On Mar. 5, 2025, the World Health Organization (WHO) announced In the past two decades, tuberculosis (TB) prevention, testing and treatment services have saved more than 79 million lives – averting approximately 3.65 million deaths last year alone from the world’s deadliest infectious disease.

This progress has been driven by critical foreign aid especially in low- and middle-income countries (LMICs), particularly from the United States Agency for International Development (USAID). However, abrupt funding cuts threaten to undo these hard-won gains, putting millions – especially the most vulnerable – at grave risk.

Based on data reported by national TB programmes to WHO and reporting by the U.S.government to the creditor reporting system of the Organisation for Economic Co-operation and Development (OECD), the United States government has provided approximately US$ 200–250 million annually in bilateral funding for the TB response at country level. This funding was approximately one quarter of the total amount of international donor funding for TB.

The 2025 funding cuts will have a devastating impact on TB programmes, particularly in LMICs that rely heavily on international aid, given the United States has been the largest bilateral donor. These cuts put 18 of the highest burden countries at risk, as they depended on 89% of the expected United States funding for TB care. The WHO African Region is hardest hit by the funding disruptions, followed by the WHO South-East Asian and Western Pacific Regions.

Data and surveillance systems are collapsing, undermining routine reporting and drug resistance monitoring. Community engagement efforts – including active case finding, screening and contact tracing – are deteriorating, reducing early TB detection and increasing transmission risks.

Without immediate intervention, these systemic failures will cripple TB prevention and treatment efforts, reverse decades of progress and endanger millions of lives. In addition, USAID, the world’s third-largest TB research funder, has halted all its funded trials, severely disrupting progress in TB research and innovation