Equitable provision of tuberculosis prevention and care for vulnerable populations

This perspective article examines the need for equitable tuberculosis prevention and care for populations at high risk and people in vulnerable situations. Drawing on a recent WHO policy brief, the authors discuss the biological, social, demographic and structural factors that increase vulnerability to tuberculosis, including poverty, food insecurity, inadequate access to health care and social protection, HIV infection, undernutrition, substance use disorders, migration, displacement and stigma. The article highlights population groups that experience disproportionate risks of developing tuberculosis or poor treatment outcomes and emphasizes that ending tuberculosis as a public health problem requires universal access to prevention, diagnosis, treatment and care.

The authors present a conceptual framework that links tuberculosis-related vulnerability to broader social determinants and structural inequities, arguing that effective responses must combine biomedical interventions with social, economic and policy measures. The article advocates for multisectoral action, human rights-based and person-centred approaches, and stronger collaboration among governments, communities, development partners and other stakeholders. It also discusses the challenges posed by persistent underfunding and competing priorities, while highlighting opportunities to improve equity through priority-setting, service integration and strengthened primary health care. The authors conclude that addressing the drivers and determinants of vulnerability is essential to achieving a more inclusive, resilient and effective response to tuberculosis.