Tuberculosis (TB) remains the world’s deadliest infectious disease. In 2023, approximately 10.8 million people contracted TB and 1.25 million died from the disease. The WHO African Region accounted for about 2.55 million cases, nearly a quarter of the global burden.Of those who fell ill with TB, 2.7 million people were not detected or officially notified and did not receive the care they needed (World Health Organization’s 2024 Global Tuberculosis Report), denying them their right to health and wellbeing.
The intersection between gender, poverty and other social determinants of health contributes to an increased vulnerability and exposure to TB.
Yet TB is a preventable and curable disease. In 2023, an estimated 4.5 million lives were saved through timely diagnosis and access to treatment. Ending TB by 2030 remains one of the core health targets under the 2015 United Nations Sustainable Development Goals (SDGs). Achieving this goal requires accelerated progress through the adoption and scale-up of technological breakthroughs for TB, including rapid diagnostic tools, shorter and more effective treatment regimens, ongoing vaccine development, and the integration of gender-equitable support packages or mechanisims that address social and economic barriers to care.
Gender and TB
Gender plays a significant role in determining health outcomes, including equitable access to quality TB prevention and care. People of different genders face different challenges to prevention, diagnosis, and treatment, therfore require responses tailored to their needs. Globally, in 2023, more than half of people with TB were in adult men (55% of all TB cases compared to 33% among adult women and 12% among children); and two out of every three undiagnosed or unreported TB cases are in men, underscoring a persistent gender gap in access to timely and appropriate care.
Despite being more affected, men are often the least reached by TB services due to a several challenhges including gendered social norms, such as harmful expressions of masculinity, stigma, economic insecurity, and health system limitations that fail to meet their specific needs. These gaps increase delays in diagnosis and treatment, contributing to worse outcomes, and continued TB transmission to the wider community, including women and children.
The global TB community recognises the need for transforming approaches to TB response in order to overcome barriers to TB prevention and care to ultimately reduce the overall TB burden and transmission for all. Ending TB therefore, demands a shift towards innovative and comprehensive rights-based, people-centred, and gender-responsive approaches that effectively address barriers to accessing TB care accounting for the various factors impacting progress for ending TB.This includes integrating new technologies, supportive policies, and community-based interventions that engage men more effectively, without sidelining the needs of women, girls, and marginalised populations.
New evidence is needed to inform policies and guidelines that are gender-responsive and effectively actioned to:
- improve male access to quality TB care;
- reduce the number of people with TB-related ill health and deaths;
- reduce transmission to the wider community, including to women and girls;
- reduce devastating associated costs for people with TB and their families.
The LIGHT research programme aims to do exactly this while exploring and accounting for the complex intersecting axes of inequality including that of gender, poverty, education, urbanisation and age.
