Tuberculosis in the UK

Abstract

Multipronged action is needed to reverse rising rates Tuberculosis (TB) is the world’s oldest pandemic, accounting for around a billion deaths in the past two centuries.1 In the UK, after more than a decade of declining incidence, numbers are on the rise. In 2024, 5480 people became unwell with TB in England—up 13% from 2023, the largest increase recorded since 1970, and reflecting a trend that started in 2021.2 The TB Action Plan for England 2021-263 commits the country to meet the World Health Organization target of eliminating TB by 2035.4 But achieving the required 18% annual rate reduction from 2025 is not certain. TB is linked to conditions of poverty. People who become unwell with the disease face stigma, financial precarity, digital exclusion, language barriers, and housing insecurity.5 They need the scaffolding provided by support networks to enable them to receive the health and social care required to complete treatment successfully. TB exists on a spectrum between asymptomatic latent infection and active disease. Around 80% of active cases in the UK occur among people born in countries where TB is common.6 Intersecting vulnerabilities such as HIV, deprivation, homelessness, asylum seeker status, and incarceration …