Long considered a relic of the past, tuberculosis – a disease responsible for more than a billion deaths throughout history – seemed to have disappeared from the health radar, at least in developed countries. So much so that the United States had reduced funding for its control programs. Yet here it is: it resurfaces. The number of cases is increasing again in the United States, the United Kingdom and several regions around the world. How can we explain the return of this infection that we thought was almost forgotten?
Tuberculosis is caused by the bacteria Mycobacterium tuberculosisa microbe that most often attacks the lungs, but can infect other organs. Highly contagious, it is transmitted by tiny droplets projected into the air when an infected person coughs or sneezes. Its most common symptoms are a persistent cough and chest pain, but some people have no obvious signs. While the disease is generally treated with antibiotics, it can become fatal if left untreated – and some strains are now resistant to the drugs.
According to the IFL Science website, the Covid-19 pandemic played a major role in this resurgence. While hospitals and health systems focused their efforts on the coronavirus, other infectious diseases fell by the wayside. Patient detection and monitoring have declined in many countries. This global relaxation has left the field open to the bacteria, already well established in certain areas of poverty.
Africa and Southeast Asia affected
Because tuberculosis remains above all a “disease of the poor”. Malnutrition, promiscuity and lack of access to healthcare create ideal conditions for its spread. In a context of falling living standards and growing inequalities, the disease is therefore finding fertile ground, even in rich countries.
“For years, sustained international funding has helped curb tuberculosis incidence and mortality in the most affected areasrecalls Leonardo Martinez, assistant professor of epidemiology at Boston University. But the threat remains: the most serious consequences affect Africa and South-East Asia, where HIV and tuberculosis spread together and where health systems depend on external aid.
In a globalized world, geography no longer protects anyone: bacteria travel freely. “When it comes to global health, there is no “them”, there is only “us””said the late humanitarian doctor and anthropologist Paul Farmer. A phrase that resonates today more than ever.
In 2025, the Trump administration has drastically reduced budgets dedicated to humanitarian aid and global health. A study by Harvard and Boston researchers estimated that these reductions could lead to 2.5 million additional cases of pediatric tuberculosis within ten years and about 340,000 child deaths. If Washington completely withdrew from the Global Fund, these figures could rise to nearly 9 million cases and 1.5 million deaths.
The return of tuberculosis is therefore not a biological inevitability. It is above all a reflection of our political and social choices. Borders are not enough to contain a bacteria; only international solidarity can contain it.
