US aid cuts: Deep reductions in US foreign aid risk setting back tuberculosis (TB) control across high-burden countries, including India, with a new modelling study estimating up to 22 lakh additional TB deaths and 1.07 crore extra cases between 2025 and 2030 if programmes are hit long-term.
The analysis, led by Avenir Health in collaboration with the UN-hosted Stop TB Partnership and published in PLOS Global Public Health, flags India as being especially vulnerable.
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The United States provided over 55% of all foreign funding for TB programmes in 2024, the researchers note. Following an 83% cut announced in March for programmes at the US Agency for International Development (USAID), the team modelled impacts across 26 high-burden, aid-dependent countries, including India, Pakistan, Bangladesh, and several in Africa.
For India, the study estimates that about 15% of the national TB program’s financing is tied to USAID flows, making any sustained shortfall a direct threat to case finding, treatment adherence and prevention services. “The loss of US funding endangers global TB control efforts and potentially puts millions of lives at risk,” the authors write, warning that short-term disruptions will hit vulnerable populations first unless alternative funding is mobilised quickly.
Even in a “best-case” scenario, where TB funds are restored within three months, the model projects an additional 6.3 lakh cases and ~1 lakh deaths across the 26 countries over five years. The “worst-case” long-term squeeze could add 1.07 crore cases and 22 lakh deaths through 2030, undermining End TB and broader SDG targets.
The estimates draw on country-reported expenditure data to WHO, used to gauge each nation’s dependence on US government support for TB. The authors call for urgent bridge financing, protection of frontline services, and accelerated adoption of high-impact tools, screening, rapid diagnostics, preventive therapy and treatment support to prevent a reversal of gains made in the last decade.
