatment. TB-related deaths also fell, from 1.27 million in 2023 to 1.23 million in 2024. However, overall progress remains insufficient and uneven. Since 2015, TB incidence has dropped by 12 percent and deaths by 29 percent, far below the WHO End TB Strategy targets of 50 percent and 75 percent reductions by 2025.    

The WHO’s 2025 Global Tuberculosis Report highlights both gains and persistent gaps. In 2024, 87 percent of new cases occurred in 30 high-burden countries, with eight countries alone accounting for 67 percent of the global total: India, Indonesia, the Philippines, China, Pakistan, Nigeria, the Democratic Republic of the Congo, and Bangladesh.  

Progress differs regionally. The African Region has reduced incidence by 28 percent and deaths by 46 percent since 2015, though gains are uneven. South-East Asia accounts for over 40 percent of global cases, with some countries experiencing post-pandemic rebounds in case detection. In the European Region, incidence has declined by 39 percent and deaths by 49 percent since 2015, yet rising TB rates among children and persistent drug-resistant cases underscore the need for targeted interventions. Several high-burden countries in the Americas and parts of Asia have seen TB incidence and mortality exceed 2015 levels.    

Overall, while most indicators are moving in the right direction following pandemic setbacks, global progress remains insufficient to meet the 2030 targets of a 90 percent reduction in deaths and an 80 percent reduction in incidence relative to 2015 levels.  

Multidrug- and extensively drug-resistant TB continue to spread in high-burden regions. Resistance arises from improper use of TB medicines, poor-quality drugs, or premature treatment discontinuation. Detection has improved slightly due to expanded diagnostics, but gaps in laboratory capacity, funding, and program support continue to hinder containment. Drug-resistant TB is also a key driver of antimicrobial resistance, underscoring its broader implications for global health security.    

Funding gaps threaten to undermine recent gains. Long-term progress requires sustained investment in prevention, diagnostics, and treatment, yet funding has stagnated in low- and middle-income countries, which account for the majority of new TB cases each year. Without sustained investment, the risk of slowed progress or resurgence remains high, particularly in countries with fragile health systems.    

Despite these challenges, progress is evident, and emerging innovations offer new opportunities in TB control. Rapid-test coverage increased from 48 percent to 54 percent in 2024, enabling earlier diagnosis and treatment. Preventive therapy is expanding among high-risk individuals, including household contacts and people living with HIV, contributing to reduced transmission risk. Novel vaccines are advancing through clinical trials, while digital and community-based tools, including AI-supported radiography and mobile reporting platforms, are enhancing surveillance, program efficiency, and case detection.  

However, these advances will only achieve lasting impact if accompanied by robust funding, equitable access, and practical implementation strategies. High costs remain a barrier for patients, and gaps in social protection and universal health coverage continue to limit access in many high-burden countries.    

Global TB control shows cautious progress after pandemic setbacks. However, the gains are fragile and uneven, with persistent challenges such as drug resistance, funding gaps, and inequities in care threatening to slow progress. Reductions in TB burden depend on expanded diagnostics, treatment, and preventive services; addressing underlying drivers of infection and disease; and technological breakthroughs such as new vaccines, all of which are dependent on robust funding and political commitment. This represents the most complete data available as of Nov. 17. 

• Avoid crowded areas whenever possible, and observe social distancing.  
• Basic hand hygiene is recommended.  
• TB is not spread by dishes, linens, other touched items, or by food; however, it can be transmitted through unpasteurized milk products, so precautions should be taken to avoid exposure.
• Persons who will spend extended periods of time in at-risk countries should have pre-travel testing for tuberculosis with at least yearly follow-up testing. Expatriates who employ household help should require tuberculosis screening prior to employing locals.  
• Avoid high exposure areas, such as hospitals, prisons, homeless shelters, and refugee camps.
• Organizations that have operations in high-risk countries, or whose personnel spend extended periods of time in those countries, should have programs in place to detect TB infections among employees. 

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