The UN World Health Organisation has warned that severe funding cuts – particularly by the United States – are threatening decades of progress in the fight against tuberculosis, still the world’s deadliest infectious disease.

The health agency highlighted that essential prevention, testing, and treatment services were collapsing, leaving millions at risk.

Africa, Southeast Asia, and the Western Pacific are the hardest-hit regions, where national TB programmes depend heavily on international support.

“Any disruption to TB services – whether financial, political or operational – can have devastating and often fatal consequences for millions worldwide,” Tereza Kasaeva, Director of WHO Global Programme on TB and Lung Health, said in a statement on Wednesday.

Explainer: Cholera
UN Secretary-General António Guterres had on Feb. 24. also raised the alarm over funding cuts, noting the immediate impact on key health programmes combatting HIV/AIDS, tuberculosis, malaria, and cholera.

Over the past two decades, global TB programmes have saved more than 79 million lives, averting approximately 3.65 million deaths last year alone.

A significant portion of this success has been driven by US Government funding, which has provided about $200 to $250 million annually – approximately a quarter of the total international donor funding secured.

The U.S. has been the largest bilateral donor for programmes combating the disease.

However, newly announced cuts for 2025 through executive orders will have devastating impacts on TB response efforts in at least 18 high-burden countries, where 89 per cent of expected US funding was allocated for patient care.

The impact will be particularly devastating in Africa, where treatment disruptions and staff layoffs could exponentially increase TB transmission rates.

Early reports from TB-affected countries indicate that funding constraints are already dismantling essential health services.

Among the most pressing concerns are health worker layoffs, drug shortages and supply chain breakdowns, data and surveillance systems collapse, and disruptions to TB research and funding.

“Without immediate action, hard-won progress in the fight against TB is at risk. Our collective response must be swift, strategic, and fully resourced to protect the most vulnerable and maintain momentum toward ending TB,” Kasaeva said.

WHO reaffirmed its commitment to supporting governments and global partners in the fight against TB.

“In these challenging times, WHO remains steadfast in its commitment to supporting national governments, civil society and global partners in securing sustained funding and integrated solutions to safeguard the health and well-being of those most vulnerable to TB,” Kaeseva said.

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António Guterres, the United Nations (UN) secretary-general, says the US decision to cut humanitarian and development funding will have dire consequences for millions of vulnerable people worldwide.

Guterres said the cuts threaten humanitarian assistance and development projects, which he noted are essential programmes.

He said reducing US financial support would worsen conditions for those in need and undermine global stability.

“These cuts will be especially devastating for vulnerable people around the world. From war-torn regions to areas struck by natural disasters, the loss of support will leave millions more at risk,” Guterres said.

“American funding directly supports people living through wars, famines, and disasters, providing essential health care, shelter, water, food, and education—the list goes on.

“The generosity and compassion of the American people have not only saved lives, built peace, and improved the state of the world. They have contributed to the stability and prosperity that Americans depend on.

“Going through with recent funding cuts will make the world less healthy, less safe, and less prosperous.

“I can only hope that these decisions can be reversed based on more careful reviews. The same applies to other countries that have recently announced reductions in humanitarian and development aid.”

The UN chief highlighted how critical programmes in countries like Afghanistan, Syria, South Sudan, and Ukraine are severely affected.

In Afghanistan, over nine million people risk losing access to healthcare and protection services.

In northeast Syria, the lack of funding will significantly disrupt relief efforts where 2.5 million people depend on aid.

Cash-based aid programmes assisting one million people in Ukraine have already been suspended while funds have run out for refugee support programmes in South Sudan, worsening overcrowding and unsanitary conditions at border areas.

Beyond humanitarian relief, Guterres warned that the cuts would severely weaken global health initiatives, counterterrorism efforts, and the fight against drug trafficking.

He noted that the UN Office on Drugs and Crime (UNODC) may have to halt key counter-narcotics operations, including those addressing the fentanyl crisis.

He added that funding for programmes tackling HIV/AIDS, tuberculosis, malaria, and cholera has been stopped.

Guterres said the UN will continue lifesaving assistance while seeking alternative funding sources.

“Our absolute priority remains clear. We will do everything we can to provide life-saving aid to those in urgent need,” he said.

“We remain committed to making the global humanitarian effort as efficient, accountable, and innovative as possible while continuing to save lives.”

Last month, UN agencies began cutting back global aid operations after the Donald Trump administration ordered a 90-day suspension of all foreign assistance provided by the US.