Aid Cuts Trigger Global Tuberculosis Treatment Crisis

Global health experts are raising alarms about a potentially catastrophic interruption in tuberculosis treatment programs worldwide following recent foreign aid cuts. The disruption threatens to reverse decades of progress against the world’s deadliest infectious disease and could lead to the emergence of more virulent, drug-resistant strains affecting millions globally, including Americans.

TB reclaimed its position as the world’s leading infectious disease killer in 2023, after briefly being surpassed by COVID-19 during the pandemic. Now, the disease that already kills approximately 1.6 million people annually faces a treatment vacuum as programs collapse across developing nations, according to The New York Times.

Patients Face Treatment Interruptions

In Kenya, patients like 40-year-old Dalvin Modore exemplify the growing crisis. Once a tall, healthy farmer, Modore has lost significant weight and now struggles to walk as tuberculosis ravages his body. Unable to access the medication he desperately needs, he fears the disease will kill him while he continues potentially spreading the infection to family and community members.

“The whole system of finding, diagnosing and treating tuberculosis has collapsed in dozens of countries across Africa and Asia,” reports the Times. With the United States having contributed approximately half of all international donor funding for TB programs last year, the impact of aid withdrawal has been immediate and severe.

A recent survey examining the impact in 31 countries found that one in four organizations providing TB care have shut down entirely, while about half have ceased screening for new cases, according to health experts. These disruptions mean potentially hundreds of thousands of infectious cases remain undiagnosed and untreated.

Drug Resistance Concerns

Medical experts warn that interrupted treatment creates ideal conditions for the development of drug-resistant tuberculosis strains. A memo from a USAID official estimated cases of multidrug-resistant tuberculosis will increase by about 30 percent in the coming years, representing an unprecedented regression in tuberculosis control.

Even a brief pause in treatment can provide the bacterium an opportunity to develop resistance. Many strains already resist decades-old first-line drugs, requiring more toxic and expensive alternatives that few developing countries can afford without assistance.

“The aid freeze will directly lead to many deaths. But giving the bacteria so many new opportunities to develop drug resistance is also a threat to all of humanity,” one public health expert noted. “We now risk the emergence of TB strains that can’t be cured with our existing tools.”

“The most proximate cause of contemporary tuberculosis deaths is not M. tuberculosis, but Homo sapiens”@johngreen outlines why the U.S. withdrawal of foreign aid for fighting diseases like tuberculosis will haunt us

Gift link for ⁦@TheAtlantic⁩ ⬇️ https://t.co/srVQfIopUZ

— Craig Spencer MD MPH (@Craig_A_Spencer) March 16, 2025

Domestic Implications

The United States is not immune to these developments. Last year, the U.S. logged more tuberculosis cases than in any year since the CDC began tracking in the 1950s. An ongoing outbreak in Kansas City and two nearby counties has affected 147 people since January 2024, with two deaths reported, according to Japan Today.

Approximately 13 million Americans carry latent TB infections that could potentially activate under certain conditions. Public health experts warn that emerging drug-resistant strains from abroad could eventually complicate domestic treatment efforts if global control measures fail.

Pandemic Setbacks Compounded

The current crisis compounds setbacks already experienced during the COVID-19 pandemic. TB cases increased globally by 4.6% from 2020 to 2023, reversing decades of steady decline. COVID-related healthcare disruptions resulted in nearly 700,000 excess TB deaths during that period.

“During mandatory shutdowns, people were less able to access health care centers for early diagnosis of TB or to fill prescriptions for treatment,” explain microbiologists Karen Dobos and Marcela Henao-Tamayo from Colorado State University. Medical supply shortages further complicated the situation, with the U.S. experiencing shortages of primary TB drugs between 2021 and 2023.

Treatment Complexities

Successfully treating tuberculosis requires significant resources and commitment. Active TB demands at least six months of uninterrupted therapy with multiple antibiotics. All TB drugs carry toxic side effects, often severely diminishing patients’ quality of life during treatment.

These treatment complexities make consistent funding crucial. When programs are interrupted, not only do individual patients suffer, but community transmission increases dramatically—a single person with untreated active TB can infect 10-15 others annually.

While administration officials have stated they are evaluating foreign aid contracts to determine their alignment with national interests, health experts emphasize that infectious disease control inherently serves both humanitarian and security interests. As one public health official noted, “Tuberculosis doesn’t recognize national borders.”