Scanning electron microscope image of *Mycobacterium tuberculosis*, the bacterium responsible for tuberculosis.

    Infectious diseases Fighting tuberculosis

    Tuberculosis is widespread. The World Health Organization (WHO) estimates that a quarter of the world’s population are infected with the pathogen – usually without knowing it.

    Only five to ten per cent fall ill with TB in the course of their life; it is estimated that 10.8 million people were affected in 2023. Almost two thirds of them were living in just eight countries: Bangladesh, China, Democratic Republic of the Congo, India, Indonesia, Nigeria, Pakistan and the Philippines. With some 1.25 million people dying of tuberculosis in 2023, the disease remains one of the ten leading causes of death worldwide (as at March 2025).

    Many cases undiscovered, increasing drug resistance

    A significant proportion of tuberculosis cases remain undetected and untreated, according to estimates. Even individuals unknowingly suffering from this life-threatening disease can infect others. As long as we fail to put in place, especially in the worst-affected countries, comprehensive and systematic screening and treatment services the number of cases cannot be reduced.

    In recent years major advances have been made in combating the disease. New diagnostic methods have been developed and mortality rates have fallen. However, the pathogens are increasingly developing resistance, jeopardising these achievements and making tuberculosis a serious global health threat.

    Tuberculosis and AIDS

    Persons with weakened immune systems are at particular risk of falling ill with tuberculosis. For instance, people infected with HIV are estimated to be 16 times more likely to contract tuberculosis than those without HIV. Among AIDS patients, tuberculosis is the leading cause of death. Efforts to control tuberculosis must therefore be closely coordinated with measures to tackle HIV/AIDS.

    German activities

    Germany is involved in a number of international initiatives working to eradicate the epidemic of tuberculosis, including the Global Fund to Fight AIDS, Tuberculosis and Malaria; Gavi, the Vaccines Alliance; and the Global Health Investment Fund (GHIF). The latter focuses on promoting innovative financial solutions tailored to health demands in developing countries.

    In the context of bilateral development cooperation, Germany focuses on supporting national tuberculosis control programmes in countries with high rates of multidrug-resistant tuberculosis strains. These strains have become resistant to multiple medications.

    German activities include

    • Providing quality-assured drugs
    • Expanding laboratory and hospital infrastructure for diagnosing and treating all forms of tuberculosis
    • Ensuring that prisons are integrated into national programmes
    • Promoting measures to inform and educate, especially on prevention
    • Providing social support for patients during their lengthy period of treatment
    • Supporting and strengthening national monitoring and screening capabilities
    • Mobilising the contribution of private health services.

    For example, effective national reference laboratories in the partner countries were set up with support from German laboratories. They now have the equipment and expertise needed to diagnose cases of drug-resistance.