Why Tuberculosis Still Kills Millions Despite a Vaccine and Effective Treatment

Despite the existence of a vaccine and effective treatments for over a century, tuberculosis continues to claim the lives of millions each year. According to the World Health Organization, the disease caused an estimated 1.23 million deaths worldwide in 2024, alongside 10.7 million new cases. The BCG vaccine, first administered in 1921, provides some protection against severe forms of the illness in children but offers limited prevention for adult pulmonary disease.

Antibiotics like streptomycin, discovered in 1943, have proven effective against drug-susceptible TB, yet this alone has not eradicated the disease. The most common regimen for treating drug-susceptible TB lasts six months, although shorter four-month regimens are now recommended for certain patients. However, sustained diagnosis and access to treatment are crucial, as undiagnosed cases and drug-resistant strains continue to fuel transmission.

The global incidence of TB fell by 1.7% from 2023 to 2024, the first decline since the COVID-19 pandemic, but this progress remains insufficient to meet the WHO's goal of cutting cases by 50% by 2025. The Americas have seen an increase in TB incidence over the past decade, with a 13% rise from 2015 to 2024, contrasting with the global decline of 12.3%.

Colombia, for instance, reported a 47% rise in TB incidence between 2015 and 2024, with 26,000 new cases in 2024 alone, including 1,300 cases of multidrug-resistant TB. Only 55% of those with multidrug-resistant TB completed treatment in 2024, highlighting the challenge of getting people diagnosed and on effective therapy before they can spread the infection.

The central obstacle in the fight against TB is the ability of health systems to detect cases early and provide appropriate treatment, rather than the availability of a cure.