This GBD 2023 systematic analysis quantified the global, regional, and national burden of TB, HIV-related TB, and MDR-TB across 204 countries and territories from 1990–2023, and evaluated progress toward WHO End TB 2035 targets for incidence and mortality reduction.
In 2023, TB caused ~9.11 million incident cases, 1.22 million deaths, and 54.6 million DALYs globally. HIV-related TB accounted for 781,000 cases and 210,000 deaths; MDR-TB for 466,000 cases and 102,000 deaths. From 2015–2023, all-form TB incidence fell 19.2% and deaths fell 22.6%—far short of the WHO 2035 targets of 90% and 95% reductions, respectively. Eliminating smoking, alcohol, and high fasting glucose could reduce TB deaths to 768,000 and MDR-TB deaths to 77,200.
- Estimates carry wide uncertainty intervals, especially for MDR-TB (e.g., 198,000–1,080,000 incident cases). - Vital registration and surveillance data quality vary widely across the 204 countries, with reliance on verbal autopsy and tissue sampling in low-data settings. - The analysis predates the full impact of recent global health funding cuts, so disruptions may not be captured.
Progress toward WHO End TB targets is well behind pace, especially for MDR-TB and in Latin America, the Caribbean, and sub-Saharan Africa—clinicians and public health teams should prioritize early drug-resistance testing and address modifiable risk factors (smoking, alcohol, dysglycemia) as part of TB care. Funding volatility poses a direct threat to TB control programs; advocacy for sustained investment is clinically relevant.
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