ISLAMABAD: With 510,000 new cases each year, Pakistan ranks fifth among countries with the most cases of tuberculosis, but recent aid cuts by the US threaten to upend efforts to control the disease in the country.

In a statement on World TB Day observed on Monday, the World Health Organisation (WHO) said Pakistan makes up for 61pc of all cases in the Eastern Mediterranean Region (EMR).

Globally, the WHO estimated that 1.25 million children and young adolescents (aged 0 to 14) fall ill with TB each year, with nearly 600 children dying every day from the preventable and treatable disease.

In Pakistan alone, an estimated 81,000 children develop TB each year, often with subtle symptoms that delay diagnosis until the disease has advanced.

The statement issued by WHO claimed that in EMR, a person is diagnosed with TB every 34 seconds and every six minutes, a life is lost.

Country reports over 0.5m new cases each year; MSF calls upon govt, intl donors to make up for funding gap

TB spreads rapidly in refugee camps, slums, and among displaced people with weakened immune systems.

While Pakistan has the highest number of cases in the region, countries like Afghanistan, Somalia, Morocco and Sudan also face significant challenges.

“It is ironic that the world is still struggling to control a disease that has existed for 4,000 years,” the statement added.

It warned that Drug-resistant TB (MDR-TB) was becoming more common, making diagnosis and treatment more difficult.

MDR-TB required complex, long-term care, yet many healthcare workers lacked the training to manage it.

“TB remains the world’s deadliest infectious disease. Even during the Covid-19 pandemic, TB caused more deaths, claiming over 1.2 million lives annually.”

The WHO warned that if TB detection remained inadequate and drug-resistant strains continued to spread, “we could witness a historic rise in deaths and illnesses”.

According to the WHO, progress has been made worldwide in TB control, but EMR has lagged behind.

TACTiC initiative

Doctors Without Borders (MSF), an NGO, has urged governments and international donors to prioritise sustained investments in diagnosing, treating, and preventing TB with a critical focus on children.

In 2024, MSF launched the groundbreaking TACTiC initiative “Test, Avoid, Cure TB in Children” to adopt the latest WHO guidelines for pediatric TB management in Pakistan.

The programme began in Gujranwala, with a targeted household contact screening campaign enrolling 42 children under 15 for early intervention.

Building on this success, in March 2025 MSF inaugurated a decentralised model of care at the Baldia Rural Health Centre in Karachi.

It offers a comprehensive package of pediatric TB services, including on-site screening, advanced diagnostics, tailored treatment regimens and preventive treatment supported by mobile chest clinics and community outreach efforts to identify high-risk contacts and raise awareness, MSF stated.

“Children with TB are our most vulnerable patients, yet their symptoms are often so subtle that diagnosis is delayed until it is too late and has become life-threatening,” said Dr Ei Hnin Hnin Phyu, the medical coordinator for MSF Pakistan.

“Through TACTiC, we are detecting TB early and providing timely, life-saving treatment and prevention, giving these children a chance to thrive.”

Aid cuts

However, efforts to control TB are under threat due to the recent funding cuts by the US, which contributes over half of all international TB funding.

Due to the cuts, only 26 per cent of the $22 billion annual target has been met.

This shortfall jeopardises essential community-based services that drive active case finding, high-risk family screening, and TB preventive treatment for children, MSF reported.

MSF teams in Sindh reported that these cuts were undermining critical screening and treatment services.

Dr Cathy Hewison, the head of MSF’s TB Working Group, called upon all countries and international donors to step up and ensure sustained funding for TB care for all, especially young children.

The Pakistan Medical Association (PMA) has raised alarm over the number of TB cases in the country.

The PMA has emphasised the urgent need for more investment in combating the deadly disease.

PMA Secretary General Dr Abdul Ghafoor Shoro called for enhanced funding for innovative diagnostic tools, treatment regimens, and preventive strategies tailored to the Pakistani population.

“Tackling poverty, malnutrition, and poor living conditions, which are significant risk factors for TB, are critical for long-term control of the disease,” Mr Shoro added.

He said the government, international organisations, and public should join hands in the fight against TB.

Published in Dawn, March 25th, 2025