Global TB response in retreat, warns SSHSPH

On March 24, World Tuberculosis Day, Hsu Li Yang of the Saw Swee Hock School of Public Health (SSHSPH), National University of Singapore, cautioned that reductions in foreign aid from the United States are negatively affecting efforts to combat tuberculosis (TB), potentially precipitating a global health crisis. The United States Agency for International Development (USAID) has been instrumental in global TB control since 1998, providing financial assistance to high-risk nations, accounting for approximately a quarter of all global donor funding, which amounted to $406 million in 2024. Asian nations with a significant TB burden represent over half of all cases globally, including India (26% of global cases in 2023), Indonesia (10%), China (6.8%), the Philippines (6.8%), and Pakistan (6.3%). To date, the United States has supported TB control initiatives to varying extents in Cambodia, Indonesia, Myanmar, the Philippines, Vietnam, Bangladesh, India, and Pakistan. In certain instances, the combined contributions of USAID and the Global Fund surpass the national TB control budgets of these countries. The risks associated with the intermittent supply of anti-TB drugs, combined with the significant increase in drug-resistant TB cases, pose a challenge. Hsu Li Yang cautions against the potential for latent infection within Singapore, given the current practice of not screening migrant laborers originating from adjacent nations characterized by elevated tuberculosis prevalence. For this particular demographic, timely diagnosis may prove critical in impeding disease propagation, particularly should instances of drug-resistant tuberculosis escalate in the aforementioned regions.