Tuberculosis funding cuts could cost households up to $80 billion

A modeling study using data for 79 low- and middle-income countries projects up to $79.7 billion in additional patient-incurred TB costs from 2025–2050 if all external funding ends, and finds the poorest households would carry most of the added burden.

A new modeling study projects that abrupt reductions in international funding for tuberculosis could add tens of billions of dollars in out-of-pocket costs for affected households over 2025–2050. Researchers linked epidemiologic and economic models tailored to 79 low- and middle-income countries that account for about 91% of global TB cases. The scenarios reflect potential termination of USAID support and varying reductions in Global Fund contributions. The study assessed household financial impacts and did not model effects on illness or deaths. Key findings: - If all external TB funding is eliminated, the study projects $79.7 billion (95% UI: $60.0 billion to $99.2 billion) in additional patient-incurred costs over 2025–2050 and about 40.5 million more households facing catastrophic costs. - Termination of USAID support alone beginning in 2025 is estimated to add $7.5 billion (95% UI: $6.1 billion to $8.9 billion) in household costs and 3.9 million additional households with catastrophic costs. - If both USAID support and all Global Fund contributions were terminated, projected additional patient costs reach $24 billion (95% UI: $19.2 billion to $28.5 billion). - Across scenarios, nearly 60% of additional catastrophic-cost cases occur in the poorest two income quintiles, with roughly two-thirds concentrated in the poorest 20% of households. Summary: The study estimates sizable increases in TB-related out-of-pocket spending for households under multiple donor-funding reduction scenarios, with the heaviest absolute increases in catastrophic costs among the poorest families. The authors compare the projected losses with earlier estimates of economic benefits from a new TB vaccine and note the potential negative financial consequences could exceed those vaccine-related gains. Undetermined at this time.