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Infectious Diseases Q4 2022

Eliminating tuberculosis by 2030: abandon the goal or revise the strategy?

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Professor Guy Marks

President and Interim Executive Director, International Union Against Tuberculosis and Lung Disease

Despite bold commitments and tuberculosis (TB) elimination strategies, we are not on track to end TB by 2030. As the deadline gets ever closer, we have come to a crossroads.


Back in 2015, world leaders committed to ending the tuberculosis (TB) epidemic globally by 2030. Fast-forward three years and these commitments were reaffirmed at the first-ever UN General Assembly high-level meeting on tuberculosis.

Global commitments

Despite such promises and several iterations of a global TB strategy, we are not on track to achieve the end TB goals. While Covid-19 has had a detrimental impact on TB – with deaths increasing for the first time in over a decade – it was clear that the deviation from the required trajectory pre-dated the pandemic.

Taking decisive action

Now almost halfway to the 2030 deadline, we are faced with a choice: either abandon (or substantially modify) the goal or revise and reinforce the strategy.

For the millions of people suffering and dying from the infectious disease each year, there is only one option. We at the International Union Against Tuberculosis and Lung Disease (The Union) believe the goal of eliminating TB is important and achievable. However, it requires us to re-focus our efforts, use new tools and knowledge, and reinvigorate the commitment to end TB in the near future.

We are not on track to achieve the end TB goals.

Championing TB science

That is not to say we haven’t made great strides over the last 100 years which has only been possible because of our willingness embrace to research and innovation.

For The Union, achieving our vision of a world free of TB means we must meet the following objectives:

  • Ending the widespread transmission of TB, by finding and treating all people with TB.
  • Implementing effective precautions to limit the airborne spread of TB in healthcare and community settings.
  • Preventing the development and spread of drug-resistant TB (i.e., TB that does not respond to standard medicines).
  • Preventing TB from becoming active in people already infected and at high risk of the disease.
  • Assessing and providing care for people with disability caused by TB or who have other conditions at the same time.
  • Preventing TB-affected families from facing catastrophic financial costs due to TB.

To meet these objectives and end TB, we must nurture an environment where evidence-based innovation can flourish and new strategies based on these innovations are implemented and scaled-up. This is the only way to make the next great breakthrough in TB elimination.

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