Tuberculosis: The Preventable Disease That Still Kills Millions — How Can We Stop It?

Tuberculosis (TB) is often seen as a disease of the past. But it remains the world’s deadliest infectious disease, claiming a life approximately every 20 seconds.

TB disproportionately affects the most vulnerable — those living in poverty, struggling with malnutrition, battling other diseases like HIV, or residing in overcrowded areas with limited access to healthcare. These conditions not only make individuals more susceptible to TB but also lead to worse outcomes when infection occurs.

Despite being entirely preventable and curable, TB continues to kill over 1.2 million people every year. Why? And more importantly, how can we be part of the movement to end TB for good?

TB: Still the World’s Deadliest Infectious Disease

TB is an airborne infectious disease, transmitted when people with active TB cough, sneeze, speak, or spit, releasing bacteria into the air. While many people infected with TB bacteria remain asymptomatic (latent TB), certain factors — such as malnutrition, diabetes, HIV, and weakened immune systems — can cause the infection to progress to active TB disease.

Why TB Persists

Several interconnected factors fuel the continued spread and fatality of TB:

1. Inadequate Resources:
   Underfunded TB programs limit access to prevention, diagnosis, treatment, and care, especially in low- and middle-income countries. Frequent shortages of TB medications and essential supplies also undermine progress.
2. Limited Access to Diagnostics and Treatment:
   Delays in diagnosing and treating TB increase the risk of ongoing transmission and complications. Many communities still lack affordable, accessible, and accurate diagnostic services.
3. Drug Resistance:
   TB bacteria have been shown to mutate and become resistant to drugs, resulting in the deadlier and more difficult-to-treat multidrug-resistant TB (MDR-TB) or extensively drug-resistant tuberculosis (XDR-TB). These strains are harder, longer, and more expensive to treat, complicating global TB control efforts.
4. Social and Economic Inequities:
   Poverty, malnutrition, overcrowding, and poor living conditions create environments where TB can thrive. Addressing these underlying social determinants is critical to reducing TB cases.
5. Political and Policy Challenges:
   Cuts to foreign aid and shifts in political priorities can undermine TB control programs, particularly in countries that rely heavily on external support or foreign aid.

How Can We Prevent TB?

Currently, around 30% of TB cases worldwide are never diagnosed or treated. However, when individuals receive proper treatment, the success rate is high — over 80%.

While treatment remains crucial, prevention efforts must begin before infection occurs. Key strategies include:

• Improving living conditions to prevent overcrowding.
• Ensuring access to nutritious food and quality healthcare.
• Enhancing ventilation in communal settings like dormitories, prisons, factories, and households.
• Strengthening early screening and diagnosis efforts in high-risk communities.

Even modest interventions can lead to dramatic improvements. For example, the Tuberculosis Local Organization Network (TB LON 3) Project in Nigeria — led by the Institute of Human Virology Nigeria (IHVN) as Principal Recipient, Society for Family Health (SFH) as Sub-Recipient, and Equitable Health Access Initiative (EHAI) as Implementing Entity — achieved the following remarkable outcomes.

Between November 2020 and December 2024, under TB LON 3, EHAI:

• Screened 772,050 individuals,
• Evaluated 104,293 presumptive TB cases,
• Diagnosed 5,288 TB-positive patients,
• Enrolled 4,566 individuals on treatment,
• And achieved an 80% treatment success rate.

This success was possible through innovative tools like PCR testing with GeneXpert, AI-powered chest X-ray screening, and Truenat diagnostics — all demonstrating that when investments are made, lives are saved.

A Call to Action

Know that ENDING TB is not just a medical challenge — it is a moral imperative. Early detection, timely and accurate treatment, and a commitment to addressing the social drivers of TB are critical tools in our fight against this preventable disease.

We can stop TB. But it will require sustained investment, political will, community engagement, and a global commitment to health equity.

Together, we can make TB a disease of the past — once and for all.

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Written by Ganiyu Agboola

Head of Clinical Laboratory Services, EHAI Nigeria