Despite being preventable and curable, tuberculosis remains one of the world’s deadliest infectious diseases, killing more people in 2023 than any other infection.
A report published by the World Health Organisation (WHO) in March 2025 shows that the disease caused 1.25 million deaths in 2023, including affecting 161,000 people living with HIV.
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This marks a grim return to TB’s long-standing position as the world’s deadliest infectious disease before the COVID-19 pandemic disrupted global health trends.
The disease continues to thrive in places where overcrowding, poor nutrition, and weak health systems leave millions at risk, especially in low- and middle-income countries like Nigeria, which remains among the top eight countries with the highest TB burden.
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While global efforts since 2000 have saved an estimated 79 million lives, the report warns that progress is stalling. It also remains the leading killer of people living with Human Immunodeficiency Virus (HIV), and a major cause of deaths linked to antimicrobial resistance.
What to know about TB
Tuberculosis is caused by a bacterium known as Mycobacterium tuberculosis. It mainly affects the lungs, a condition called pulmonary TB, but can also spread to other parts of the body, such as the kidneys, spine or brain.
The disease spreads through the air when an infected person coughs, sneezes or spits. While many people carry the infection in a latent form that causes no symptoms, TB can become active and dangerous if the immune system is weakened.
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Those at higher risk of developing active TB include people living with HIV, individuals with diabetes or undernutrition, and those who use tobacco or alcohol.
Symptoms, transmission of TB
The most common symptoms of TB include a persistent cough lasting more than two weeks, coughing up blood, chest pain, fatigue, weight loss, fever, and night sweats.
TB may present differently in children or in people whose immune systems are already compromised.
In its active form, TB is contagious. It spreads easily in overcrowded environments, particularly where people lack access to quality healthcare or live in conditions of poverty and poor nutrition.
Persistent global threat
The WHO estimates that 10.8 million people fell ill with TB in 2023, including 6 million men, 3.6 million women and 1.3 million children.
Over 80 per cent of these cases occurred in low- and middle-income countries. The South-East Asia Region recorded the highest number of new cases (45 per cent), followed by Africa (24 per cent), and the Western Pacific (17 per cent).
TB hits hardest among adults in their most productive years, undermining economic and social development.
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In addition, it causes heavy financial burdens. In 2023, nearly half of TB-affected households experienced catastrophic costs, meaning health-related expenses exceeded 20 per cent of household income.
The rise in drug-resistant TB (MDR-TB) has further complicated the fight. Only about two in five people with drug-resistant TB received treatment in 2023, highlighting significant gaps in care and access.
HIV, TB connection
TB and HIV form a deadly partnership. People living with HIV are at least 16 times more likely to fall ill with TB than those without HIV.
In 2023 alone, an estimated 161,000 people died of HIV-associated TB, with the African region carrying the heaviest burden.
While progress has been made in testing TB patients for HIV, only 56 per cent of co-infected individuals were on antiretroviral therapy in 2023.
The WHO recommends a coordinated 12-part strategy to manage TB-HIV co-infection, including joint prevention, screening, and treatment services.
Treatment
TB remains curable with a full course of antibiotics, yet barriers to diagnosis and treatment persist.
Many patients are either not diagnosed at all or start treatment late, often due to poor access to healthcare or social stigma.
The global community has pledged to end the TB epidemic by 2030 as part of the Sustainable Development Goals.
To achieve this, an estimated 22 billion US dollars is required each year for prevention, diagnosis, treatment, and support.
The 2023 UN High-Level Meeting on TB reaffirmed this commitment, but funding and political will remain major hurdles.
Until these gaps are addressed, TB will continue to thrive in silence, especially among the world’s poorest and most vulnerable populations.
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