Williamsburg, VA, USA, Mar 21 (IPS) – Tuberculosis (TB), caused by the aerophilic intracellular obligate pathogen Mycobacterium tuberculosis, is a globally endemic bacterial infection transmitted person-to-person through airborne droplets. Although fully preventable and curable, TB remains a persistent global health challenge and is projected to be a leading infectious disease by 2025.
Since its discovery in 1882, TB has claimed over one billion lives, continuing to be a deadly threat worldwide. While TB has been overshadowed by recent health crises such as COVID-19, it continues to be a leading cause of death in low- and middle-income countries (LMICs).
Mortality rates in these regions are significantly impacted by a lack of access to prevention, diagnosis, and treatment. The Trump administration’s freeze on foreign aid through the US Agency for International Development (USAID), followed by the agency’s shutdown, threatens decades of progress in TB efforts.
USAID, a leading donor providing about one-third of international TB funding, supports services through various partners. The abrupt cessation of support poses an existential challenge in high-burden TB countries, risking program shutdowns and leaving millions without essential TB services.
While it is unclear yet if the funding will eventually be restored, this disruption could reverse years of progress, increase mortality rates, and cause a resurgence of TB in vulnerable populations, severely affecting the overall TB treatment cascade.
TB is a challenging disease to diagnose, treat, and control. The dwindling resources and loss of public health capacity, coupled with existing limited access to care and difficulties maintaining both clinical and public health experts, exacerbate these challenges.
Currently, the only approved vaccine for TB is the century-old Bacillus Calmette-Guerin (BCG) vaccine, which is widely used despite its inconsistent effectiveness in adults.
The emergence of drug-resistant strains of Mycobacterium tuberculosis in geographically distinct communities remains an emerging concern. This is further compounded by a complex interplay of factors, including exposure to anti-TB drugs during treatment, person-to-person transmission, global travel, and inadequate TB care.
Anti-TB drugs, such as isoniazid, rifampin, pyrazinamide, and ethambutol, are essential for treating TB, but improper or incomplete use can lead to drug resistance.
These challenges are even more pronounced among AfricaÂ’s 268 million nomadic pastoralists. This is driven by a combination of individual behaviors, community beliefs, and systemic deficits, uniquely impacting nomadic communities and increasing their vulnerability to TB infection and spread.
Their mobility, driven by the need for water and pasture across different ecological zones, complicates TB control efforts. This mobility disrupts consistent treatment, delays diagnoses, and facilitates the spread of drug-resistant TB strains.
Additionally, cultural norms and preconceived ideas about TB lead many individuals to actively avoid TB diagnoses by refusing to seek treatment after exposure or when symptoms emerge.
The general treatment for TB requires at least six months of antibiotics, meaning that individuals must maintain access to health services for this entire period. With the everyday demands of life, this is a lot to ask of anyone. But, for those in nomadic communities, this long treatment period is nearly impossible to achieve because their migratory lifestyles often prevent them from receiving long-term care at a single healthcare facility.
The lack of healthcare-seeking behaviors among individuals can partly be attributed to social stigma associated with HIV/AIDS. TB is a common co-infection of HIV/AIDS, leading to the belief that someone infected with the bacteria causing TB must also be infected with this virus, extending existing stigma against HIV patients to those with TB.
Finally, at the healthcare system level, some of the most significant TB care challenges are prompt detection, consistent treatment, and case profiling.
The healthcare system must address these challenges to improve TB outcomes, particularly in nomadic communities where mobility and cultural factors complicate access to care. Ensuring timely diagnosis and maintaining consistent treatment are critical to controlling the spread of TB and preventing the development of drug-resistant strains.
Effective case profiling can help tailor interventions to the specific needs of different communities, ultimately improving health outcomes and reducing the burden of TB.
While it’s unclear yet if global TB funding will eventually be restored, this disruption could reverse years of progress, increase mortality rates, and cause a resurgence of TB in vulnerable populations across the world.
As the world steps up efforts to end the global epidemic on March 24, 2025, addressing these challenges is more crucial than ever.
Caroline Mullen, Pablo Troop, and Brenna Keam are Research Assistants in the Ignite Lab. Dr. Julius Odhiambo is an Assistant Professor of Public Health. Ignite Lab is a multidisciplinary research lab based at the William & Mary Global Research Institute and focuses on the effective, efficient, and equitable distribution of global health resources.
© Inter Press Service (2025) — All Rights Reserved. Original source: Inter Press Service
