Combating Tb in an Era of Global Health Challenges

Tuberculosis (TB), once considered on a path toward eradication, has experienced a concerning resurgence, posing a major global public health threat. Despite being preventable and curable, socio-economic, immunological, and geopolitical factors have hindered TB control, contributing to its re-emergence. In 2022, an estimated 10.6 million individuals developed TB, and 1.3 million died, highlighting the ongoing burden of the disease. Key drivers of this resurgence include co-infection with human immunodeficiency virus (HIV), irregular migration due to armed conflicts and humanitarian crises, and the increasing use of immunosuppressive therapies such as anti-tumor necrosis factor (anti-TNF) drugs. HIV co-infection compromises immune defenses, increasing susceptibility to TB and complicating treatment outcomes, particularly in sub-Saharan Africa. Irregular migration exposes displaced populations to overcrowded and poorly resourced living conditions, facilitating TB transmission, as exemplified by Türkiye’s refugee populations. Moreover, the use of anti-TNF agents for inflammatory diseases reactivates latent TB infections, emphasizing the need for integrated TB screening and management strategies. Addressing the resurgence of TB requires coordinated public health interventions, enhanced screening protocols, and targeted strategies to mitigate the impacts of HIV, migration, and immunosuppressive therapies on TB control, particularly in high-burden and vulnerable populations