By Keith Johnson, Fund for Global Health

Tuberculosis (TB) advocates are urging President Biden to launch a Global Tuberculosis Initiative, including a request to Congress for US$1 billion in fiscal year 2022 for the U.S. Agency for International Development’s TB program. 

This relatively modest level of annual investment could have a transformative impact on global health because TB has been – prior to COVID-19 – the world’s biggest infectious killer of adults, and most TB cases are very inexpensive to cure.  In addition, this investment could lay the foundation for a broader airborne pathogen defense system, preparing the world for future respiratory pandemics. 

According to the World Health Organization’s 2020 Global Tuberculosis Report, ten million people fell ill with TB in 2019. 1.4 million died of the disease and an estimated three million of the ten million never received treatment. TB mostly strikes adults in their prime parenting and working years, with often devastating impact on their families.

About 85% of people who develop TB can be cured with US$31 worth of antibiotics. Experts estimate the return on the investment netted from TB prevention and treatment programs at eighteen to one.  

The focus on dealing with COVID-19 has been causing unintended adverse consequences for other ongoing health programs. Of the twenty-three high priority countries served by USAID’s TB program, 83% had to shift personnel to work on the COVID-19 response and 52% had to reallocate TB funds for COVID-19. Over half of the countries have seen significant decreases in TB diagnoses due to COVID-19. Experts from the Stop TB Partnership projected that TB eradication would be set back five to eight years as personnel and resources were shifted from TB to battle the pandemic.  

TB resources were re-tasked because they represented the people, facilities, and equipment best suited to dealing with an infectious respiratory disease outbreak. It is clear that enhancing global capacity for dealing with TB is also key to addressing the next global pandemic.

This is not just a problem beyond the US’ borders. In addition to defending America against the next pandemic, it is important to note that TB itself poses an important threat because failure to adequately address global TB is leading to an increasing problem of drug-resistant TB, which poses a direct and substantial danger to U.S. health security.

Relative to its burden of disease, TB is by far the most under-funded program in US assistance for global health. Advocates are calling for the Biden Administration to put forward a Global TB Initiative with strong management and US$1 billion in funding for USAID TB in the coming fiscal year. 

If your organization is concerned about the global tuberculosis epidemic and would consider joining a sign-on letter, please contact Keith Johnson, Director of Advocacy, Fund for Global Health at .

The Fund for Global Health is a non-partisan aid and advocacy organization working to make health care accessible to vulnerable communities.