Kampala — The World Health Organisation (WHO) wants tuberculosis TB and lung health services to be integrated into primary healthcare systems as a sustainable solution to maintain essential services.
This is as the global fight against TB faces major challenges, including funding shortfalls that threaten to undermine decades of progress to ending the lung disease. The destabilising effects of conflicts across the Middle East, Africa, and Eastern Europe compound the crisis for the most vulnerable.
Despite saving an estimated 79 million lives since 2000, the global fight against TB is facing a critical moment. Drastic reductions in global health funding threaten to undo years of progress while escalating drug resistance in Europe.
Recognising this urgency, the World Tuberculosis Day 2025 campaign, "Yes! We Can End TB: Commit, Invest, Deliver," demands immediate commitment, investment, and delivery to reclaim momentum and save lives.
"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 Dr Tedros Adhanom Ghebreyesus, WHO Director-General, "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."
Dr Tedros Adhanom Ghebreyesus said WHO is committed to working with all donors, partners and affected countries to mitigate the impact and find innovative solutions to the funding cuts.
Recent funding cuts have severely impacted access to TB services worldwide, endangering millions of lives. The disruption of drug supply chains, suspension of staff, and data failures have compromised treatment and prevention efforts. Laboratory services have also been severely affected, with delays in sample transportation and shortages of essential consumables halting diagnostic activities.
A notable contributor to this crisis is the 90-day funding freeze by the United States Agency for International Development (USAID), which provided approximately $406 million in 2024 for global TB control. This abrupt termination has left no part of the worldwide TB control community untouched, highlighting the vulnerability of programs dependent on international donor funding.
In response to increasing resource constraints, WHO has issued new technical guidance promoting the integration of TB and lung health within primary healthcare. This guidance outlines critical actions across the care continuum, including strengthened prevention, early detection of TB and comorbidities, improved management at first contact, and enhanced patient follow-up. It also advocates for better utilisation of existing health systems and addressing common risk factors such as overcrowding, tobacco use, undernutrition, and environmental pollutants.
Dr Tereza Kasaeva Director of the WHO's Global Programme on Tuberculosis & Lung Health says TB does not exist in isolation; its linkages with lung health amplify these vulnerabilities, increasing healthcare costs and straining systems that are already struggling to provide equitable, people-centred care.
"If we do not confront these intersections head-on, the fight to end TB will continue to face obstacles. By ensuring universal access to prevention, diagnosis, treatment and care, while strengthening social protection, the strategy aims to remove the barriers that allow TB to persist."
"Integrating TB and lung health ensures patients receive seamless, continuous care for their wellbeing, optimising resources and saving lives," Dr Kasaeva added.
Africa hard hit
The WHO African Region is suffering the most from recent funding cuts, followed by the Southeast Asian and Western Pacific regions.
These cuts are causing human resource shortages, disrupting diagnostic services, and collapsing data and surveillance systems, all delaying detection, treatment, and disease management.
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WHO points out that the 2025 cuts worsen existing underfunding: in 2023, only 26% of the required US$ 22 billion for TB prevention and care was available. TB research, receiving only one-fifth of its US$ 5 billion target in 2022, is also in crisis, hindering vital progress.
The WHO Director-General and the Civil Society Task Force on Tuberculosis issued a joint statement this week demanding immediate, coordinated action to prevent further TB service disruptions. Their statement outlines five key priorities: urgent disruption resolution, sustainable domestic funding, essential service protection, national collaboration platforms, and enhanced monitoring.
"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 Dr Kasaeva.
"Investing in ending TB is not only a moral imperative but also an economic necessity, every dollar spent on prevention and treatment yields an estimated US$ 43 in economic returns."