1.1 TB incidence
An estimated global total of 10.7 million people (95% uncertainty interval [UI]: 9.9–11.5 million) fell ill with TB in 2024, equivalent to 131 incident cases (95% UI: 122–141) per 100 000 population (Table 1.1.1). Among all incident TB cases, 5.8% were among people living with HIV. Most TB cases in 2024 were in the WHO regions of South-East Asia (34%), the Western Pacific (27%) and Africa (25%), with smaller shares in the Eastern Mediterranean (8.6%), the Americas (3.3%) and Europe (1.9%).
Table 1.1.1 Global and regional estimates of TB incidence, numbers (in thousands) and rates (per 100 000 population) in 2024
| Region or country group | Population | Best estimate | Low | High | Best estimate | Low | High | Best estimate | Low | High | Best estimate | Low | High |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| African Region | 1 270 000 | 2620 | 2240 | 3030 | 428 | 357 | 506 | 207 | 177 | 239 | 34 | 28 | 40 |
| Region of the Americas | 1 050 000 | 350 | 319 | 383 | 36 | 32 | 40 | 33 | 30 | 37 | 3.4 | 3.0 | 3.9 |
| South-East Asia Region | 1 830 000 | 3680 | 3250 | 4150 | 64 | 52 | 77 | 201 | 177 | 226 | 3.5 | 2.8 | 4.2 |
| European Region | 941 000 | 204 | 175 | 235 | 23 | 16 | 31 | 22 | 19 | 25 | 2.5 | 1.7 | 3.3 |
| Eastern Mediterranean Region | 824 000 | 920 | 712 | 1150 | 4.7 | 1.0 | 11 | 112 | 86 | 140 | 0.57 | 0.12 | 1.4 |
| Western Pacific Region | 2 220 000 | 2910 | 2480 | 3380 | 63 | 53 | 73 | 131 | 112 | 152 | 2.8 | 2.4 | 3.3 |
| High TB burden countries | 5 010 000 | 9280 | 8520 | 10 100 | 494 | 422 | 572 | 185 | 170 | 201 | 9.9 | 8.4 | 11 |
| Global | 8 130 000 | 10 700 | 9920 | 11 500 | 619 | 545 | 698 | 131 | 122 | 141 | 7.6 | 6.7 | 8.6 |
In 2024, the estimated number of people who fell ill with TB worldwide decreased year-on-year for the first time since the COVID-19 pandemic, reversing consecutive years of increases between 2020 and 2023 (Fig. 1.1.1, panel a). The TB incidence rate (new cases per 100 000 population per year) also fell, by 1.7% between 2023 and 2024 (Fig. 1.1.1, panel b), and is back to the level of 2020 (the historic low, pre-COVID).
Globally, the net reduction in the TB incidence rate from 2015 to 2024 was 12.3%, far from the WHO End TB Strategy milestone of a 50% reduction by 2025 (1, 2).
Fig. 1.1.1 Global trends in the estimated number of incident TB cases (a) and the incidence rate (b), 2010–2024
(a) Number
(b) Rate per 100 000 population
The estimated increases in TB incidence between 2020 and 2023 were the consequence of disruptions to TB diagnosis and treatment during the COVID-19 pandemic, when the reported number of people newly diagnosed with TB fell from 7.1 million in 2019 to 5.8 million in 2020 and 6.4 million in 2021 (Section 2.1). These reductions were assumed to have resulted in an increase in the number of people with undiagnosed and untreated TB, and subsequent increases in transmission.
The big global recovery in the reported number of people newly diagnosed with TB in 2022–2024 (Section 2.1) has subsequently resulted in first a slowing of increases in TB incidence, and then a reversal of the upward trend.
In 2024, both the TB incidence rate and the estimated number of people who fell ill with TB have decreased, for the first time since the COVID-19 pandemic.
In 2024, eight countries accounted for two thirds of global TB cases: India (25%), Indonesia (10%), the Philippines (6.8%), China (6.5%), Pakistan (6.3%), Nigeria (4.8%), the Democratic Republic of the Congo (3.9%) and Bangladesh (3.6%) (Fig. 1.1.2 and Fig. 1.1.3).
Fig. 1.1.2 Estimated number of incident TB cases for countries with at least 100 000 incident cases, 2024
Fig. 1.1.3 Geographic distribution of the estimated number of incident TB cases in 2024
The severity of national TB epidemics, in terms of the number of incident TB cases per 100 000 population in 2024, varies widely among countries: from less than ten to more than 500 cases per 100 000 population (Fig. 1.1.4).
In 2024, countries with the highest rates were mostly in the African Region, where 12 countries had a rate of more than 300 per 100 000 population. There were 62 countries with a low incidence of TB (<10 cases per 100 000 population), mostly in the WHO Region of the Americas and the European Region, plus a few countries in the WHO Eastern Mediterranean and Western Pacific regions.
Fig. 1.1.4 Estimated TB incidence rates, 2024
In 2024, the global proportion of people with a new episode of TB (either new or recurrent cases) who were living with HIV was 5.8% (95% UI: 5.0–6.7%) and was highest in countries in the WHO African Region, exceeding 50% in parts of southern Africa (Fig. 1.1.5). The proportion has been falling for many years, following a peak at 17% in 2000.
Fig. 1.1.5 Estimated HIV prevalence in people with a new episode of TB (new or recurrent cases), 2024
TB can affect anyone, regardless of age or sex (Fig. 1.1.6). The highest burden is in adult men (aged ≥15 years), with an estimated 5.8 million cases (95% UI: 4.2–7.4 million) in 2024, equivalent to 54% of the estimated total; by comparison, there were an estimated 3.7 million cases (95% UI: 2.7–4.7 million) among adult women (aged ≥15 years), equivalent to 35% of the estimated total, and 1.2 million (95% UI: 0.87–1.5 million) cases among children (aged 0–14 years), equivalent to 11% of the estimated total.
Case notifications of people newly diagnosed with TB in 2024 were 78% of the estimated TB incidence overall, with the same figures for adult men and women (79%). The figure was much lower for children aged 0–14 years (58%) and lower still for children aged <5 years (50%).
Global estimates of TB incidence during pregnancy and postpartum will be published later this year.
Fig. 1.1.6 Global estimates of TB incidence (absolute numbers) disaggregated by age group and sex, compared with case notifications (female in purple; male in orange), 2024
(a) Female
(b) Male
Regional estimates of the distribution of incident TB cases, disaggregated by age and sex and compared with case notifications, are shown in Fig. 1.1.7. The largest numbers are typically in the age groups of 25–34, 35–44 or 45–54 years. The WHO Western Pacific Region is an exception, with the largest number of cases in the age group ≥65 years; this is mostly influenced by numbers for China and can be explained by the country’s aging population and declining burden of TB disease (with higher rates of infection and a higher risk of new cases arising from reactivation of previous infections among older people).
Fig. 1.1.7 Regional estimates of TB incidence (absolute numbers) disaggregated by age group and sex, compared with case notifications (female in purple; male in orange), 2024
(a) Female
(b) Male
Regional trends in TB incidence rates vary, and progress in relation to the 2025 milestone of the End TB Strategy is mixed (Fig. 1.1.8).
Fig. 1.1.8 Trends in estimated TB incidence rates by WHO region, 2010–2024
In 2024, the TB incidence rate increased for the fourth consecutive year in the Region of the Americas, reflecting the estimated impact of shortfalls in TB case detection in 2020 and a still incomplete recovery by 2024. An upward trend in 2020–2023 was reversed in 2024 in the Western Pacific Region. In two regions, the Eastern Mediterranean Region and the South-East Asia Region, the TB incidence rate decreased for the second consecutive year, reinforcing the 2023 reversal of the 2020–2022 COVID-related upward trend. In the European Region, the TB incidence rate had been falling since 2022. In the African Region, the decline in the TB incidence rate that has been sustained for many years continued in 2024.
The biggest estimated reduction in the TB incidence rate since the End TB Strategy baseline year of 2015 has been in the European Region, with a net reduction of 39% by 2024. This was mainly driven by progress in the Russian Federation. A large reduction has also been achieved in the African Region, with a 28% decline by 2024. In the South-East Asia Region, the decline was 16%. The net decline in 2024 compared with 2015 was relatively small in the Eastern Mediterranean Region (5.9%).
Between 2015 and 2024, there was a net increase in TB incidence in two regions: the Western Pacific (up 1.7%) and more noticeably, the Region of the Americas (up 13%).
Trends in TB incidence rates by income group are shown in (Fig. 1.1.9).
Fig. 1.1.9 Trends in estimated TB incidence rates by income group, 2010–2024
Progress in reducing the TB incidence rate at country level is highly variable (Fig. 1.1.10). In total, 101 countries (including 67 in the European and African regions) achieved estimated reductions of more than 20% between 2015 and 2024, thus surpassing the first (2020) milestone of the End TB Strategy; and 30 countries are estimated to have achieved reductions of at least 50% between 2015 and 2024, including one high TB burden country (South Africa). At the other extreme, there are 37 countries where the TB incidence rate in 2024 was more than 5% higher than in 2015. These countries are most noticeably in the Region of the Americas but also include three high TB burden countries in Asia: Indonesia, Myanmar and the Philippines.
Fig. 1.1.10 Change (%) in the estimated TB incidence rate (new cases per 100 000 population per year), 2024 compared with 2015
Trends in the TB incidence rate in the 30 high TB burden countries are also highly variable (Fig. 1.1.11). In 2024, the best estimate of the TB incidence rate suggested that the 2025 milestone of the End TB Strategy had been reached in South Africa and was close to being reached in Kenya, the United Republic of Tanzania and Zambia.
Fig. 1.1.11 Trends in estimated TB incidence rates in the 30 high TB burden countries compared with notifications of new and recurrent cases, 2010–2024
In 2024, the estimated TB incidence rate continued to decrease in all three global TB watchlist countries. The Russian Federation is close to reaching the 2025 milestone of the End TB Strategy (Fig. 1.1.12).
Fig. 1.1.12 Trends in estimated TB incidence rates in the three global TB watchlist countries compared with notifications of new and recurrent cases, 2010–2024
Box 1.1.1 provides a summary of the methods used to produce estimates of TB incidence for the period 2010–2024.
Box 1.1.1
Methods used by WHO to estimate TB incidence
The main methods used by WHO to estimate TB incidence at country level in the period 2010–2024 are shown in Fig. 1.1.13. These methods adhere to global guidelines for accurate and transparent reporting of health estimates (3) and are described in detail in a technical appendix. Updates to methods used for this report are explained in Annex 4 of the core report document. The main update for this report is use of country-specific values for the Universal Health Coverage Service Coverage Index (UHC SCI) in combination with TB notification data to produce incidence estimates for 130 countries that collectively accounted for 11.2% of global incident cases in 2024.
Methods used by WHO to estimate TB incidence for 2010–2024 included:
Results from national TB prevalence surveys combined with estimates of the duration of disease, used for 28 countries with 40% of the global number of incident TB cases in 2024;
Results from a national TB prevalence survey combined with a country-specific dynamic model that was calibrated to survey data as well as other data (e.g. notifications, drug sales) and WHO TB mortality estimates. This was used for India, which had 26% of the global number of incident TB cases in 2024 (for further details, see the technical appendix);
Results from national inventory studies that measured the level of underreporting of detected TB cases, used for 10 countries with about 18% of the global number of incident TB cases in 2024;
TB notifications upward adjusted according to an incidence:notification ratio derived from a UHC SCI-based statistical model, used for 32 countries with 7.4% of the global number of incident TB cases in 2024;
TB notifications upward adjusted according to country-specific values for the UHC SCI, used for 98 countries with 3.8% of the global number of incident TB cases in 2024;
A country-specific customized approach, which was used for six African countries for which the UHC SCI methods did not work well. These countries accounted for 5.0% of the global number of incident TB cases in 2024;
TB notifications combined with TB mortality data from a national vital registration system. This was used for Brazil, which had 1.0% of the global number of incident TB cases in 2024;
TB notifications with no adjustment, used for 32 countries that reported less than 10 cases of TB in 2024 and three countries for which country-specific evidence suggested that no adjustment was appropriate (e.g. due to high levels of population-based screening as well as potential for overdiagnosis), which collectively accounted for 0.6% of the global number of incident cases in 2024;
TB notifications and a standard upward adjustment to account for underreporting, overdiagnosis and underdiagnosis, retained based on bilateral discussions with national TB programmes for four countries for which this method had previously been used for several years, which accounted for about 0.4% of the global number of incident TB cases in 2024
For 26 countries with the biggest absolute reductions in TB notifications during the COVID-19 pandemic that were a clear departure from historic trends, estimates of TB incidence in 2020–2024 were based on country or region-specific dynamic models. These methods are described in detail technical appendix. For all other countries, the same methods as those used for the period 2010–2019 continued to be applied.
The orange dots on the map show the 19 countries for which a country-specific dynamic model has been used and the brown dots show the 7 countries for which a region-specific dynamic model has been used. These two groups of countries accounted for 59% and 0.4% of the estimated total global number of incident cases in 2024, respectively.
Fig. 1.1.13 Main methods used to estimate TB incidence, 2010–2024
Country-specific details are available in the Global tuberculosis report app and country profiles.
Note: All of the percentage reductions or increases referred to in the text of this webpage were calculated based on unrounded numbers, as opposed to the rounded numbers that appear in the interactive graphics.
References
Floyd K, Glaziou P, Houben R, Sumner T, White RG, Raviglione M. Global tuberculosis targets and milestones set for 2016-2035: definition and rationale. Int J Tuberc Lung Dis. 2018;22(7):723-30 ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005124/).
World Health Organization. Resolution WHA67.1. Global strategy and targets for tuberculosis prevention, care and control after 2015. Geneva: World Health Organization; 2014 ( http://apps.who.int/gb/ebwha/pdf_files/WHA67/A67_R1-en.pdf).
Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) [website] ( http://gather-statement.org/).
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