Pakistan faces alarming rise in TB cases, deaths
Tuberculosis (TB) continues to cast a long and deadly shadow across the globe, with Pakistan standing among the countries most affected by the disease. TB claimed over 1.25 million lives worldwide in 2023, with 8.2m new cases reported despite the fact that it is both preventable and curable.
For Pakistan, the numbers are especially sobering. Over 686,000 Pakistanis, including 81,000 children, developed TB last year. An estimated 47,000 lives were lost to the disease, many of them due to late diagnosis and lack of access to treatment.
Experts say that overcrowding, poverty, and weak healthcare infrastructure are some of the conditions where TB thrives.
What makes it particularly dangerous is its ability to spread silently. The infected individuals remain asymptomatic for months, unknowingly passing on the disease. While first-line treatment can cure most TB cases, the rising number of drug-resistant TB cases presents a serious public health threat.
In 2023, 15,000 people in Pakistan developed Rifampicin-resistant TB (RR-TB)—a particularly hard-to-treat form of the disease. Rifampicin, a cornerstone of TB treatment, becomes ineffective in such cases, forcing patients to rely on more complex and toxic second-line therapies. Historically, RR-TB treatment lasted up to two years and involved painful injections, often with disappointing outcomes. Fortunately, recent advances have introduced shorter, all-oral regimens such as BPaLM, offering hope for better results and fewer side effects.
Still, major challenges persist. Globally, less than 50% of RR-TB cases are diagnosed. In Pakistan, the figure is even lower—just 25% of estimated cases are identified and treated.
According to the National TB Programme, treatment success rate for RR-TB patients in 2021 was 74%, better than the 68% global average, but still well below the 95% success rate for drug-susceptible TB.
A senior health official explained, “A 74% success rate means that one in every four patients fails to complete treatment successfully." “That’s unacceptable for a disease we know how to cure.”
The fight against TB suffered a major blow in early 2025 when the United States slashed funding for global TB programmes. Of $22 billion required for global TB care in 2023, only 26% was secured.
The funding shortfall has triggered a domino effect with the result that the diagnostic labs reduced capacity, outreach programmes were closed and frontline healthcare workers laid off.
In high-burden countries like Pakistan, these cutbacks have all the more serious consequences. Programmes that provided mobile specimen collection and active case finding in remote areas were suspended, leading to further delays in diagnosis and treatment.
If the funding gap continues, millions more infections and deaths are feared to be projected by 2030. In this way gains of the past two years would go down the drains, public health experts warn.
Despite daunting obstacles, local organisations are stepping up. The Dopasi Foundation, for example, has played a pivotal role in sustaining Pakistan's TB response. Through digital innovations like eTB and RxTracker, they have helped local pharmacies and clinics report TB cases and refer patients for proper treatment.
In areas with limited healthcare access, Dopasi's mobile screening units—equipped with AI-powered X-ray systems—are reaching out to high-risk populations, such as mining communities and villagers.
Pakistan’s heavy reliance on international donors leaves its TB programmes dangerously exposed to external shocks. The government needs to intervene with domestic funding, strong healthcare system, and innovative financing options like social bonds and public-private partnerships.
Expressing her concern, the CEO of Dopasi Foundation noted that this reprioritisation process might lead to a decline in funding for community-based efforts, either because they lose Global Fund support or because governments divert resources to fill other gaps created by the retrenchment. Experts stress the importance of housing, nutrition, and sanitation—all of which affect TB risk and recovery.
The path to a TB-free Pakistan by 2030 is difficult but not impossible. Every undiagnosed patient, every interrupted treatment, and every funding cut takes the country a step back. At the same time, early detection, community intervention, and policy shift can bring it closer to that goal.