The Global Epidemiology of Tuberculosis: Burden, Trends, and Determinants.

Tuberculosis (TB) remains the leading cause of death from an infectious disease worldwide despite availability of effective treatment. In 2024, an estimated 10.7 million people developed TB disease, including 5.8 million men, 3.7 million women, and 1.2 million children. An estimated 1.23 million people died of TB, including 150,000 deaths among people living with human immunodeficiency virus (HIV). TB occurs in all regions of the world but is highly concentrated in a number of countries and populations, reflecting persistent social, economic, and health-system inequalities. Approximately one-fifth of the world's population has TB infection. TB burden varies markedly by age, sex, geography, and risk profile. TB/HIV coinfection remains a major driver of TB mortality, particularly in sub-Saharan Africa. Children and adolescents account for a substantial and underrecognized share of the global burden. Drug-resistant TB remains a major threat, driven by ongoing transmission and gaps in access to timely diagnosis and effective treatment. Global TB incidence declined between 2000 and 2019 but stalled during the COVID-19 pandemic. Case detection and mortality have partially recovered since 2022. Currently, 131 cases per 100,000 population and funding cuts highlight the fragility of TB control efforts. Sustained reductions in TB burden and achieving WHO End TB goals will require strong political and funder commitments in early diagnosis, expanded prevention, universal access to effective treatment for all forms of TB, strengthened surveillance, and action on the social and structural determinants that drive transmission and disease.