Funding cuts impact access to TB services endangering millions of lives

​​资金削减导致结核病防治服务可及性下降，危及数百万患者生命安全

In the past two decades, tuberculosis (TB) prevention, testing and treatment services have saved more than 79 million lives – averting approximately 3.65 million deaths last year alone from the world’s deadliest infectious disease. This progress has been driven by critical foreign aid especially in low- and middle-income countries (LMICs), particularly from USAID. However, abrupt funding cuts now threaten to undo these hard-won gains, putting millions – especially the most vulnerable – at grave risk.

过去二十年，结核病防治服务已挽救超过7900万生命——仅去年一年就避免了约365万例死亡，这一传染病仍是全球头号致命杀手。这一进展得益于国际援助的关键支持，尤其是对中低收入国家（LMICs）的援助，其中美国国际开发署（USAID）的贡献尤为突出。然而，突然的资金削减正威胁着这些来之不易的成果，使数百万患者——尤其是最脆弱群体——陷入致命危机。​

Based on data reported by national TB programmes to WHO and reporting by the United States of America government to the creditor reporting system of the Organisation for Economic Co-operation and Development (OECD), the United States government has provided approximately US$ 200–250 million annually in bilateral funding for the TB response at country level. This funding was approximately one quarter of the total amount of international donor funding for TB.

根据各国结核病防治规划向世界卫生组织提交的数据，以及美国政府向经济合作与发展组织（OECD）债权人报告系统披露的信息，美国政府每年在国家层面为结核病防治提供约2亿至2.5亿美元的双边资金支持。这一资金规模约占国际捐助方结核病防治资金总额的四分之一。

The 2025 funding cuts will have a devastating impact on TB programmes, particularly in LMICs that rely heavily on international aid, given the United States has been the largest bilateral donor. These cuts put 18 of the highest burden countries at risk, as they depended on 89% of the expected United States funding for TB care. The WHO African Region is hardest hit by the funding disruptions, followed by the WHO South-East Asian and Western Pacific Regions.

2025年的资金削减将对结核病防治项目造成毁灭性冲击，尤其对严重依赖国际援助的中低收入国家（LMICs）而言——美国作为该领域最大的双边捐赠国，其资金断供将使18个高负担国家的结核病防治陷入危机，这些国家原计划依赖美国承诺资金的89%。世卫组织非洲区域受资金链断裂影响最为严重，其次是东南亚及西太平洋区域。

“Any disruption to TB services – whether financial, political or operational – can have devastating and often fatal consequences for millions worldwide,” said Dr Tereza Kasaeva, Director of WHO’s Global Programme on TB and Lung Health. “The COVID-19 pandemic proved this, as service interruptions led to over 700 000 excess deaths from TB between 2020 and 2023, exacerbated by inadequate social protection measures. 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.”

“结核病服务领域的任何中断——无论是财务、政治还是运营层面——都可能对全球数百万人造成毁灭性且往往致命的后果。”世卫组织全球结核病和肺健康项目主任特蕾莎·卡萨耶娃博士表示，“新冠疫情已印证了这一点：2020至2023年间，服务中断导致结核病超额死亡病例超过70万例，而社会保护措施不足使情况进一步恶化。若不立即采取行动，结核病防治工作取得的来之不易进展将面临风险。我们必须迅速、战略性地调动充足资源开展联合应对，保护最脆弱群体，维持终结结核病的势头。”​

Mandated by heads of state, WHO plays a crucial leadership role in guiding countries toward the End TB targets for 2027 and 2030. Early reports to WHO from the 30 highest TB-burden countries confirm that funding withdrawals are already dismantling essential services, threatening the global fight against TB. This includes health and community workforce crises with thousands of health workers in high-burden countries facing layoffs, while technical assistance roles have been suspended, crippling national TB programs.

​​根据各国元首授权，世卫组织在指导各国实现2027年及2030年终结结核病目标中发挥着关键领导作用。来自30个结核病负担最高国家的早期报告显示，资金撤回已导致核心服务被逐步拆除，威胁全球结核病防治进程。这包括卫生与社区人力危机——高负担国家数千名卫生工作者面临裁员，技术援助岗位遭冻结，使国家结核病防治项目陷入瘫痪。

Drug supply chains are breaking down due to staff suspensions, lack of funds and data failures, jeopardizing access to TB treatment and prevention services. Laboratory services are severely disrupted, with sample transportation, procurement delays and shortages of essential consumables halting diagnostic efforts.

药品供应链因人员停职、资金链断裂及数据系统失效而濒临崩溃，严重危及结核病治疗与预防服务的可及性。实验室服务亦遭重创：样本运输受阻、采购延迟与基本耗材短缺三重困境叠加，导致诊断工作中断。

Data and surveillance systems are collapsing, undermining routine reporting and drug resistance monitoring. Community engagement efforts – including active case finding, screening and contact tracing – are deteriorating, reducing early TB detection and increasing transmission risks.

数据与监测系统正加速崩溃，导致常规报告机制失效与药物耐药性监测能力弱化。社区参与式防控网络——涵盖主动病例发现、筛查及接触者追踪等核心环节——持续恶化，不仅削弱早期发现能力，更使结核病传播风险呈指数级攀升。​

Without immediate intervention, these systemic failures will cripple TB prevention and treatment efforts, reverse decades of progress and endanger millions of lives.

若不采取紧急行动，这些系统性危机将摧毁结核病防治体系，使数十年成果付诸东流，并威胁数百万生命安全。​

In addition, USAID, the world's third-largest TB research funder, has halted all its funded trials, severely disrupting progress in TB research and innovation.

此外，作为全球第三大结核病研究资助方，美国国际开发署（USAID）已全面暂停其资助的所有试验项目，严重阻碍结核病研究及创新工作的推进。