The African region has recorded the steepest decline globally in tuberculosis (TB) deaths since 2015, despite falling short of key milestones to significantly lower the burden of the disease and end its toll on health and lives.
Deaths from TB fell by 42% between 2015 and 2023 while cases declined by 24% over the same period, according to the World Health Organization (WHO) Global TB Report 2024.
The reductions were mainly due to increased efforts by countries to reinforce case detection and provision of treatment, thus averting deaths. About 1.9 million cases were detected in 2023 compared with 1.4 million in 2020. Over the same period, treatment coverage rose from 55% to 74% across the region.
This year, World TB Day is being marked under the theme “Yes! We Can End TB: Commit, Invest, Deliver”, which calls for urgent action to turn commitments into tangible impact. It emphasizes the need for strong investment and decisive measures to scale up WHO-recommended interventions for early detection, diagnosis, preventive treatment and high-quality TB care.
The WHO End TB Strategy calls for countries to reduce TB deaths and cases by 75% and 50% respectively by 2025, compared with 2015 levels.
Several African countries have made notable progress. South Africa achieved a 50% reduction in TB incidence between 2015 and 2023, becoming the first country in the region to surpass the 2025 milestone ahead of schedule.
Mozambique, Tanzania, Togo and Zambia have also already met the 2025 goal of a 75% reduction in TB deaths. Other countries, including Kenya, Malawi, Rwanda, Sierra Leone and Uganda are close behind, with mortality reductions of 66% or more.
At a subregional level, Eastern and Southern Africa has been the main driver of TB reduction, cutting incidence from 466 to 266 per 100 000 between 2000 and 2023. Progress has been slower in Central and West Africa, where TB incidence and mortality remain a concern.
Despite the progress, several challenges still need to be overcome. Limited access to rapid diagnostics, which currently reach only 54% of TB patients, is one of the most pressing issues. While this marks a significant improvement from just 24% in 2015 – nearly doubling coverage in 10 years – access is insufficient to curb the spread of multidrug-resistant TB strains.
The burden of MDR-TB persists, with more than half of these cases undiagnosed and untreated in 2023.
TB also imposes a severe economic burden. For nearly 68% of TB-affected households in Africa, the cost of seeking treatment is catastrophic. Many families face high out-of-pocket medical expenses, loss of income and inadequate social protection, hindering adherence and full recovery.
Low funding continues to impede TB control efforts at national and regional levels. The African region requires US$ 4.5 billion annually for comprehensive TB services, yet only US$ 0.9 billion is currently available, leaving a US$ 3.6-billion gap. Without urgent investment, life-saving interventions will remain out of reach for many.
WHO continues to support countries to reinforce TB control and contribute to global efforts against the disease. This includes working with countries to adopt rapid diagnosis and updated treatment guides, in line with the UN High-Level Meeting Political Declaration on TB 2023.
To meet the global targets, urgent action is required to close the diagnostic gap, increase funding, and expand access to treatment and prevention.
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