Rising Risks Highlight the Heavy Burden of Tuberculosis Care Worldwide

The global battle against tuberculosis (TB), a preventable and treatable airborne infection, faces unprecedented challenges as cases rise and resources dwindle. Despite being the deadliest infectious disease, TB continues to disproportionately affect vulnerable populations, and recent setbacks from the COVID-19 pandemic have exacerbated the situation.

Funding cuts, particularly from the U.S. government, which has historically supported TB prevention and treatment initiatives, threaten to undermine efforts to combat this chronic disease. The scarcity of resources is likely to facilitate the spread of drug-resistant strains of TB, putting millions at risk.

A recent study conducted by a team from the University of Ottawa's Faculty of Medicine sheds light on the severe economic implications of TB care. This collaborative research emphasizes that while many countries provide free treatment for TB, patients often incur significant out-of-pocket expenses that can destabilize their financial situation.

Under the guidance of an epidemiologist and health economist, the review led by Dr. Alice Zwerling compiled findings from 76 studies, primarily from low- and middle-income countries, and was published in PLOS Global Public Health. The research highlights alarming cost figures: patients with drug-resistant TB face an average total care cost of approximately $3,617, while those with drug-sensitive TB incur costs averaging $1,083. Such expenses can represent over 80% of a household's monthly income in many regions.

Dr. Zwerling notes that the perception of free TB treatment can lead to a misunderstanding of the actual financial burden on patients. Issues such as loss of income due to hospitalization or isolation during treatment can have a devastating impact on a family's finances.

As funding for essential services continues to decline, the pathways for TB diagnosis and treatment are expected to become longer and more complicated, potentially resulting in delayed care, increased community transmission, and broader socio-economic consequences.

The systematic review underscores the need for health policymakers and providers to develop sustainable strategies for TB management. Key recommendations include enhancing active case finding and improving access to drug resistance testing, which could significantly alleviate patient costs and curb transmission rates.

Looking ahead, the research team aims to conduct further studies to assess the financial burden of TB care in regions like Nunavut in Canada and parts of sub-Saharan Africa, where the economic impacts of TB are particularly pronounced.