No Funding No Vax for TB?

The World Health Organization (WHO)'s latest updates on tuberculosis (TB) released on November 12 reveal significant progress in diagnosis, treatment, and political commitment, but also expose deep vulnerabilities—especially in the South-East Asia Region (SEARO)—related to funding gaps and the uncertain future of novel TB vaccines. SEARO remains the global epicentre of the TB epidemic, carrying more than 45 per cent of the world's TB incidence despite representing only a quarter of the global population.

- Narayan Kulkarni Editor [e-mail]

In 2022, the region reported over 4.8 million TB cases and more than 600,000 deaths, accounting for the majority of global TB mortality excluding HIV-associated deaths. Six high-burden countries—Bangladesh, India, Indonesia, Myanmar, DPR Korea and Thailand—are located in SEARO, with Nepal joining the list for multidrug-resistant TB (MDR-TB).

Despite substantial political commitment, exemplified by the Gandhinagar Declaration in 2023 and record case notification numbers in 2022, the region continues to struggle with large care gaps, especially for drug-resistant TB. SEARO accounts for over 38 per cent of global MDR-/RR-TB cases, yet less than half of those affected are diagnosed and enrolled in treatment, underscoring the challenges of scaling molecular diagnostics, securing uninterrupted drug supplies, and sustaining programmatic funding.