Tuberculosis (TB), long overshadowed by modern pandemics like COVID-19, remains the world’s deadliest infectious disease.

Despite decades of global efforts to control it, TB killed an estimated 1.3 million people in 2022, according to the World Health Organization (WHO)—more than HIV/AIDS and malaria.

Now, health experts warn that the United States may be facing a potential resurgence of this ancient killer.

The WHO’s 2023 Global Tuberculosis Report revealed a troubling trend: TB infections are rising globally for the first time in years, particularly in regions affected by healthcare disruptions caused by the COVID-19 pandemic.

Countries such as India, Indonesia, and the Philippines experienced severe declines in TB detection and treatment services, leading to increased transmission and more drug-resistant strains.

According to the Centers for Disease Control and Prevention (CDC), the United States saw a 16% increase in TB cases from 2022 to 2023—the highest year-over-year jump in over a decade.

The CDC recorded 8,300 TB cases in 2023, a number that, while relatively low compared to global figures, reflects a disturbing reversal of a downward trend seen since the 1990s.

Dr. Philip LoBue, director of the CDC’s Division of Tuberculosis Elimination, told NBC News in March 2024 that the spike is “a wake-up call” for public health agencies.

“We’re seeing TB cases pop up in communities with limited resources and among populations that may not have adequate access to healthcare, including immigrants, the homeless, and incarcerated individuals.”

More alarming is the rise of multidrug-resistant tuberculosis (MDR-TB), which the New York Times recently described as “a looming global health emergency.”

MDR-TB does not respond to the two most powerful first-line anti-TB drugs, making it more difficult and expensive to treat. In 2022 alone, nearly 500,000 cases of drug-resistant TB were reported globally, per the WHO.

Health officials in California, Texas, and New York have reported isolated MDR-TB outbreaks in recent years, often linked to international travel or migration.

In a 2024 report by Kaiser Health News, several U.S. hospitals reported difficulty obtaining newer TB drugs like bedaquiline due to supply chain disruptions and lack of funding for TB programs.

The recent rise in immigration from TB-endemic countries has added urgency to the situation. While immigrants are screened for TB before entering the U.S., latent TB infections can evade early detection and manifest years later.

A 2023 report from the Brookings Institution stressed the importance of enhancing post-arrival screening and long-term care.

Yet public health funding remains a hurdle. As Politico reported in February 2024, federal funding for TB programs has stagnated, even as the costs of testing and treatment have surged.

Experts argue this leaves the U.S. ill-prepared for a potential outbreak, especially of drug-resistant strains.

Despite the CDC’s ongoing efforts to enhance TB surveillance and treatment, many health experts believe the country is not adequately prepared for a full-scale outbreak.

“We’ve let our guard down,” said Dr. Anthony Fauci, former head of the National Institute of Allergy and Infectious Diseases, in a January 2024 interview with STAT News. “TB has never gone away, and in a globalized world, diseases don’t respect borders.”

Hospitals and clinics nationwide are already grappling with resource strain post-COVID, and adding TB to the equation could overwhelm vulnerable systems. Furthermore, public awareness of TB is low, with most Americans viewing it as a disease of the past.