Foreign aid cuts by the United States could result in more than 10m additional TB cases and 2.5m more deaths in the next years across 26 countries with a high TB burden.
This is according to a study by Centre for Modelling and Analysis, in the US, and Stop TB Partnership, Switzerland, reports MedicalXpress. The US' financial support has played a significant role in developing and running global health programmes, particularly in combating diseases like HIV, malaria and TB, according to the study, published in PLOS Global Public Health.
In 2024 alone, US contributions comprised more than 55% of all external funds available for TB programmes. The abrupt funding freeze and subsequent cuts early this year led to many projects worldwide closing their doors.
Halting HIV treatment, malaria prevention, and TB care programmes due to lack of money has jeopardised essential health care for millions and probably worsened the overall disease burden.
Funding cuts to USAID’s TB programmes are causing major disruptions in critical areas such as diagnosis and treatment of both regular and drug-resistant TB, taking care of people with TB-HIV co-infection, and preventing new infections.
The funding withdrawal has also disrupted vital research aimed at developing new drugs, vaccines, and diagnostics. Overall, many efforts central to the Global Plan to End TB by 2030 have taken a hit.
The researchers examined the extent to which 26 high-burden countries – accounting for 80% of global TB cases – were dependent on US funding for TB care and what would happen if that support were to disappear.
Using mathematical modelling, the researchers simulated the impact under three recovery scenarios: (a) minimal impact scenario, in which services recover within three months; (b) moderate impact scenario, in which services recover within one year; and (c) worst-case scenario, in which, if the funding gap is not addressed, service coverage remains at the reduced level reached during the 90-day disruption period.
The projections allowed for an increase in TB cases and deaths between 2025 and 2030.
Even under minimal disruption, an additional 634 700 cases and nearly 100 000 deaths can be expected.
With moderate disruption, the toll could rise to 1.66m new cases and 268 600 deaths. In the worst-case scenario (S3), the projections look catastrophic with more than 10.6m extra cases and 2.24m deaths.
A sensitivity analysis revealed that only half of the funding cuts would affect TB services and yet it could lead to 884 000 additional deaths in the worst case.
The researchers note that while some nations might adapt to this changing landscape, the repercussions of these disruptions will have a lasting impact on vulnerable populations. They call for finding urgent alternative funding to sustain critical TB prevention and treatment efforts.
Study details
A deadly equation: The global toll of US TB funding cuts
Sandip Mandal, Sreenivas Nair, Suvanand Sahu, Lucica Ditiu, Carel Pretorius.
Published in PLOS Global Health on 10 September 2025
Abstract
The recent withdrawal of US financial support threatens essential TB service delivery, including diagnostics, treatment, TB-HIV co-infection interventions and research initiatives critical to eradicating TB. This study analyses the dependency of and potential impact of funding cuts to 26 high-burden TB countries (HBCs). We modelled three recovery scenarios: (1) minimal impact (services recover within three months), (2) moderate impact (recovery within one year), and (3) worst-case scenario (long-term service reduction). Extrapolations were made for all 26 HBCs based on representative countries from each dependency category. Across all 26 HBCs, additional TB cases between 2025 and 2030 are estimated at 0.63 million (CI 0.45–0.81) (minimal impact), 1.66 million (CI 1.2–2.1) (moderate impact), and 10.67 million (CI 7.85–13.19) (worst-case). Corresponding TB deaths are projected to increase by 99,900 (CI 65,200–130,000), 268,600 (CI 185,800–337,900), and 2,243,700 (CI 1,570,800–2,807,300), respectively. The loss of U.S. funding endangers global TB control efforts, jeopardising progress towards End TB and SDG targets, and potentially puts millions of lives at risk. While some nations may adapt, short-term disruptions will severely impact vulnerable populations. Urgent alternative funding is needed to sustain critical TB prevention and treatment efforts.
PLOS Global Health article – A deadly equation: The global toll of US TB funding cuts (Open access)
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