AS the world observes World Tuberculosis Day, we confront the sombre fact that despite being both preventable and curable, the disease continues to claim over a million lives each year. TB is a contagious bacterial infection which most commonly affects the lungs but can also spread to the brain, kidneys and bones. In 2023, the WHO estimated that 10.8m people fell ill with TB and 1.25m people died. Multidrug-resistant TB — which does not respond to the two most powerful TB drugs — has emerged as a global health security threat, with only two in five patients receiving appropriate treatment. The disease disproportionately affects low- and middle-income countries and is fuelled by risk factors such as undernutrition, smoking, diabetes and HIV. Although some progress has been made globally — with over 79m lives saved through TB efforts since 2000 — the WHO warns that progress is now at risk. A severe drop in funding has disrupted diagnostics, human resource deployment, data systems, and medicine supply chains. In 2023, only 26pc of the $22bn required for global TB care was available. TB research also remains underfunded, with just one-fifth of the $5bn target achieved in 2022.

Pakistan’s situation is deeply worrying. According to the World TB Report 2024, it accounted for 6.3pc of the global TB burden in 2023, ranking it among the countries with the highest number of cases. It also contributed nearly 8pc to the global gap between estimated TB incidence and the number of people who were actually diagnosed and reported — highlighting critical challenges in case detection. Furthermore, Pakistan is among the 10 countries with the widest gaps in access to MDR-TB treatment, which suggests major shortcomings in diagnosis, reporting and treatment rollout. Decades of underinvestment in public health have left our TB control programme reliant on donor support. This must change. Pakistan must increase domestic investment in TB diagnosis, treatment and research, expand coverage of WHO-recommended rapid diagnostics, improve reporting and surveillance mechanisms, and scale up access to shorter all-oral MDR-TB treatment regimens such as BPaLM. The country also needs to integrate TB care with broader primary and lung health services — especially given the overlapping risks posed by diabetes, undernutrition and pollution. The WHO has called on all governments to ‘Commit. Invest. Deliver’. Pakistan must heed that call — and make TB elimination a health priority.

Published in Dawn, March 24th, 2025