Recent research on TB program financing yields three essential insights for policymakers and health leaders. First, three-quarters of high-burden countries possess demonstrable financial capacity to self-sustain TB responses, making domestic resource mobilization a viable strategy rather than an unrealistic aspiration.
Second, current donor-dependent models have created structural inefficiencies by circumventing national budget processes, weakening local capacity and accountability. This finding suggests that transitioning to domestic financing—where feasible—strengthens system resilience and improves coordination between TB programs and broader health budgets.
Third, low-income countries require continued targeted international support, as only 31% can achieve financial self-sufficiency. Rather than uniform donor withdrawal, countries should pursue income-adjusted strategies: upper-middle and lower-middle income nations can prioritize domestic reallocation, while low-income countries need sustained, predictable international partnerships paired with capacity-building assistance.
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