World TB Day 2026: A whole-of-society approach to end TB – sure, but how?

By guest contributors Tra Vu, Ashna Ashesh, and Luan Vo

Every year on March 24—the day of the discovery of the bacteria in 1882—the world is reminded that tuberculosis (TB) remains one of the world’s deadliest infectious diseases. Given that our global response continues to fall short of what is needed to end TB, it seems that every year we pay no heed to this reminder. However, given the current polycrises—be it conflict, climate change, or funding cuts—which will only serve to exacerbate inequity and in turn the TB burden, we must stop looking the other way.

Around the time that Robert Koch discovered the microbe, contemporaries such as Rudolph Virchow had already noted that TB is a social disease that requires social medicine. This observation holds true even today.

The World Health Organization’s End TB Strategy aptly outlines that progress against this social disease will depend not only on better tools but also on a fundamental shift in how TB is addressed, and importantly who we are able to pursue to join the cause—the systems and actors required to fight the disease at scale.

For too long, TB has been primarily regarded as a clinical and programmatic challenge. While gains have been made through improved screening tools, diagnostics, and treatment regimens, these advances alone are not enough. Progress remains uneven and vulnerable to disruption.

In our commentary “Pursuing policymakers, payors and public – expanding the beginning and end of the tuberculosis care cascade to reflect whole-of-society ambitions“ we argue that a whole-of-society approach is needed to end TB. This assertion on its own is likely to be uncontroversial. As usual, it is the ‘how’ that is the bigger question.

We think this question is best answered by those living the ‘how’: TB-affected persons and communities, financiers and policymakers.

Ingrid Schoeman, Director of TB Proof and an XDR-TB survivor, highlights the persistent gap between policy commitments and real-world impact. She underscores that community leaders are uniquely positioned to shape effective responses. They understand local priorities, can address stigma, and help ensure that services are accessible and acceptable. Ensuring that these voices are included in decision-making is not simply good practice. It is essential for advancing the right to health and driving uptake of TB innovations.

While we must do a better job listening to community voices, there also has to be enough fuel in the tank to make a difference. Too often the financial burden of eliminating TB is actually borne by affected communities. This stands in sharp contrast to the capital that is available for national security, economic development and financial speculation, even in low- and middle-income countries. Amandeep Singh, Senior Social Sector Specialist at the Asian Development Bank, explains that we are at a critical junction in global health financing, which requires a reform in the way countries view TB—from a cost burden to an investment opportunity to strengthen infrastructure and stabilize economic growth.

This shift toward domestic ownership is essential. Where political will and national financing have aligned behind TB responses, countries have seen measurable progress. However, political will is usually the missing piece. Empathy is an important, perhaps paramount, ingredient to elicit individual motivation, political will and social change. Simon Lee, Policy Lead for Malaria, Tuberculosis, Neglected Tropical Diseases at the United Kingdom’s Foreign, Commonwealth and Development Office, recounts the insights granted from an immersive experience in the field that helped to shape understanding, empathy and policy.

“The UK has provided nearly £4.8 million to support the Stop TB Partnership’s TB REACH Wave 11 Initiative. As part of this, we visited Vietnam last June to see the work of Friends for International TB Relief (FIT), who are delivering one of the Wave 11 projects.We travelled with colleagues from Global Affairs Canada, also Wave 11 funders, and members of the TB REACH team. FIT organised an outstanding programme that included meetings with the Government of Vietnam’s Deputy Health Minister, the National TB Programme, the National TB Reference Laboratory in Hanoi, and with people who had or were being treated for TB. We also visited Central Viet Nam to observe a rural health‑screening event, including TB screening, delivered as part of the project.From past experience I know that as a policy adviser and programme manager on TB based predominantly in London there’s a real limit to the extent to which you can understand the realities, complexities and challenges of countries’ TB responses. There is simply no substitute for travelling to see and understand the work you’re funding and the context in which it’s taking place. These visits reveal things you didn’t realise you didn’t know, and they can be genuinely transformative for future policy and programming. As an example, one specific realisation for me – that wouldn’t have come about but from our Vietnam trip – was on the potential opportunities from the new class of low cost near point of care tests. This in turn directly influenced a later decision to provide additional UK funding to TB REACH to help build the evidence base around their use.There is no single answer to improving engagement between donors, policymakers and affected communities. But meaningful field visits like the one we made to Vietnam are invaluable. They deepen understanding, build relationships, ground decision‑making in reality, and ultimately help donors like us make better, more informed choices for the future of TB programming.”

Simon Lee, Policy Lead – Malaria, Tuberculosis, Neglected Tropical Diseases, Foreign, Commonwealth and Development Office (FCDO)

Few people understand the need for political ownership better than Lucica Ditiu, Executive Director of the Stop TB Partnership. Her experience reflects years of engagement with government leaders, development banks, civil society, and TB-affected communities, which has mobilized engagement from Health Ministers to First Ladies and bi- and multilateral funders. She says that ending TB requires finding common ground between these groups and framing TB not only as a health issue, but as a shared societal risk and responsibility. Critically, Dr. Ditiu emphasizes that building alignment across diverse stakeholders is both possible and necessary.

This perspective is echoed by Norbert Ndjeka, Chief Director of TB Control and Management at South Africa’s National Department of Health. While acknowledging progress in diagnostics, treatment, and improved outcomes, he points to the somber reality that TB continues to claim tens of thousands of lives each year. For him, ending TB cannot rely on the health sector alone. It requires coordinated action across all sectors, including social development, to address the economic burden faced by people with TB and to overcome persistent barriers such as stigma and delayed care seeking. 

 Natalie Paruzel, Analyst for Infectious Diseases and Immunization with Global Affairs Canada, reminds us that the TB bacteria knows no borders and affects marginalized communities even in low TB burden countries like Canada. A whole-of-society approach must also involve a whole-of-global-society approach to eliminate TB, with the Global North and Global South jointly leading TB elimination efforts.

“TB is the world’s deadliest infectious disease and it is present all over the world, despite being preventable and treatable. It affects many aspects of society – individuals, families, health systems, economies, and so much more.  While Canada is a low-incidence country for TB, Indigenous Peoples and newcomers are disproportionately affected by the disease and efforts are underway for collaborative work between all levels of government, communities, provincial and territorial partners and Indigenous rights-holders to end TB. Canada is also at the forefront of supporting diagnostics, treatments and new innovations that are critical to ending TB globally, through its support to the Stop TB Partnership’s TB REACH and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Existing and new TB innovations are expansive, and we need to work together to ensure that decision makers at all levels are aware of the significant impacts these innovations can have at home and abroad if they are widely and effectively used.  The fight to end TB is not the responsibility of one or a few actors; it requires a whole-society approach. Hence, we must tell the story of ending TB in a way that resonates with all members of society, and especially decision-makers. We must share lessons learned, even between high and low burden countries, to address the epidemic globally. To end TB, we must work together to encourage decision makers from every region of the world to prioritize the fight against TB in their domestic and international engagements.”

Natalie Paruzel, Analyst, Infectious Diseases and Immunization, Global Affairs Canada

The message is clear. Ending TB will not be achieved through incremental improvements within the health sector. It requires an ambitious policy framework that engages the leaders of our countries and financing bodies they control, as well as the communities that power them. 

We call on our TB community to adopt whole-of-society ambitions. A good place to begin is the TB care cascade. This performance yardstick must start earlier, whereby whole-of-society must mean reaching the entire population in our efforts to end TB. It also must end later in recognition of the long-term social and economic consequences faced by TB survivors.

In turn, this requires engaging actors who have not traditionally been at the center of TB responses, including social protection systems, ministries of finance, planning bodies, and private sector partners. Without their involvement, critical gaps in funding, access, and equity will persist.

World TB Day is an opportunity to reaffirm commitments. It is also a moment to acknowledge shortcomings. The tools to end TB are increasingly within reach. What is needed now is the political will to act on them, the financing to sustain them, and the partnerships to deliver them equitably.

A whole-of-society approach is not an abstract concept. It is an ambitious but necessary conviction. Ending TB will depend on governments, communities, and global partners moving beyond traditional boundaries and working together to close the gaps that have allowed this disease to endure for far too long.

We thank Amandeep Singh, Ingrid Schoeman, Lucica Ditiu, Natalie Paruzel, Norbert Ndjeka, and Simon Lee for their generous time to contribute to this article, and for their tireless efforts to fight for a world free of tuberculosis within our lifetimes.