Tuberculosis makes dangerous comeback as global health efforts stall

Tuberculosis (TB), once considered a conquered foe, is making a dangerous comeback, reclaiming its title as the world’s deadliest infectious disease. In a recent article by The Atlantic, the resurgence of TB is linked to critical failures in global health funding and the devastating impact of political decisions, such as cuts to foreign aid programs.

Despite antibiotics existing since the 1950s, the lack of widespread access to these drugs, particularly in low-income nations, has caused over 100 million deaths. Today, political decisions, such as those made by the Trump administration, have exacerbated this issue, threatening to undo decades of progress.

TB is an opportunistic predator, often latent but capable of turning deadly when triggered by factors like poor nutrition, stress, or other illnesses, such as HIV. It thrives in overcrowded, poorly ventilated areas like slums and factories, and untreated active TB often leads to death. Since the 1980s, TB has been a global challenge, with a deadly synergy between the disease and HIV, particularly in sub-Saharan Africa.

Although antiretroviral drugs have significantly reduced TB deaths among HIV patients in wealthier countries, many low-income nations still lack access to both TB and HIV treatments. Initiatives like PEPFAR and the Global Fund have made strides in combating these diseases, saving millions of lives. However, recent disruptions—especially during the COVID-19 pandemic—have led to a resurgence in TB cases, with the U.S. seeing its highest rates in decades.

The Trump administration's cuts to foreign aid and health programs, including the dismantling of USAID, have had catastrophic effects. With fewer resources for diagnosing and treating TB, more people are falling through the cracks. The consequences are dire: TB infections are spreading unchecked, and drug-resistant strains are emerging, which are far harder—and more expensive—to treat.

This regression in global health efforts comes at a time when new vaccine candidates and diagnostic tests are on the verge of offering hope. Yet, without adequate funding and support, these innovations risk being rendered ineffective. The U.S. has been a significant contributor to global TB efforts, but its withdrawal from international aid has left millions without the necessary care, setting the stage for a resurgence of drug-resistant TB—a looming threat to humanity's fight against one of the deadliest diseases in history.

By Vugar Khalilov