TB still kills 1.23 million a year as WHO warns progress may slip away

The WHO's Global Tuberculosis Report 2025 shows the first decline in cases since Covid, but warns that shrinking funding and persistent risks could undo gains against the world's deadliest infection

Tuberculosis killed 1.23 million people in 2024, making it the world’s deadliest infectious disease despite being preventable and treatable.

 

The new WHO Global Tuberculosis Report 2025 shows that 10.7 million people fell ill with TB last year, marking the first decline in cases and deaths since the Covid-19 pandemic. WHO says the improvement is encouraging but warns that funding gaps and unequal access to care could quickly stall progress.

 

WHO said in a statement that while the world is “moving in the right direction”, the fact that TB still kills over a million people each year is “simply unconscionable.” Dr Tedros Adhanom Ghebreyesus warned that “progress is not victory” and urged countries to accelerate action before gains slip away.

Why does TB remain the world’s biggest infectious disease killer?

Tuberculosis may be ancient, but it is far from defeated. In 2024, 10.7 million people fell ill with TB. This included 5.8 million men, 3.7 million women, and 1.2 million children, according to the WHO report.

 

TB spreads through the air, and coughing, sneezing, or even speaking can release bacteria. It primarily affects the lungs, and without treatment, it can be fatal in half of all cases.

 

WHO notes that despite progress, TB is still among the top 10 causes of death globally and remains the leading killer from a single infectious agent.

Which regions and countries saw the highest TB burden in 2024?

TB does not affect the world equally. It concentrates heavily in certain regions.

 

The WHO report shows the highest proportions of cases in:

• South-East Asia: 34 per cent
• Western Pacific: 27 per cent
• Africa: 25 per cent

 

Only eight countries accounted for 67 per cent of all new TB cases, with India responsible for 25 per cent of global cases. Other major contributors included:

• Indonesia (10 per cent)
• Philippines (6.8 per cent)
• China (6.5 per cent)
• Pakistan (6.3 per cent)
• Nigeria (4.8 per cent)
• Democratic Republic of the Congo (3.9 per cent)
• Bangladesh (3.6 per cent)

WHO said in a statement that ending TB “will require accelerated progress in countries with the highest burden.”

Is the world finally seeing a drop in TB cases and deaths?

For the first time since the pandemic, the global burden has declined.

 

The report highlights:

• TB cases fell by nearly 2 per cent between 2023 and 2024
• TB deaths dropped by 3 per cent in the same period

This reflects a recovery in health services disrupted by Covid-19.

 

The number of people falling ill with TB dropped from 10.8 million (2023) to 10.7 million (2024). While a marginal reduction, it breaks the upward trend of the past three years.

 

But the world is nowhere close to the WHO End TB Strategy milestones. By 2025, countries were expected to reduce TB incidence by 50 per cent from 2015 levels, but only 12 per cent has happened so far.

 

As WHO put it, progress is evident, but far too slow.

Why does India continue to have the world’s highest TB burden?

India remains the epicentre of TB globally, accounting for one in every four TB cases worldwide. It also contributed 28 per cent of global TB deaths in 2024.

 

Factors such as poverty, undernutrition, high population density, diabetes, smoking, and co-infections like HIV worsen the risk.

 

India also reported:

• The highest number of multidrug-resistant/rifampicin-resistant TB (MDR/RR-TB) cases (32 per cent of the global total)
• One of the world’s largest gaps between estimated TB cases and reported diagnoses

However, India also stands out for progress in detection. More than 80 per cent of estimated cases were detected and officially reported, which is among the best in high-burden countries.

What factors are driving TB infections worldwide?

TB’s spread is closely tied to social and economic vulnerabilities. The report highlights five major drivers:

• Undernutrition
• HIV infection
• Diabetes
• Smoking
• Alcohol use disorders

Why is funding the biggest threat to global TB control?

 

According to the WHO, funding for TB services in 2024 was US$5.9 billion, only 27 per cent of the target for 2027.

 

Funding for research reached US$1.2 billion in 2023, which is just a quarter of the goal.

 

WHO warned that cuts to international donor funding from 2025 onward could reverse hard-won gains.

What must countries do to stay on track to end TB by 2030?

WHO said ending TB requires political courage, domestic funding, social protection, and scientific innovation.

 

The report calls for:

• Strong primary healthcare
• Universal access to rapid tests
• Faster rollout of preventive therapy
• Scale-up of shorter, all-oral DR-TB regimens
• Investment in upcoming vaccines
• Coordinated action on poverty, nutrition, and chronic diseases

 

“WHO is working with countries to build on progress and accelerate the path to ending TB by 2030,” said Dr Tedros. 

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