Tuberculosis testing.
Image: Armand Hough/ Independent Media FILE
In marking World Tuberculosis (TB) Day on Monday, the widespread implications of US funding cuts is expected to dominate conversation and events around the globe.
“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 World Health Organization (WHO) Director-General Dr Tedros Ghebreyesus.
WHO has called for an urgent investment of resources to protect and maintain TB care and support services for people in need across regions and countries.
This comes after the US government issued termination letters to programmes funded by the US Agency for International Development (USAID) and the Department of State and the President’s Emergency Plan for AIDS Relief (PEPFAR). Many provided essential and lifesaving healthcare services for HIV and TB, malaria, Ebola, malnutrition, and vaccination among other critical health issues.
WHO said global efforts to combat TB have saved an estimated 79 million lives since 2000. However, the drastic and abrupt cuts in global health funding happening now was threatening to reverse these gains.
Rising drug resistance especially across Europe and the ongoing conflicts across the Middle-East, Africa and Eastern Europe, are further exacerbating the situation for the most vulnerable, WHO noted.
Ghebreyesus said: “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.”
Early reports to WHO reveal that severe disruptions in the TB response are seen across several of the highest-burden countries following the funding cuts.
Countries in the WHO African Region are experiencing the greatest impact, followed by countries in the WHO South-East Asian and Western Pacific Regions.
Twenty seven countries are facing crippling breakdowns in their TB response, with devastating consequences, such as human resource shortages undermining service delivery; diagnostic services severely disrupted, delaying detection and treatment; data and surveillance systems collapsing, compromising disease tracking and management; community engagement efforts, including active case finding, screening, and contact tracing, deteriorating, leading to delayed diagnoses and increased transmission risks.
Nine countries have also reported failing TB drug procurement and supply chains, jeopardizing treatment continuity and patient outcomes.
“The 2025 funding cuts further exacerbate an already existing underfunding for global TB response. In 2023, only 26% of the US$22 billion annually needed for TB prevention and care was available, leaving a massive shortfall. TB research is in crisis, receiving just one-fifth of the US$5 billion annual target in 2022 - severely delaying advancements in diagnostics, treatments, and vaccines. WHO is leading efforts to accelerate TB vaccine development through the TB Vaccine Accelerator Council, but progress remains at risk without urgent financial commitments.”
In response to the urgent challenges threatening TB services worldwide, WHO’s Director-General and Civil Society Task Force on Tuberculosis issued a statement demanding immediate, coordinated efforts from governments, global health leaders, donors, and policymakers to prevent further disruptions.
Renier Coetzee, an Associate Professor at the UWC’s School of Public Health (SOPH) said the USAID and PEPFAR funding crisis placed immense strain on NGOs that are critical to efforts in fighting TB.
“Many organisations like TB Proof, ANOVA and TB/HIV Care rely heavily on such funding to sustain their programmes. Without adequate resources, mentorship programs, workshops, and advocacy campaigns risk being scaled back or discontinued altogether.
“This funding shortfall also affects the ability to address service gaps identified by community leaders. For instance, in Elsies River and Delft, leaders have pointed out shortages in diagnostic tools and treatment facilities. While they are eager to advocate for change, limited funding hampers their ability to implement solutions effectively.”
Cape Times