Health
Tuberculosis Emerges as Leading Infectious Disease, Affecting 10.8 Million People Worldwide
Tuberculosis Emerges as Leading Infectious Disease, Affecting 10.8 Million People Worldwide
In a resurgence that has health officials alarmed, tuberculosis (TB) has once again claimed the title of the world’s deadliest infectious disease, with new cases reaching a record high of 10.8 million in 2023, according to the World Health Organization (WHO). This represents a stark increase from the 10.1 million cases recorded in 2020, illustrating the ongoing challenge in managing this ancient but persistent disease.
TB, a highly contagious airborne infection primarily targeting the lungs, is fueled by factors like undernutrition, HIV, diabetes, smoking, and alcohol abuse. Despite a drop in TB-related deaths, the toll remains high, with 1.25 million fatalities recorded last year, placing TB above COVID-19 as the leading infectious cause of death for the first time in three years.
The global distribution of TB cases highlights significant regional and national disparities. India accounts for 26% of all new cases, followed by Indonesia at 10%, with China, the Philippines, and Pakistan each contributing over 6%. Southeast Asia, Africa, and the Western Pacific emerged as the hardest-hit regions, collectively representing 86% of cases.
“TB occurs in every part of the world,” said Dr. Tereza Kasaeva, head of WHO’s global TB program, during a recent press briefing. “But we are not on track to eliminate it.”
Challenges in Containment
Despite advances in TB treatments, rapid diagnostics, and ongoing vaccine research, Kasaeva expressed concern that global efforts are falling short of the United Nations General Assembly (UNGA) targets set for 2027. These targets aim to provide rapid diagnostic testing and preventive treatment to those at risk, yet only 48% of newly diagnosed TB patients received a rapid test last year. Among high-risk groups, 56% of individuals with HIV and 21% of household contacts of TB patients received preventive care.
Drug-resistant TB remains a significant hurdle. In 2023, an estimated 400,000 people developed multi-drug-resistant TB, though only 44% of these patients were accurately diagnosed and treated. This lack of treatment access is particularly troubling, as drug-resistant TB requires more costly and complicated care. “Drug-resistant TB continues to pose a major public health threat,” Kasaeva warned, underscoring the need for timely access to effective treatments.
Funding Shortfalls Impede Progress
The UNGA has set a funding target of $22 billion to combat TB through prevention, diagnostics, and treatment. However, as of last year, only 26% of this goal had been met, with $5.7 billion allocated worldwide. Research funding is similarly limited, with only $1 billion allocated toward the $5 billion target in 2022. Kasaeva highlighted the pressing need for increased investment, noting that low- and middle-income countries are especially constrained by the current funding gap.
Despite these financial challenges, there are promising developments in TB vaccine research. Six vaccine candidates are in late-stage clinical trials, with the WHO optimistic that a new TB vaccine could become available within the next few years. “We’re seeing clinical trials in the hardest-hit countries, and preparations for vaccine distribution should begin now,” Kasaeva noted, expressing hope for future breakthroughs.
With cases of drug-resistant TB rising and funding for prevention and care lagging, health officials are calling for urgent international support to bridge financial and logistical gaps. The resurgence of TB underscores the need for a comprehensive, well-funded approach to contain what remains a leading cause of death worldwide.
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Uzbekistan to Launch Nationwide State Medical Insurance System in 2026
Uzbekistan will begin introducing a nationwide state medical insurance system from 2026, part of a broader overhaul of the country’s healthcare financing and service delivery. The reform will introduce digital referrals, a national health insurance fund, and a guaranteed package of essential medical services funded through the state budget. Officials say the changes aim to improve efficiency, expand access, and reduce informal payments.
“State health insurance is a social protection system designed to guarantee access to quality healthcare services,” said Zokhid Ermatov, executive director of the State Health Insurance Fund.
Discussions about state medical insurance in Uzbekistan began in 2017, but implementing such a system required years of preparation. The State Health Insurance Fund was formally established in December 2020, and pilot programmes launched in the Syrdarya region in 2021 tested new financing mechanisms, regulatory frameworks, and digital health systems. In November 2025, the Cabinet of Ministers approved regulations governing how medical care funded through the state budget will be provided in public and private medical institutions, with the rules set to come into force on January 1, 2026.
At the centre of the new model is stronger primary healthcare. Patients will first visit their assigned family clinic, where doctors provide consultations, prescribe tests, and determine whether specialist care is needed. If necessary, patients will receive an electronic referral to hospitals or specialists. Emergency and urgent care will remain available without referrals.
The reform introduces a patient-centred financing model, where healthcare providers are paid by the State Health Insurance Fund based on services delivered. Primary healthcare will be funded through capitation payments, while hospital treatment will follow case-based payments, a structure designed to improve efficiency and treatment outcomes.
A fully digital referral system will allow patients to choose hospitals from a list of institutions contracted with the State Health Insurance Fund using a government portal or mobile app. Referrals will remain valid for 60 days, and waiting lists and hospitalisations will be managed through a unified electronic health information system.
The insurance system guarantees essential healthcare services, including family doctor consultations, diagnostic tests, outpatient treatment, preventive screening, some medicines, hospital care, and certain rehabilitation services. Patients will not be charged additional fees for services included in the approved package.
Funding for the program will come primarily from the state budget, ensuring citizens do not pay direct insurance contributions. Priority access will be given to socially vulnerable groups, including children with disabilities, orphans, pensioners, pregnant women, unemployed citizens, and low-income families. The State Health Insurance Fund will allocate resources across regions to strengthen medical services and reduce inequalities.
International organisations have praised Uzbekistan’s approach, noting that general tax financing and universal coverage can improve financial protection and ensure predictable healthcare funding. Jessika Yin, Health Policy Adviser at the World Health Organization in Uzbekistan, said the reforms align with global trends toward universal health coverage.
If implemented successfully, Uzbekistan’s state medical insurance system could represent a major step toward universal healthcare, ensuring that people receive care without facing financial hardship.
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