Impact of Tuberculosis Funding Cuts – Center for Health Decision Science

CHDS’ Allison Portnoy, Nicolas Menzies, and collaborators authored a recent modeling study that examined how the dismantling of the United States Agency for International Development (USAID) and potential reductions in support from the Global Fund to Fight AIDS, TB, and Malaria (Global Fund) could affect the household economic burden of tuberculosis (TB) in low- and middle-income countries.

The study analyzed 79 low- and middle-income countries and evaluated six funding scenarios involving reductions in international donor funding for TB programs. The analysis estimated that ending USAID funding alone would result in an additional $7.5 billion in patient-incurred TB costs and nearly 4 million more households experiencing catastrophic TB-related costs between 2025 and 2050. “These findings highlight how international funding has played a critical role in expanding access to TB diagnosis and treatment,” said Portnoy. In the most extreme scenario, the elimination of all external funding for TB programs was projected to generate nearly $80 billion in additional household costs and more than 40 million additional households facing catastrophic financial burdens. The study also found that the greatest impacts would fall on the poorest households, with more than half of the additional catastrophic costs occurring among the lowest-income 20% of households.

The authors concluded that abrupt reductions in international donor funding could reverse recent progress in financial risk protection and health equity in low- and middle-income countries. “Without sustained support from donors such as USAID and the Global Fund, many countries could see disruptions in essential TB services, leading not only to worse health outcomes, but also to severe financial hardship for families—particularly the poorest households,” Portnoy explained. They emphasized that strategies to reduce disruptions to TB testing and treatment services and protect vulnerable populations were urgently needed.

Learn more: Read the publication, The Potential Impact of Reduced International Donor Funding on the Household Economic Burden of Tuberculosis in Low- and Middle-Income Countries: A Modeling Study
Learn more: Read the Boston University press release, Foreign Aid Cuts to Tuberculosis Services Could Cost Families $80 Billion Worldwide