“Funding Cuts to Tuberculosis Programmes Endanger Millions of Lives”- WHO Warns

The World Health Organization (WHO) has issued a stark warning that funding cuts to tuberculosis (TB) programs could endanger millions of lives globally, including in Sierra Leone, where TB remains a major public health threat. The crisis stems from the United States Agency for International Development (USAID) halting its TB-funded trials, a move that is severely disrupting research, innovation and treatment efforts.

Sierra Leone, one of the 30 high-burden TB countries, heavily depends on international donor support for its TB response. The country recorded approximately 18,000 TB cases in 2022, with an estimated 5,000 TB-related deaths, according to WHO. The USA has been the largest bilateral donor to global TB efforts, providing $200–250 million annually, which accounted for about a quarter of total international donor funding. However, with the upcoming 2025 funding cuts, 18 high-burden countries, including Sierra Leone, are at severe risk, as they depend on 89% of the expected U.S. funding for TB care.

A Looming Health Crisis- The funding crisis is already having catastrophic effects on TB prevention, diagnosis, and treatment services, with critical failures across health systems. WHO reports drug supply chains are breaking down, leaving many without life-saving medication. Laboratory services are severely disrupted, leading to delays in diagnosis and treatment, whilst surveillance systems are collapsing, making it harder to monitor drug resistance and TB outbreaks.

Meanwhile, Community engagement programs such as contact tracing and screening are deteriorating, leading to increased transmission rates.

Dr. Tereza Kasaeva, Director of WHO’s Global TB Programme, warned that “any disruption to TB services, whether financial, political, or operational, can have devastating and often fatal consequences for millions worldwide.”

Sierra Leone’s TB Fight in Jeopardy- Sierra Leone has made significant progress in TB control over the past two decades, with increased testing and treatment services preventing thousands of deaths. However, these gains are now at risk. The country has struggled with a high TB-HIV co-infection rate, and funding cuts could worsen the situation by limiting access to essential diagnostic tools and medicines.

Health experts warn that without sustained funding, Sierra Leone’s already fragile health system could face a surge in TB cases, leading to increased mortality and economic strain on families. The COVID-19 pandemic had already set back TB efforts, with service disruptions causing over 700,000 excess TB deaths globally between 2020 and 2023, according to WHO.

With TB remaining the world’s deadliest infectious disease, WHO is calling for urgent global action to secure sustainable funding for TB programs. The organization is working with governments, civil society, and international partners to find alternative funding sources and ensure that progress toward the End TB targets for 2027 and 2030 is not lost.

For Sierra Leone, maintaining and expanding TB services will require stronger domestic health investments and new partnerships to offset donor shortfalls. Failure to act could see years of progress undone, putting thousands of lives at risk.