Yes! We Can End TB: Led by Countries, Powered by People

1. Overview
Tuberculosis (TB) is one of the oldest and most lethal infectious diseases in human history. Caused by the bacterium Mycobacterium tuberculosis, it primarily attacks the lungs, yet it is capable of affecting virtually any organ. Despite the existence of effective vaccines, diagnostics, and treatments for decades, TB continues to claim more than one million lives every year — the vast majority in low- and middle-income countries.
Every year on 24 March, the global health community marks World Tuberculosis Day. The date honours the 1882 announcement by German physician Dr Robert Koch, who identified M tuberculosis as the causative agent of TB — a discovery that fundamentally shaped modern medicine. In 2026, the World Health Organization (WHO) and the Stop TB Partnership set the theme: “Yes! We Can End TB: Led by Countries, Powered by People.” This theme signals a decisive shift from global aspiration to concrete, country-owned, community-powered action.
TB is preventable, diagnosable, and curable. Yet it remains the world’s second deadliest infectious disease after COVID-19 during pandemic years. The paradox of a curable disease killing over a million people annually is a moral, political, and public health failure — one that World TB Day 2026 calls every nation to correct.

2. Global Prevalence
According to the WHO Global Tuberculosis Report 2025, approximately 10.7 million people developed TB globally in 2024 — the fourth consecutive year of elevated incidence following the disruptions caused by the COVID-19 pandemic. Of these, an estimated 1.23 million people died: roughly 1.08 million HIV-negative individuals and 150,000 people living with HIV. Drug-resistant TB (DR-TB) remains a critical challenge, with an estimated 150,000 new DR-TB cases recorded in 2024.
Global reduction in TB incidence from 2015 to 2024 stands at only 12.3 per cent — far short of the WHO End TB Strategy milestone target of a 50 per cent reduction by 2025. South-East Asia alone, home to less than a quarter of the global population, accounts for more than one in every three new TB cases worldwide. Encouragingly, coordinated global TB control efforts have saved an estimated 83 million lives since 2000, demonstrating the transformative impact of sustained international action. However, COVID-19 disruptions reversed hard-won progress and accelerated undetected transmission, making the recovery period of 2022–2026 critically important.
TB is fundamentally a disease of inequity, driven by poverty, overcrowding, malnutrition, and limited access to healthcare. Ending it will demand not only medical interventions but comprehensive, multisectoral strategies that address these upstream social determinants.

3. Tuberculosis in Myanmar
Myanmar carries one of the heaviest TB burdens in the world and is designated as one of the WHO’s 30 high-TB-burden countries. According to the WHO South-East Asia Regional Office, Myanmar’s TB incidence rate in 2024 was approximately 480-500 cases per 100,000 population — far above the regional average of 201 and the global average of 131 per 100,000. In absolute terms, an estimated 263,000 people developed TB in Myanmar in 2024. Approximately 50,000 deaths annually are attributed to the disease
Myanmar faces what public health experts describe as a “triple burden” — drug-susceptible TB, drug-resistant TB, and HIV-associated TB — making its TB response among the most complex in the region. The fourth National TB Prevalence Survey conducted between 2017 and 2018 found a bacteriologically confirmed TB prevalence of 468 per 100,000 adults, though this represented a notable 51 per cent reduction from the 2009-2010 survey, reflecting an average annual decline of 7.6 per cent. This steady progress demonstrates that Myanmar’s National TB Programme, with international support, has been making significant gains.
The COVID-19 pandemic severely disrupted that trajectory. In 2020, case detections fell by approximately 40 per cent compared to the prior year, reversing years of achievement and leading to increased rates of undiagnosed and untreated TB — particularly among vulnerable populations in urban slums, and hard-to-reach communities. Recovery since 2022 has been notable, and a 2025 hybrid WHO review commended the Ministry of Health for maintaining essential TB services under exceptionally difficult conditions. Myanmar is now in the process of developing its National Tuberculosis Strategic Plan 2026-2030, which aims to close detection gaps, scale up preventive treatment, and restore the downward trend in incidence.

4. Signs and Symptoms
The clinical presentation of TB varies by the site of infection and the immune status of the individual. Pulmonary TB — the most common form — primarily manifests with respiratory and systemic symptoms. Extrapulmonary TB, in which the bacterium spreads beyond the lungs, can affect virtually any organ and may present with diverse, organ-specific features.
Pulmonary TB
The hallmark of pulmonary TB is a persistent productive cough lasting two weeks or more, sometimes with blood-streaked sputum or frank haemoptysis. Chest pain, tightness, and progressive shortness of breath are also common. Systemic symptoms accompanying pulmonary TB include prolonged low-grade fever (often worse in the evenings), drenching night sweats, significant unexplained weight loss, loss of appetite, and persistent fatigue. The combination of these symptoms in a patient from a high-burden country like Myanmar should prompt immediate TB evaluation.
Extrapulmonary TB
When TB disseminates beyond the lungs, it may present as painless cervical lymph node swelling (scrofula), back pain and spinal deformity in Pott’s disease, severe headache and neck stiffness in TB meningitis, joint pain and swelling in musculoskeletal TB, abdominal pain and ascites in abdominal TB, or haematuria and flank pain in genitourinary TB. In young children under five and immunocompromised individuals — including people living with HIV — TB may present atypically, and severe disseminated or miliary TB can develop rapidly, with non-specific systemic features that may not suggest the diagnosis without a high index of suspicion.

5. Risk Factors
TB infection and disease progression are shaped by a complex interplay of host vulnerability, pathogen exposure, and environmental conditions. The following groups carry the highest risk and are priority targets for screening and preventive intervention.
Immunocompromised states markedly increase the risk of progression from TB infection to active disease. HIV infection remains the single most powerful individual risk factor for TB — a person living with HIV is up to 18 times more likely to develop active TB than an HIV-negative individual. Diabetes mellitus is an increasingly significant risk factor in Asia, where its prevalence is rising rapidly. Other immunosuppressive conditions and treatments — including renal failure, malnutrition, corticosteroids, and tumour necrosis factor-alpha inhibitors — similarly elevate risk.
Beyond medical vulnerabilities, social and environmental determinants are equally critical. Poverty, overcrowding, poor housing, food insecurity, and incarceration create conditions in which TB spreads readily and goes undetected. Smoking and alcohol use disorder are independent risk factors. Healthcare workers exposed to active TB cases, miners at risk of silicosis, and migrants or displaced persons from high-burden settings are among the occupational and demographic groups requiring particular attention. In Myanmar’s specific context, populations in urban slums and individuals in hard-to-reach communities are among the most vulnerable.

6. Diagnosis
Early and accurate diagnosis is the cornerstone of TB control. Delayed diagnosis sustains transmission, worsens outcomes, and drives drug resistance. Multiple modalities are available, and their appropriate use depends on available resources and clinical context.
Sputum smear microscopy — examining sputum for acid-fast bacilli — is rapid and widely available but offers limited sensitivity, particularly in HIV-positive patients and children. Sputum culture on Lowenstein-Jensen or liquid MGIT media remains the diagnostic gold standard, detecting TB and drug susceptibility with high accuracy, but takes two to eight weeks. The Xpert MTB/RIF and Xpert MTB/RIF Ultra assays represent a transformational advance: these WHO-recommended rapid molecular tests detect M. tuberculosis and rifampicin resistance within two hours and are now widely used in Myanmar’s TB diagnostic network. Line probe assays provide additional drug resistance profiling.
Chest X-ray is an indispensable screening and diagnostic tool, identifying pulmonary infiltrates, cavitations, and pleural effusions characteristic of TB. CT scanning offers higher resolution for complex or atypical presentations. For the detection of latent TB infection, the Tuberculin Skin Test (Mantoux) and Interferon-Gamma Release Assays (IGRAs) are used, with IGRAs offering greater specificity in BCG-vaccinated populations such as Myanmar’s.
A landmark development for World TB Day 2026 is the WHO’s Call to Action, urging Member States to fast-track the rollout of the first-ever WHO-recommended near point-of-care diagnostic tests. These tests are designed to be deployed at health centres and community-level facilities, dramatically reducing diagnostic delays that fuel transmission and preventable deaths — a critical development for high-burden settings like Myanmar.

7. Treatment
TB is curable. Treatment success depends on timely initiation, accurate drug susceptibility testing, and full adherence to the prescribed regimen. Myanmar’s National TB Programme delivers treatment through the directly observed therapy, short-course (DOTS) strategy.
Drug-Susceptible TB
The standard first-line regimen for drug-susceptible TB is a six-month course: two months of Isoniazid, Rifampicin, Pyrazinamide, and Ethambutol, followed by four months of Isoniazid and Rifampicin (2HRZE/4HR). When completed as prescribed, treatment success rates exceed 85 per cent. HIV-positive TB patients require concurrent antiretroviral therapy — initiated within two to eight weeks of starting TB treatment — alongside cotrimoxazole preventive therapy.
Drug-Resistant TB
Multidrug-resistant TB (MDR-TB), resistant to at least isoniazid and rifampicin, and extensively drug-resistant TB (XDR-TB) represent the most challenging treatment scenarios. New all-oral regimens — BPaL (Bedaquiline, Pretomanid, Linezolid) and BPaLM (with Moxifloxacin) — have transformed the management of MDR/XDR-TB, reducing treatment duration from 18-24 months to as little as six months with improved outcomes. WHO recommends these regimens as priority options, and their rollout in Myanmar is a strategic priority.
TB Preventive Treatment
For individuals with latent TB infection — those infected but not yet ill — TB Preventive Treatment (TPT) is a proven strategy to prevent progression to active disease. Recommended regimens include six months of daily isoniazid (6H), three months of weekly rifapentine plus isoniazid (3HP), or one month of daily rifapentine plus isoniazid (1HP). Scale-up of TPT for household contacts and PLHIV is central to Myanmar’s 2026-2030 strategic plan.