The Global and Individual Economics of Tuberculosis

Tuberculosis (TB) negatively affects economic growth and hits poorest households hardest. This chapter focuses on the principles of economic analysis, global TB financing, micro and macroeconomics, and the catastrophic costs associated with TB. The guiding principles of equity and efficiency are fundamental to the health economics of TB, as well as describing societal losses, including household’s burden. Global TB financing in low- and middle-income countries has substantially increased since 2002 and reached US$ 6.5 billion in 2020 but is still half of amounts needed to meet 2018 United Nations’ high-level commitments. To accelerate domestic investments, prioritization will be key. Both micro- and macroeconomics of TB described here are important for assessing the economic impact of the disease in order to inform TB investment. The issue of catastrophic costs and individual implications examined here is central to the World Health Organization End TB strategy that includes a target that no TB patients and their households face catastrophic costs due to TB disease. Seventeen national facility surveys, implemented between 2015 and 2020, show 19–83% of TB-affected households incurred catastrophic costs, jeopardizing access and adherence to TB care. Monitoring progress for country actions to lower the economic burden will be key to reap the benefits of survey evidence.