In Abuja, Nigeria’s capital, health workers recently gathered to urgently review drug inventories and testing data, grappling with the fallout of recent US funding cuts that threaten to undermine years of progress in battling tuberculosis (TB) in one of Africa’s hardest-hit countries.

For days, officials brainstormed ways to minimize the impact after the abrupt halt of US support for the TB Local Network (TB LON), a program vital for TB screening, diagnosis, and treatment across Nigeria.

“To effectively control TB, identifying cases is essential—but that effort is now ‘in a coma’ due to funding cuts,” said Ibrahim Umoru, coordinator of the African TB Coalition civil society network, who attended the meeting in Abuja. “This will inevitably lead to more undetected cases and a looming health crisis.”

This struggle to preserve essential TB programs is not limited to Nigeria. Similar disruptions are being felt from the Philippines to South Africa, as experts warn that the withdrawal of US aid jeopardizes global TB control efforts. Tuberculosis, which claims around one million lives annually, risks resurging with reduced testing, rising drug resistance, and ongoing conflicts.

The Trump administration’s cuts to the US Agency for International Development (USAID) have paused TB screening in Pakistan and Nigeria, hindered research in South Africa, and left survivors in India without critical support.

The World Health Organization (WHO) has expressed grave concern, warning that “drastic and sudden cuts in global health funding” could reverse decades of progress—progress that has saved approximately 79 million lives since 2000.

Nigeria’s TB Program at Risk

TB LON was launched in 2020 with $45 million in funding from USAID, which pledged to support a “TB-free Nigeria.” However, with the re-election of President Trump and his “America First” policy, funding for TB LON’s community testing was terminated in February this year, according to sources close to the project.

In Pakistan, where around 510,000 new TB cases emerge annually, aid reductions have disrupted community-based TB screening and services in the heavily affected Sindh province. Ei Hnin Hnin Phyu, medical coordinator for Médecins Sans Frontières (MSF) in Pakistan, warned that these cuts could disproportionately affect children, resulting in more TB cases and preventable deaths.

“Hard Work in Jeopardy”

TB claims the lives of approximately 268 Nigerians daily, with many cases historically going unreported, increasing transmission risk. The WHO estimates that one untreated TB patient can infect up to 15 others within a year.

Health workers involved in TB LON reported halting sample collection from January after the USAID funding freeze. Between 2020 and 2024, TB LON screened roughly 20 million people in Nigeria’s southwest and treated over 100,000 patients.

“Years of hard work are at risk if swift action is not taken,” Umoru stressed. The funding cuts have also led to layoffs of more than 1,000 contract workers responsible for TB screening.

Despite the crisis, Nigeria’s government has remained largely silent on the issue. However, First Lady Oluremi Tinubu declared TB a national emergency in March and donated 1 billion naira (about $630,000) toward eradication efforts by 2030.

South Africa’s Struggle to Sustain Progress

South Africa, where TB incidence has declined by 57% since 2015, also faces setbacks as MSF reports disruptions to TB and HIV programs nationwide, hampering patient tracking and testing.

Health Minister Aaron Motsoaledi announced a new “End TB” campaign aiming to screen five million people, while seeking fresh donor funding. He pledged that decades of progress in battling TB and HIV would not be allowed to collapse.

Threat to Critical Research

South Africa is a vital center for TB and HIV research, but funding shortfalls threaten about 39 clinical trial sites and dozens of ongoing studies. Lindsay McKenna of the Treatment Action Group emphasized that every major TB treatment or vaccine breakthrough in recent decades involved research from South Africa.

Malnutrition and HIV—affecting 8 million South Africans—heighten TB risk, with aid cuts further limiting nutrition programs and outreach efforts. Cathy Hewison of MSF called TB the leading killer of people with HIV.

Impact in the Philippines

In the Philippines, USAID funding cuts have disrupted four TB programs and caused drug shortages nationwide, according to the Stop TB Partnership. Ghazali Babiker of MSF Philippines noted that these shortages directly undermine the country’s TB elimination efforts.