Amid U.S. Aid Cuts, Tuberculosis Efforts in Nigeria Face Choppy Waters
Global TB Testing Stagnates in Countries Affected after US Aid Reduction, From Nigeria to Pakistan
Around the conference table in Nigeria's capital of Abuja, health professionals huddled together, poring over drug registers and testing records in a desperate bid to gauge the fallout from U.S. aid cuts potentially unraveling years of vital work against tuberculosis.
Over several nerve-wracking days in May, these dedicated professionals brainstormed ways to avert the impending crisis sparked by a halt to U.S. funding for the TB Local Network (TB LON), a program delivering screening, diagnosis, and treatment initiatives.
Ibrahim Umoru, coordinator of the African TB Coalition civil society network, who attended the meeting, put it bluntly: "With these aid cuts, identifying cases is in a coma. This means more cases will go undetected, and disaster looms."
This alarming scenario is being echoed across the African continent, from the Philippines to South Africa, as experts caution that U.S. aid reductions could give a deadly leg up to tuberculosis, the infectious disease that each year claims about one million lives.
President Donald Trump's administration's axing of USAID has stalled TB screening and tracing in Pakistan and Nigeria, slowed important research initiatives in South Africa, and left TB patients in India without essential support.
According to the World Health Organisation (WHO), "drastic and abrupt cuts in global health funding" could put a halt to the progress made by international efforts to combat the disease, with drug resistance and ongoing conflicts dramatically increasing risks.
Nigeria's Air Fight
In Nigeria, the TB LON initiative, launched in 2020, received $45 million in funding from USAID and was established with a promise of a "TB-free Nigeria." However, with President Trump's goals shifting more towards an "America first" mindset, USAID ceased its financial support for TB LON's community testing work in February. A TB LON official, who wished to remain anonymous, confirmed this change.
TB takes the lives of 268 Nigerians each day, and accurate case numbers have historically been under-reported, heightening the risk of transmission. If just one case is missed, that person could potentially spread TB to 15 others throughout a single year, according to the WHO.
According to communications with half a dozen health workers performing sample collections for TB LON, they ceased working in January due to the U.S. aid freeze. Between 2020 and 2024, the TB LON program screened around 20 million people in southwestern Nigerian states and treated more than 100,000 patients as a result.
"The progress made over the years risks being undone if we don't act quickly," Umoru urged. Furthermore, non-profit organisations working with TB LON have let go over 1,000 contract workers who formerly handled TB screenings.
Nigeria's health ministry did not respond to a request for comment on the impact of the USAID cuts on TB programs.
South Africa's Battles
South Africa has a TB incidence rate of 427 per 100,000 people in 2023, down 57% from 2015, according to government data. TB-related deaths in South Africa decreased by 16% over that period, the data showed.
Medical charity Médecins Sans Frontières (MSF) revealed that TB and HIV programs were disrupted across the nation, making patient tracking and testing more challenging. According to a statement sent to the Thomson Reuters Foundation, these challenges were worsened by dwindling funding for nutrition programs, community outreach, and testing.
In response, Minister of Health Aaron Motsoaledi has declared the intention to launch an End TB campaign in June, aiming to screen and test 5 million people. Furthermore, the government is actively seeking new donor funding to bolster its efforts.
"Under no circumstances will we allow this invaluable work, performed over a long period, to collapse and burn out," Motsoaledi stated in May while discussing the country's plans to tackle TB and HIV.
A Blow to Critical Research
South Africa serves as a hub for research into both TB and HIV. Sacrificing funding for these efforts, experts warn, could stymie ongoing vaccine and treatment advancements.
The Treatment Action Group (TAG), a community-based research and policy think tank, estimates that around 39 clinical research sites and at least 20 TB trials and 24 HIV trials are at risk[1].
Cathy Hewison, head of MSF's TB working group, emphasised the danger posed by such cuts: "TB is the number-one killer of people living with HIV."
In the Philippines, U.S. funding cuts have disrupted TB testing in four USAID-supported projects, leading to drug shortages. According to the Stop TB Partnership, a U.N.-backed agency, the nation faces a widespread issue with drug shortages, which is exacerbating TB control efforts.
In Pakistan, which sees 510,000 TB infections each year, MSF has reported that these U.S. funding cuts have disrupted TB screening in communities, as well as other essential services in the hard-hit southeastern province of Sindh.
"We worry that the U.S. funding cuts impacting community-based services will have a disproportionate effect on children, leading to more children developing TB and unnecessary deaths," stated Ei Hnin Hnin Phyu, medical coordinator with MSF in Pakistan. "We cannot afford to let funding decisions cost children's lives."
[1] TAG TB Project Co-Director Lindsay McKenna's statement from March ( https://www.treatmentactiongroup.org/resources/news/treatment-action-group-urges-union-conference-delegates-refocus- eliminate-tuberculosis )
- As the situation unfolds, health professionals in Nigeria worry that the consequences of reduced U.S. funding for health and wellness programs could lead to an increase in undetected TB cases due to a halt in community testing work.
- In light of the potential risks, finance experts warn that drastic reductions in global health funding may halt progress made in combating tuberculosis, as demonstrated by the suspension of TB screening and tracing in Pakistan and Nigeria.
- In the realm of medical-conditions and research, experts in South Africa emphasize that the stalling of funding for critical studies into tuberculosis and HIV could stymie ongoing vaccine and treatment advancements.
- Meanwhile, across the African continent, from Nigeria to South Africa, entertainment and news outlets are drawing attention to the impact of U.S. finance decisions on the lives of those suffering from tuberculosis, urging for swift action to avoid undoing years of progress made in combating this deadly disease.
