WHAT THIS MEANS FOR ASIA
Asia, in particular, will feel the impact. The top five high-burden TB countries account for over half of all cases worldwide, and all are in Asia: India (26 per cent of global cases in 2023), Indonesia (10 per cent), China (6.8 per cent), the Philippines (6.8 per cent) and Pakistan (6.3 per cent).
The US supports TB control efforts to varying degrees in Cambodia, Indonesia, Myanmar, Philippines, Vietnam, Bangladesh, India and Pakistan. For some of these countries, the combined USAID and Global Fund contributions exceed domestic TB control budgets.
Their and other low- and middle-income countries’ heavy reliance on US foreign aid means – as World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus warned on Mar 17 – that they are “facing crippling breakdowns in their [TB] response”.
Already, nine countries have reported failing supply chains for anti-TB drugs. The consequences are a short- and medium-term rise in TB cases and deaths as health workers are laid off, diagnosis rates fall, and the supply of anti-TB drugs becomes intermittently interrupted. Drug-resistant TB cases may also increase significantly.
These countries cannot easily cover the funding shortfall by reallocating funds from other health programmes such as HIV, malaria, childhood vaccination and nutrition – these are often supported by the US and also facing similar cuts. Governments now face terrible choices in these health priorities.
