TB is spread through the air when a person with active pulmonary TB coughs, sneezes, speaks or sings, releasing infectious droplet nuclei that can remain suspended for hours in poorly ventilated spaces. Close, prolonged contact is the main risk factor. TB cannot be spread through surfaces, food, water or casual contact.

What is the difference between latent and active TB?

Latent TB infection means the bacteria are present but dormant — the immune system is containing them. People with LTBI have no symptoms and cannot transmit TB. Active TB occurs when the immune system can no longer contain the bacteria, causing symptoms. About one quarter of the world's population has LTBI; most will never develop active disease without a co-factor like HIV or malnutrition.

Drug-sensitive TB is treated with a standard 6-month regimen: isoniazid, rifampicin, pyrazinamide and ethambutol for 2 months, then isoniazid and rifampicin for 4 months. Treatment completion is essential — stopping early risks drug resistance. MDR-TB requires 18+ months of second-line drugs. New shorter regimens (BPaL — bedaquiline, pretomanid, linezolid) are now approved for XDR-TB.

Who is at highest risk of TB?

Highest risk groups include: people with HIV (20-30 times higher risk); close contacts of TB patients; recent migrants from high-burden countries; healthcare workers; prisoners; malnourished people; those with diabetes, kidney disease or on immunosuppressive therapy; and people who smoke heavily. Poverty, overcrowding and poor ventilation are the fundamental structural drivers.

What is drug-resistant TB and why is it a crisis?

MDR-TB develops when TB bacteria survive drug treatment — typically due to inadequate treatment, interrupted supply or inappropriate prescribing. 450,000 new MDR-TB cases occurred in 2022. Treatment requires 18+ months of toxic second-line drugs, with cure rates of only 60% even under optimal conditions. XDR-TB, resistant to virtually all first- and second-line drugs, remains an existential threat to TB control.

What is the connection between TB and HIV?

HIV is the single most powerful risk factor for TB — people living with HIV are 16-27 times more likely to develop active TB. TB is the leading cause of death among people with HIV, responsible for about one-third of HIV-related mortality. The WHO and UNAIDS mandate integrated TB/HIV services — testing, prophylaxis and co-treatment — to address both epidemics simultaneously.

Why did TB worsen during COVID-19?

COVID-19 caused the worst disruption to TB services in decades: lockdowns closed clinics, diverted health workers, stopped testing and interrupted drug supplies. TB deaths increased in 2020-2021 for the first time since 2005. An estimated 1.4 million fewer people received TB treatment in 2020 than in 2019. The COVID-19 experience exposed how fragile TB programmes are without sustained primary health care delivery.

Is there a TB vaccine?

The BCG vaccine (1921) is still the only licensed TB vaccine. It protects young children well against severe forms but provides inconsistent protection against adult pulmonary TB. New vaccine candidates in trials include M72/AS01E, which showed 50% efficacy in a Phase IIb trial against active pulmonary TB — a promising result that has energised the TB vaccine field.

What is the End TB Strategy?

The WHO End TB Strategy, adopted by the World Health Assembly in 2014, targets a 90% reduction in TB deaths and 80% reduction in TB incidence by 2030 vs 2015, with zero TB-affected families facing catastrophic costs. Its three pillars are: integrated patient-centred care; bold policies and supportive systems; and intensified research and innovation. Progress is severely off-track, particularly after the COVID-19 setback.

How does poverty drive TB?

TB is fundamentally a disease of poverty. Poverty drives overcrowding and poor ventilation (increasing transmission), malnutrition (weakening immune defences), delays in diagnosis and incomplete treatment. TB's social determinants explain why it persists despite 70 years of effective antibiotic treatment. Addressing TB requires social protection, housing, nutrition support and equitable health system access alongside biomedical interventions.

What is the Stop TB Partnership?

The Stop TB Partnership (hosted by UNOPS, Geneva) brings together over 1,500 organisations and develops the Global Plan to End TB — the investment case for achieving WHO's End TB Strategy. It also manages the Global Drug Facility (GDF), which procures and supplies quality-assured TB medicines to over 100 countries, enabling access at negotiated low prices.

How does GMJ News cover TB?

GMJ News tracks annual WHO Global TB Report releases, clinical trial results for new regimens and vaccine candidates, Stop TB Partnership milestones, and TB in the WHO European region — of direct relevance to Georgia. All statistics are sourced to the WHO Global TB Report and updated annually.

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Tuberculosis

GMJ News knowledge hub · last reviewed September 2026 · Georgian Medical Journal

Summary Statistics Glossary GMJ news FAQ Documents Organizations Research

Tuberculosis has returned to being the world's deadliest infectious disease: about 10.8 million people fell ill and 1.25 million died in 2023 (WHO Global TB Report 2024) — despite being preventable and curable. Drug-resistant TB remains a public-health crisis, while shorter all-oral regimens (BPaLM) and renewed vaccine pipelines offer real momentum toward the WHO End TB Strategy targets.

Key messages

Scale

TB is the world's second deadliest infectious disease: 7.8 million people newly fell ill with TB in 2022 — the highest ever recorded — and 1.13 million died (WHO Global TB Report 2023).

Preventable and curable

TB can be prevented with the BCG vaccine and latent TB treatment, and cured with a standard 6-month antibiotic course. Yet millions go undiagnosed and treatment completion rates fall short.

Drug resistance

450,000 people developed MDR-TB in 2022 — resistant to the two most powerful first-line drugs — requiring 18+ months of more toxic treatment with far lower cure rates.

TB/HIV co-infection

TB is the leading cause of death among people living with HIV, accounting for about one-third of all HIV-related mortality. Integrated TB/HIV responses are essential.

COVID-19 setback

The pandemic disrupted TB services so severely that TB deaths increased in 2020-2021 for the first time in a decade, reversing hard-won progress toward the End TB Strategy targets.

End TB Strategy

The WHO End TB Strategy targets a 90% reduction in TB deaths and 80% reduction in incidence by 2030 compared to 2015 — progress remains severely off-track.

Key statistics

7.8M

new TB cases (2022)

WHO GTB 2023

1.13M

TB deaths (2022)

WHO GTB 2023

450K

MDR-TB cases (2022)

WHO GTB 2023

66M

lives saved 2000-2022

WHO GTB 2023

30%

of HIV deaths are TB

UNAIDS 2022

2nd

deadliest infectious disease

WHO

TB incidence rate (per 100,000 population) 2000-2022 — WHO Global TB Report

Source: WHO Global TB Report (annual series). COVID-19 disruption visible 2020-2021.

Glossary of key terms

Active TB disease
WHOTB infection in which bacteria are actively multiplying, causing symptoms (cough, fever, night sweats, weight loss) and the potential to transmit infection to others.

Latent TB infection (LTBI)
WHOPersistent immune response to M. tuberculosis without evidence of active disease. People with LTBI are not infectious but have a 5-15% lifetime risk of developing active TB.

MDR-TB
WHOMultidrug-resistant TB — resistant to at least rifampicin and isoniazid, the two most powerful first-line drugs. Requires longer, more toxic, more expensive treatment with lower cure rates.

XDR-TB
WHOExtensively drug-resistant TB — MDR-TB plus resistance to fluoroquinolones and at least one second-line injectable. Extremely difficult to treat.

BCG vaccine
WHOBacille Calmette-Guerin — the only licensed TB vaccine. Highly effective against severe TB in young children but less protective against adult pulmonary TB.

DOTS
WHODirectly Observed Therapy Short-course — the WHO-recommended TB treatment strategy involving supervised medication-taking to ensure treatment completion.