By Bunmi Yekini
Tuberculosis (TB) remains the world’s leading cause of death from an infectious disease despite being curable for decades, with gaps in diagnosis, treatment and funding continuing to leave millions without care, global health experts say.
More than 1.2 million people died from TB in 2024, while an estimated 10.7 million fell ill, according to data cited by Unitaid. Yet one in four cases goes undiagnosed and untreated each year, allowing the disease to spread further.
Experts say the burden falls disproportionately on people in low- and middle-income countries and among marginalized communities, where access to healthcare remains limited.
“Some population groups remain invisible,” said Carol Nawina Nyirenda, a TB survivor and community advocate. She highlighted miners in southern Africa, whose exposure to silica dust increases their vulnerability to the disease, and who often return home without follow-up care.
Children are among the hardest hit, with more than 40% of cases going undetected and untreated annually, largely due to difficulties in diagnosis and gaps in child-focused care.
“Children have been systematically overlooked,” said Dr. Cherise Scott, who oversees TB strategy at Unitaid.
Although timely diagnosis and treatment can cure more than 90% of cases, barriers such as cost, distance to health facilities and delays in testing continue to prevent access, experts say.
“TB is not just a medical issue – it is also a social emergency,” said Allan Maleche, citing stigma, discrimination and weak community-level health systems as key obstacles.
Recent advances, including shorter treatment regimens for drug-resistant TB and rapid molecular diagnostics, offer new hope. Some treatment courses have been reduced from two years to as little as six months, while newer tests can detect drug resistance more quickly.
However, experts warn that innovation alone will not be enough if access barriers are not addressed.
“New tools can turn the tide, but their impact will be limited if people cannot access them,” Scott said, calling for better integration of TB services into primary healthcare and more community-based approaches.
Funding constraints are adding to the challenge. Declining global health financing risks undermining progress, with modelling suggesting that sustained cuts could lead to up to 2 million additional deaths and 10 million more TB cases by 2035.
As the largest multilateral funder of TB research and development, Unitaid says it is working to expand access to diagnostics, treatment and preventive therapies, particularly for high-risk groups.
Health experts say targeted investments and more inclusive approaches will be critical to closing gaps in care and reducing transmission.
Without such efforts, they warn, a disease that is both preventable and curable will continue to claim lives worldwide.