Yes, tuberculosis is a leading cause of death worldwide. In 2024, TB killed an estimated 1.23 million people globally, making it the deadliest infectious disease on the planet. That figure is nearly double the 630,000 deaths caused by HIV/AIDS in the same period. Despite being preventable and curable, TB continues to claim more lives each year than most people realize.
Where TB Ranks Among Global Killers
Heart disease holds the top spot as the world’s single deadliest condition, responsible for roughly 13% of all deaths. Stroke follows behind it. Among infectious diseases specifically, TB sits at or near the top depending on the year. In 2021, lower respiratory infections (like pneumonia) ranked as the fifth leading cause of death overall and the deadliest communicable disease after COVID-19. TB ranked just behind. By 2024, with COVID deaths declining, TB’s position as the leading infectious disease killer became even clearer.
The 1.23 million total includes about 1.08 million deaths among people who did not have HIV and another 150,000 among people living with HIV. There’s an important technical wrinkle here: when someone dies of TB while also HIV-positive, that death gets officially classified as an HIV/AIDS death in international disease coding systems. This means TB’s true toll is often undercounted in standard mortality rankings.
TB Kills Nearly Twice as Many People as HIV
For decades, HIV/AIDS dominated public attention as the world’s most feared infectious disease. That perception hasn’t caught up with reality. TB deaths in 2024 among HIV-negative people alone (1.08 million) were nearly double the 630,000 deaths attributed to HIV/AIDS. The gap has widened as antiretroviral treatment has dramatically improved HIV survival rates while TB treatment access has lagged behind.
When both diseases strike the same person, the combination is especially dangerous. People co-infected with TB and HIV face roughly twice the risk of dying compared to HIV-positive individuals without TB. The mortality rate among co-infected patients in studies across African countries runs around 12.5 deaths per 100 person-years of follow-up, a strikingly high figure that reflects how each disease accelerates the other.
Drug-Resistant TB Is Far More Lethal
Standard TB is curable with a course of antibiotics lasting several months. Drug-resistant strains are a different story. In one large study, patients with multidrug-resistant TB (MDR-TB) had 7.5 times the risk of dying during treatment compared to patients with standard TB. Mortality rates for MDR-TB range from 20% to 55% depending on the country and available care, compared to 4.5% to 17% for drug-susceptible cases.
Drug resistance also compounds the financial devastation. Among 31 countries reporting data, 82% of people treated for drug-resistant TB faced catastrophic costs, defined as spending more than 20% of their household’s annual income on care. Even for standard TB, nearly half of all patients globally (49%) experience catastrophic costs. In some countries like the Solomon Islands, that figure reaches 92%.
Children Bear a Hidden Burden
TB killed an estimated 191,000 children in 2023. That number is especially tragic because 96% of the children who died never received TB treatment at all. More than half of children under 5 with TB go undiagnosed, untreated, or unreported. Young children are harder to diagnose because they often can’t produce the sputum samples used in standard testing, and their symptoms overlap with many common childhood illnesses. The result is that tens of thousands of children die each year from a disease that existing medications can cure.
Global Targets Are Falling Short
The WHO’s End TB Strategy set a milestone of reducing TB deaths by 75% between 2015 and 2025. As of the most recent assessment, the actual reduction was just 23%. Progress on reducing new infections has been similarly slow: the target was a 50% drop in TB incidence by 2025, but only an 8.3% reduction has been achieved. The COVID-19 pandemic made things worse by disrupting TB diagnosis and treatment services in many countries, pushing death counts higher during 2020 and 2021.
The strategy also aimed for zero TB-affected households facing catastrophic costs by 2025. The current figure, 49%, shows how far that goal remains. TB overwhelmingly affects people in low- and middle-income countries, where access to diagnosis and treatment is most limited and where the economic impact of months-long treatment can push families into poverty.
Why TB’s Death Toll Stays So High
TB is caused by bacteria spread through the air when an infected person coughs or sneezes. About a quarter of the world’s population carries a latent TB infection that could activate later in life, particularly if the immune system weakens due to HIV, malnutrition, diabetes, or aging. This enormous reservoir of latent infection means new active cases keep emerging year after year.
Several factors keep the death toll stubbornly high. Treatment requires multiple antibiotics taken for at least six months, a regimen that’s difficult to complete without support, especially for people in poverty. Diagnosis still relies heavily on tests that miss many cases, particularly in children and people with HIV. And funding for TB research and programs has consistently fallen short of what’s needed. The result is a disease that kills more than a million people annually despite being both preventable and treatable, a gap between what’s medically possible and what’s actually happening on the ground.