Global Tuberculosis Resurgence Threatens Public Health Advances
Tuberculosis, once considered a disease in retreat, has reclaimed its position as the world’s deadliest infectious disease outside pandemic years. Public health officials are now grappling with a troubling resurgence of this ancient killer, as cases climb globally and a new outbreak in Kansas raises concerns about the disease’s spread in the United States.
In 2023, tuberculosis regained from COVID-19 its grim title as the most lethal infectious disease worldwide, according to health experts. The United States logged more TB cases last year than in any year since the CDC began keeping records in the 1950s, signaling a reversal of decades of progress against the disease.
Kansas Outbreak Highlights Domestic Concerns
An ongoing tuberculosis outbreak that began in January 2024 in Kansas City and two nearby counties has affected 147 people, with 67 developing active illness and 80 others diagnosed with latent infections that remain asymptomatic, according to Japan Today. Two people have died, and the outbreak has disproportionately impacted low-income communities.
The Kansas situation illustrates a concerning aspect of TB transmission: a single patient with untreated active tuberculosis can infect 10 to 15 others. This high transmission rate underscores the importance of early detection and complete treatment courses to prevent further spread.
Pandemic Disruptions Fuel Global Increase
The COVID-19 pandemic has played a significant role in tuberculosis’s comeback. TB cases increased globally by 4.6% from 2020 to 2023, reversing decades of steady decline. In the United States alone, cases rose by more than 15% from 2022 to 2023.
Several factors contributed to this increase, including reduced access to health care during pandemic shutdowns, which hampered early diagnosis and treatment. According to medical experts, COVID-19-related disruptions in care resulted in nearly 700,000 excess deaths from tuberculosis globally.
Shortages in the medical supply chain exacerbated the problem, with the U.S. experiencing significant shortages of primary TB drugs between 2021 and 2023, limiting treatment options for patients and potentially allowing the disease to spread further.
🚨BREAKING: Kansas is experiencing a massive outbreak of tuberculosis, which is now being called the largest one in recorded history.
— Really American 🇺🇸 (@ReallyAmerican1) January 27, 2025
Due to an order from the Trump Administration to restrict and freeze information coming from any and all Health and Human Services Agencies, the… pic.twitter.com/m3w0u4RTqV
Foreign Aid Cuts Risk Further Setbacks
Recent cuts to foreign aid programs threaten to worsen the global TB crisis. Funding reductions have impacted tuberculosis testing and treatment programs in dozens of countries, with potentially devastating consequences. A survey of organizations providing TB care in 31 countries found that one in four have shut down entirely, and about half have stopped screening for new cases.
Medical experts warn that these developments could lead to an increase in drug-resistant tuberculosis. A memo from a USAID official estimated that cases of multidrug-resistant tuberculosis will rise by about 30% in the next few years, an unprecedented regression in humanity’s fight against the disease.
“By revoking money from global-health efforts, the U.S. has created the conditions for the health of people around the world to deteriorate, which will give tuberculosis even more opportunities to kill,” noted health researchers in a recent analysis. The official who released the memo was subsequently placed on administrative leave.
Treatment Challenges Persist
Treating tuberculosis requires a lengthy commitment. Active TB demands at least six months of uninterrupted therapy with multiple antibiotics. Disruptions in treatment not only allow the disease to spread but can also contribute to the development of drug-resistant strains that are much more difficult to treat.
For drug-resistant TB, treatment can extend beyond nine months and requires more toxic medication combinations. All TB drugs carry significant side effects, often diminishing patients’ quality of life during treatment and sometimes causing lasting health impacts.
The first antibiotics for TB were developed in the late 1930s, revolutionizing treatment of a disease that previously relied on questionable methods such as bloodletting, cod liver oil consumption, and stays in mountain sanatoriums where the cold, dry air was incorrectly believed to be curative.
Finding Hope Amid Challenges
Despite the concerning trends, some positive developments offer hope. High-quality vaccine candidates were in late-stage trials before recent funding cuts, and in December, the World Health Organization made its first endorsement of a TB diagnostic test that could improve detection rates.
Health experts emphasize that education and awareness remain crucial weapons against TB’s spread. Many people with latent TB may harbor the bacterium for years without symptoms, making community-based screening programs essential for identifying and treating cases before they become active and contagious.
As tuberculosis reclaims its historical position as humanity’s deadliest microbial foe, the global health community faces the challenge of rebuilding momentum against a disease that has plagued civilization for thousands of years and continues to demonstrate remarkable resilience in the face of modern medicine.
