Tuberculosis

14 March 2025
‫العربية‬
中文
Français
Русский
Español
Key facts
A total of 1.25 million people died from tuberculosis (TB) in 2023 (including 161
000 people with HIV). Worldwide, TB has probably returned to being the world’s
leading cause of death from a single infectious agent, following three years in
which it was replaced by coronavirus disease (COVID-19). It was also the leading
killer of people with HIV and a major cause of deaths related to antimicrobial
resistance.
In 2023, an estimated 10.8 million people fell ill with TB worldwide, including 6.0
million men, 3.6 million women and 1.3 million children. TB is present in all
countries and age groups. TB is curable and preventable.
Multidrug-resistant TB (MDR-TB) remains a public health crisis and a health
security threat. Only about 2 in 5 people with drug resistant TB accessed treatment
in 2023.
Global efforts to combat TB have saved an estimated 79 million lives since the year
2000.
US$ 22 billion is needed annually for TB prevention, diagnosis, treatment and care
to achieve the global target by 2027 agreed at the 2023 UN high level-meeting on
TB.
Ending the TB epidemic by 2030 is among the health targets of the United Nations
Sustainable Development Goals (SDGs).

Overview
Tuberculosis (TB) is an infectious disease caused by bacteria that most often
affects the lungs. It spreads through the air when people with TB cough, sneeze or
spit.

Tuberculosis is preventable and curable.

About a quarter of the global population is estimated to have been infected with TB
bacteria. About 5–10% of people infected with TB will eventually get symptoms and
develop TB disease.

Those who are infected but free of disease cannot transmit it. TB disease is
usually treated with antibiotics and can be fatal without treatment.

In certain countries, the Bacille Calmette-Guérin (BCG) vaccine is given to babies

or small children to prevent TB. The vaccine prevents deaths from TB and protects
children from serious forms of TB.

Certain conditions can increase a person’s risk for TB disease:

diabetes (high blood sugar)

weakened immune system (for example, from HIV or AIDS)
being malnourished
tobacco use
harmful use of alcohol.
Symptoms
People with TB infection don’t feel sick and aren’t contagious. Only a small
proportion of people who get infected with TB will get TB disease and symptoms.
Babies and children are at higher risk.
TB disease occurs when bacteria multiply in the body and affect different organs.
TB symptoms may be mild for many months, so it is easy to spread TB to others
without knowing it. Some people with TB disease do not have any symptoms.

Common symptoms of TB are:

prolonged cough (sometimes with blood)

chest pain
weakness
fatigue
weight loss
fever
night sweats
The symptoms people get depend on which part of the body is affected by TB. While
TB usually affects the lungs, it can also involve the kidneys, brain, spine and
skin.

Prevention
Follow these steps to help prevent tuberculosis infection and spread:

Seek medical attention if you have symptoms like prolonged cough, fever and
unexplained weight loss as early treatment for TB can help stop the spread of
disease and improve your chances of recovery.
Get tested for TB if you are at increased risk, such as if you have HIV or are in
contact with people who have TB in your household or workplace.
TB preventive treatment (or TPT) prevents infection from becoming disease. If
prescribed TPT, complete the full course.
If you have TB, practice good hygiene when coughing, including avoiding contact
with other people and wearing a mask, covering your mouth and nose when coughing or
sneezing, and disposing of sputum and used tissues properly.
Special measures like respirators and ventilation are important to reduce infection
in healthcare facilities and other institutions.
Diagnosis
WHO recommends the use of rapid molecular diagnostic tests as the initial
diagnostic test in all persons with signs and symptoms of TB.

Rapid diagnostic tests recommended by WHO include the Xpert MTB/RIF Ultra and
Truenat assays. These tests have high diagnostic accuracy and will lead to major
improvements in the early detection of TB and drug-resistant TB.

A tuberculin skin test (TST), interferon gamma release assay (IGRA) or newer
antigen-based skin tests (TBST) can be used to identity people with infection.

Diagnosing multidrug-resistant and other resistant forms of TB (see multidrug-

resistant TB section below) as well as HIV-associated TB can be complex and
expensive.

Tuberculosis is particularly difficult to diagnose in children.

Treatment
Tuberculosis disease is treated with special antibiotics. Treatment is recommended
for both TB infection and disease.

The most common antibiotics used are:

isoniazid
rifampicin
pyrazinamide
ethambutol.
To be effective, medications need to be taken daily for 4–6 months. It is dangerous
to stop the medications early or without medical advice as it can prompt TB
bacteria in the body to become resistant to the drugs.

TB that doesn’t respond to standard drugs is called drug-resistant TB and requires

treatment with different medicines.

Multidrug-resistant TB (MDR-TB)
Drug resistance emerges when TB medicines are used inappropriately, through
incorrect prescription by health care providers, poor quality drugs, or patients
stopping treatment prematurely.

MDR-TB is a form of TB caused by bacteria that do not respond to isoniazid and

rifampicin, the two most effective first-line TB drugs. MDR-TB is treatable and
curable by using other drugs, which tend to be more expensive and toxic.

In some cases, extensively drug resistant TB or XDR-TB can develop. TB caused by

bacteria that do not respond to the most effective drugs in MDR-TB treatment
regimens can leave patients with very limited treatment options.

MDR-TB remains a public health crisis and a health security threat. Only about 2 in
5 people with multidrug resistant TB accessed treatment in 2023.

In accordance with WHO guidelines, detection of MDR-TB requires bacteriological

confirmation of TB and testing for drug resistance using rapid molecular tests or
culture methods.

In 2022, new WHO guidelines prioritized a short 6-month all-oral regimen known as
BPaLM/BPaL as a treatment of choice for eligible patients. Globally in 2023, 5646
people with MDR/RR-TB were reported to have been started treatment on the
BPaLM/BPaL regimen, up from 1744 in 2022. The shorter duration, lower pill burden
and high efficacy of this novel regimen can help ease the burden on health systems
and save precious resources to further expand the diagnostic and treatment coverage
for all individuals in need. In the past, MDR-TB treatment used to last for at
least 9 months and up to 20 months. WHO recommends expanded access to all-oral
regimens.

TB and HIV
People living with HIV are 16 (uncertainty interval 14–18) times more likely to
fall ill with TB disease than people without HIV. TB is the leading cause of death
among people with HIV.

HIV and TB form a lethal combination, each speeding the other's progress. In 2023,
about 161 000 people died of HIV-associated TB. The percentage of notified TB
patients who had a documented HIV test result in 2023 was 80%, this was the same
level as in 2022, but up from 76% in 2021. The WHO African Region has the highest
burden of HIV-associated TB. Overall in 2023, only 56% of TB patients known to be
living with HIV were on antiretroviral therapy (ART).

WHO recommends a 12-component approach of collaborative TB-HIV activities,

including actions for prevention and treatment of infection and disease, to reduce
deaths.

Impact
TB mostly affects adults in their most productive years. However, all age groups
are at risk. Over 80% of cases and deaths are in low- and middle-income countries.

TB occurs in every part of the world. In 2023, the largest number of new TB cases
occurred in the WHO South-East Asia Region (45%), followed by the African Region
(24%) and the Western Pacific Region (17%). Around 87% of new TB cases occurred in
the 30 high TB burden countries, with more than two-thirds of the global total in
Bangladesh, China, Democratic Republic of the Congo, India, Indonesia, Nigeria,
Pakistan and the Philippines.

Globally, about 50% of people treated for TB and their households face total costs
(direct medical expenditures, non-medical expenditures and indirect costs such as
income losses) that are catastrophic (>20% of total household income), far from the
WHO End TB Strategy target of zero. Those with compromised immune systems, such as
people living with HIV, undernutrition or diabetes, or people who use tobacco, have
a higher risk of falling ill. Globally in 2023, there were estimated 0.96 million
new TB cases that were attributable to undernutrition, 0.75 million to alcohol use
disorders, 0.70 million to smoking, 0.61 million to HIV infection, and 0.38 million
to diabetes.

Investments to end TB
US$ 22 billion are needed annually for TB prevention, diagnosis, treatment and care
to achieve global targets by 2027 agreed on at the 2023 UN high level-TB meeting.

As in the past decade, most of the spending on TB services in 2023 (80%) was from
domestic sources. In low- and middle-income countries, international donor funding
remains crucial. From 2019 to 2023, there was a decline (of US$ 1.2 billion) in
available funding from domestic sources and a very slight increase (of US$ 0.1
billion) in funding provided by international donors. Most of the reduction in
domestic funding is largely explained by reductions in domestic funding trends in
Brazil, the Russian Federation, India, China and South Africa (BRICS). Financing
for TB research and innovation at US$ 1.0 billion in 2022 also continues to fall
far short of the global target of US$ 5 billion per year, constrained by the
overall level of investment.

WHO response
WHO is working closely with countries, partners and civil society in scaling up the
TB response. Six core functions are being pursued by WHO to contribute to achieving
the targets of the 2023 UN high-level meeting political declaration, Sustainable
Development Goals, End TB Strategy and WHO strategic priorities:

providing global leadership to end TB through strategy development, political and

multisectoral engagement, strengthening review and accountability, advocacy, and
partnerships, including with civil society;
shaping the TB research and innovation agenda and stimulating the generation,
translation and dissemination of knowledge;
setting norms and standards on TB prevention and care and promoting and
facilitating their implementation;
developing and promoting ethical and evidence-based policy options for TB
prevention and care;
ensuring the provision of specialized technical support to Member States and
partners jointly with WHO regional and country offices, catalysing change, and
building sustainable capacity; and
monitoring and reporting on the status of the TB epidemic and progress in financing
and implementation of the response at global, regional and country levels.
Related
Publications
Global Tuberculosis Report
End TB Strategy
Data
Data and analysis on TB
News
Funding cuts impact access to TB services endangering millions of lives 5 March
2025
Facts in pictures
10 facts on tuberculosis 29 October 2024
Events
WHO World TB Day 2025: Online Talk Show 24 March 2025 13:30 – 16:00 CET
More
Drug-resistant tuberculosis
WHO's work on tuberculosis