A female researcher in a full body hazmat suit, face mask and gloves is working in a lab.
Credit:

Patrick Shepherd / Wellcome

Licence: All Rights Reserved

Tuberculosis is curable and preventable – why do millions still die?

Over the last 100 years, tuberculosis research has saved millions of lives but it has failed to curb the epidemic. While some recent scientific developments are promising, progress is slow, and the tuberculosis health crisis persists. Here’s what you need to know.

A female researcher in a full body hazmat suit, face mask and gloves is working in a lab.
Credit:

Patrick Shepherd / Wellcome

Licence: All Rights Reserved

Listen to this article
Tuberculosis is curable and preventable – why do millions still die?
Elapsed time:00:00Total time:00:00

Tuberculosis (TB) is a curable and preventable infectious disease. And yet, 10.8 million people fell ill with tuberculosis and 1.25 million people died from it in 2023.

We need new tuberculosis treatments and vaccines 

There is only one licensed vaccine for tuberculosis: the Bacille Calmette-Guérin (BCG) vaccine.  

It was invented over 100 years ago, and while it has saved millions of lives since, it has limitations. The BCG vaccine provides protection against the most severe forms of tuberculosis in children but offers variable and limited protection for adolescents and adults.  

And although tuberculosis is curable with a combination of antibiotics, the standard course of drugs takes between four and nine months to complete. Treatment for drug-resistant tuberculosis takes even longer (up to two years) with much lower chances of cure.    

New treatment options have become available in the last ten years to help reduce treatment lengths, remove toxic drugs from regimens and tackle the growing tide of multi-drug-resistant tuberculosis. However, access to these drugs in many of the most deeply affected countries is still challenging.    

Meanwhile, drug-resistant tuberculosis poses a persistent and deadly threat to global health security. In 2023 alone, over 400,000 cases occurred worldwide, with diagnosis and treatment of drug-resistant tuberculosis falling well short of global targets.  

So, despite being declared a global public health emergency more than 30 years ago, the world still faces high disease prevalence, increasing drug resistance and inadequate resources to limit further spread.  

The pace of tuberculosis innovation has not matched this need – with insufficient political interest and financial investment contributing to the slow progress of research and development.

More research into tuberculosis could save millions of lives 

Developing new tools to tackle this epidemic would save millions of lives. But we need to transform research and development for tuberculosis.

Funding for research into new tuberculosis vaccines, treatments and diagnostic tools falls well below the estimated US$5 billion needed every year to reach global targets to end TB by 2030.

Private sector financing has been persistently low because tuberculosis primarily impacts low- and middle-income countries – accounting for over 80% of all cases. Tuberculosis products are not expected to secure sufficient return on investment, and as a result, industry sources only make up about 10% of the overall investment.

Even as newer products have been approved, these have not been equitably available as high prices have limited access to some of the communities that need them most. 

After almost 50 years of limited innovation, the last decade has shown the life-saving potential if we can reinvigorate the field and ensure equitable access to new products. 

For example, safer, quicker and more effective oral treatments have replaced painful injectable drugs with toxic side effects, and other new, promising drug candidates are in development. 

There have also been breakthroughs in the development of new tuberculosis vaccines.

For example, the M72/AS01E vaccine candidate. In the phase 2b study, M72 showed around 50% efficacy and, with support from Wellcome and the Gates Foundation, reached full enrollment of the phase 3 trials in April 2025. If approved, estimates show that this vaccine could prevent between 37 and 76 million cases by 2050 – and even more lives could be saved if the efficacy is found to be higher than 50%.

Wellcome is supporting the fight against tuberculosis 

Our infectious disease programme focuses on accelerating interventions and improving understanding of how and why infectious diseases emerge or escape control.

As part of this work, Wellcome is investing in tuberculosis research and development, focussing on the countries that are most impacted by the disease.

We want to make sure that new interventions to tackle tuberculosis are accessible and affordable to the people who need them most, and developed with the urgency that the devastating health crisis demands.