When people hear about tuberculosis, they tend to assume it's long gone. However, as the most deadly infectious disease on the planet, it's still alive and well. Just this week, a case of TB was reported at Waukegan High School in Illinois. While the disease can be treated with antibiotics, resistance is becoming more of an issue. And Trump's health policies could increase the spread globally.
TB or not TB
Tuberculosis is a "near-perfect predator," John Green said in his book "Everything is Tuberculosis." The bacterial infection, caused by the organism Mycobacterium tuberculosis, mostly affects the lungs, but can also affect the kidneys, liver, heart, genitals and other organs. The disease can be spread through the air, and those with HIV, AIDS or who are otherwise immunocompromised are more susceptible. The good news is that with proper health care, TB is treatable and preventable. However, without it, TB has an approximately 50% death rate.
Researchers have traced TB in humans to approximately 9,000 years ago, making it a disease that has persisted through millennia. Even today, the disease is a worldwide public health crisis and cases have been rising recently. A report by the World Health Organization found a 10% surge in pediatric TB in 2023, compared to the previous year. In January 2025, Kansas experienced "one of the largest recorded tuberculosis outbreaks" in U.S. history, said ABC News. "TB cases are rising again in Europe and elsewhere because of disruption of diagnostic and therapeutic services due to armed conflicts, Covid-related avoidance of direct medical care and a reduction in financial support," William Schaffner, a professor of infectious diseases at Vanderbilt University Medical Center, said to Healthline.
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While TB is curable, it is not a "straightforward one-and-done kind of thing," said Slate. "It involves six months of a multidrug regimen; using just one drug can lead to the bacteria's becoming resistant such that they simply do not respond to that drug." Also, not everyone infected with TB shows symptoms, making them more likely to spread the disease. "In the absence of symptoms, these people are unlikely to seek care and will not be diagnosed and treated unless identified as part of an outbreak, as was the case for more than half of the patients in Kansas," Karen Dobos and Marcela Henao-Tamayo, microbiologists from Colorado State University, said in The Conversation.
Grave new world
"Failure to control TB anywhere will have effects everywhere, so we are seeing either rising cases or slowed progress in TB control in many places," Jason Andrews, an infectious disease specialist and a professor of medicine at Stanford University, said to Healthline. Geopolitical conflict plays a large role in the spread of TB. "Any time there's turbulence in the world, the risk of transmission increases," said Slate. "That's true of most diseases, but especially for TB, which requires long courses of treatment to work."
USAID was responsible for funding many of the global efforts against TB, but Donald Trump has essentially dismantled the federal agency. The cuts are "likely to cause thousands of unnecessary deaths and a rise in TB infections worldwide, including in the U.S. itself," said CNN. Trump's cuts will also "create the conditions for an extremely drug-resistant form of the disease to spread."
"We can cure virtually everyone with tuberculosis," said Schaffner to Slate. "We have the capacity to do that." But without global cooperation, "we now risk the emergence of TB strains that can't be cured with our existing tools," said Green. "The millennia-long history of humans' fight against TB has seen many vicious cycles. I fear we are watching the dawn of another."
