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1.1 TB incidence

An estimated global total of 10.6 million people (95% uncertainty interval [UI]: 9.8–11.4 million) fell ill with TB in 2025, equivalent to 129 incident cases (95% UI: 119–138) per 100 000 population (Table 1.1.1). Among all incident TB cases, 5.6% were among people living with HIV. Most TB cases in 2025 were in the WHO regions of South-East Asia (35%), the Western Pacific (27%) and Africa (25%), with smaller shares in the Eastern Mediterranean (8.7%), the Americas (3.4%) and Europe (1.7%).

Table 1.1.1 Global and regional estimates of TB incidence, numbers (in thousands) and rates (per 100 000 population) in 2025

Lower and upper ends of the 95% uncertainty interval (UI).
Number of cases (in thousands)
Number per 100 000 population
Total
People living with HIV
Total
People living with HIV
Region or country group Population Best estimate Low High Best estimate Low High Best estimate Low High Best estimate Low High
African Region 1 300 000 2610 2230 3020 412 341 490 201 172 233 32 26 38
Region of the Americas 1 050 000 356 329 384 36 32 40 34 31 36 3.4 3.0 3.8
South-East Asia Region 1 850 000 3640 3200 4110 57 47 69 197 173 223 3.1 2.5 3.7
European Region 942 000 184 172 197 20 17 23 20 18 21 2.1 1.8 2.5
Eastern Mediterranean Region 839 000 923 726 1140 4.8 3.5 6.3 110 87 136 0.58 0.42 0.75
Western Pacific Region 2 220 000 2840 2410 3300 62 53 71 128 109 149 2.8 2.4 3.2
High TB burden countries 5 080 000 9230 8470 10 000 478 406 557 182 167 197 9.4 8.0 11
Global 8 200 000 10 600 9790 11 400 592 518 671 129 119 138 7.2 6.3 8.2


In 2025, the estimated number of people who fell ill with TB worldwide decreased for the second consecutive year, continuing the reversal of increases between 2020 and 2023 that occurred during and in the aftermath of the COVID-19 pandemic (Fig. 1.1.1, panel a). The TB incidence rate (new cases per 100 000 population per year) also continued to decrease, by 1.6% between 2024 and 2025 (Fig. 1.1.1, panel b), and is now below the level of 2020 (the historic low, pre-COVID).

Globally, the net reduction in the TB incidence rate from 2015 to 2025 was 14%, far short of the WHO End TB Strategy milestone of a 50% reduction by 2025 (1, 2).

Shaded areas represent 95% uncertainty intervals. The horizontal dashed line shows the 2025 milestone of the End TB Strategy, which was a 50% reduction in the TB incidence rate between 2015 and 2025.

(a) Number

(b) Number 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 (Fig. 1.1.1 above; Section 2.1). These reductions were assumed to have resulted in an increase in the number of people with untreated TB and an associated increase in transmission.

The big global recovery in the reported number of people newly diagnosed with TB in 2022 and 2023, which was then consolidated in 2024 and 2025 (Section 2.1), has resulted in first a slowing of increases in TB incidence, and then a reversal of the upward trend. In 2025, both the TB incidence rate and the estimated number of people who fell ill with TB continued to decrease, for the second consecutive year since the COVID-19 pandemic.

In 2025, eight countries accounted for about two thirds of global TB cases: India (about a quarter), Indonesia (10%), the Philippines (6.8%), China (6.5%), Pakistan (6.4%), Nigeria (4.9%), the Democratic Republic of the Congo (3.9%) and Bangladesh (3.7%) (Fig. 1.1.2 below and Fig. 1.1.3).

Fig. 1.1.2 Estimated number of incident TB cases for countries with at least 100 000 incident cases, 2025

Fig. 1.1.2 Estimated number of incident TB cases for countries with at least 100 000 incident cases, 2025

Fig. 1.1.3 Geographic distribution of the estimated global number of incident TB cases in 2025

Fig. 1.1.3 Geographic distribution of the estimated number of incident TB cases in 2025


The severity of national TB epidemics, in terms of the number of incident TB cases per 100 000 population in 2025, varies widely among countries: from less than 10 to more than 500 cases per 100 000 population (Fig. 1.1.4).

In 2025, countries with the highest rates were mostly in the WHO African Region, where 11 countries had a rate of more than 300 per 100 000 population. There were 50 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, 2025


In 2025, the global proportion of people with a new episode of TB (either new or recurrent cases) who were living with HIV was 5.6% (95% UI: 4.8–6.5%) 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), 2025

Fig. 1.1.5 Estimated HIV prevalence in people with a new episode of TB (new or recurrent cases), 2025


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 5.7 million cases (95% UI: 4.1–7.3 million) in 2025, equivalent to 54% of the estimated total; by comparison, there were an estimated 3.7 million cases (95% UI: 2.6–4.7 million) among adult women (aged ≥15 years), equivalent to 35% of the estimated total, and 1.2 million (95% UI: 0.86–1.5 million) cases among children and young adolescents (aged 0–14 years), equivalent to 11% of the estimated total.

Case notifications of people newly diagnosed with TB in 2025 were 79% of the estimated TB incidence overall, with the same figures for adult men and women (81%). The figure was much lower for children and young adolescents aged 0–14 years (59%) and lower still for children aged <5 years (52%).

Global estimates of TB incidence during pregnancy and postpartum, in 2023 specifically, have been published recently (3). It was estimated that 239 500 pregnant women (95% UI 216 300–262 800) and 97 600 postpartum women (95% UI 90 100–105 200) developed TB globally in 2023.

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), 2025

Bars show TB notifications. Dots and error bars show best estimates of incidence and 95% uncertainty intervals, respectively.

(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), 2025

(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).

The overall TB incidence rate is shown in green and the incidence rate among people living with HIV is shown in red. The black solid lines show case notifications of people newly diagnosed with TB, for comparison with estimates of the overall incidence rate. Shaded areas represent 95% uncertainty intervals. The horizontal dashed line shows the 2025 milestone of the End TB Strategy, which was a 50% reduction in the TB incidence rate between 2015 and 2025.


In 2025, the TB incidence rate increased for the fifth consecutive year in the WHO Region of the Americas, reflecting the estimated impact of shortfalls in TB case detection in 2020 and a still incomplete recovery by 2025. In the Western Pacific Region, the TB incidence rate has been declining since 2024, following an upward trend in 2020–2023. In 2 other WHO regions, the Eastern Mediterranean Region and the South-East Asia Region, the TB incidence rate decreased for a third consecutive year, continuing to reinforce the 2023 reversal of the 2020–2022 COVID-related upward trend. In the WHO European Region, the TB incidence rate has been falling since 2021. In the WHO African Region, the decline in the TB incidence rate that has been sustained for many years (including during the COVID-19 pandemic) continued in 2025.

The biggest estimated reduction in the TB incidence rate since the End TB Strategy baseline year of 2015 has been in the WHO European Region, with a net reduction of 42% by 2025. This was mainly driven by progress in the Russian Federation. A large reduction has also been achieved in the African Region, with a 30% decline by 2025. In the South-East Asia Region, the decline was 18%. The net decline in 2025 compared with 2015 was relatively small in the Eastern Mediterranean Region (6.6%).

There was no net decline in the Western Pacific Region, due to increases in Indonesia, the Philippines and Papua New Guinea that cancelled out reductions in other countries. Between 2015 and 2025, there was a net increase in TB incidence in one WHO region: the Region of the Americas (up 13%).

Regional trends in the estimated number of people who fell ill with TB are available in Figure 2.3.1 (Section 2.3).

Trends in TB incidence rates by income group are shown in Fig. 1.1.9.

TB incidence rates are shown in green and the incidence rate among people living with HIV is shown in red. The black solid lines show notifications of new and recurrent cases for comparison with estimates of the total incidence rate. Shaded areas represent 95% uncertainty intervals.


Progress in reducing the TB incidence rate at country level is highly variable (Fig. 1.1.10). In total, 99 countries (including 63 in the WHO European and African regions) achieved estimated reductions of at least 20% between 2015 and 2025, thus reaching or surpassing the first (2020) milestone of the End TB Strategy; and 28 countries are estimated to have achieved reductions of at least 50% between 2015 and 2025, including 2 high TB burden countries (Namibia and South Africa). At the other extreme, there are 43 countries where the TB incidence rate in 2025 was more than 5% higher than in 2015. These countries are most noticeably in the WHO 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), 2025 compared with 2015

The first milestone of the End TB Strategy was a 20% reduction by 2020, compared with 2015; the second milestone was a 50% reduction by 2025, compared with 2015. The last 2 categories (decrease 20–49%, and decrease ≥50%) distinguish the countries that have made the most progress towards the second milestone of the End TB Strategy.
Fig. 1.1.10 Change (%) in the estimated TB incidence rate (new cases per 100 000 population per year), 2025 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 2025, the best estimate of the TB incidence rate suggested that the 2025 milestone of the End TB Strategy had been reached in Namibia and South Africa, and was close to being reached in Kenya, the United Republic of Tanzania and Zambia.

TB incidence rates are shown in green. The black solid lines show notifications of new and recurrent cases for comparison with estimates of the total incidence rate. Shaded areas represent 95% uncertainty intervals. The horizontal dashed line shows the 2025 milestone of the End TB Strategy, which was a 50% reduction between 2015 and 2025.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
a WHO lists of high burden countries and global TB watchlist countries have been updated for the period 2026–2030 (Annex 3 of the core report document). Estimates are not shown for the Democratic People’s Republic of Korea and India because they are under review. For India, see Annex 4 of the core report document.


In 2025, the estimated TB incidence rate continued to decrease in one of the 2 global TB watchlist countries, Gabon, and stabilized in Liberia (Fig. 1.1.12).

TB incidence rates are shown in green. The black solid lines show notifications of new and recurrent cases for comparison with estimates of the total incidence rate. Shaded areas represent 95% uncertainty intervals. The horizontal dashed line shows the 2025 milestone of the End TB Strategy, which was a 50% reduction between 2015 and 2025.
a WHO lists of high burden countries and global TB watchlist countries have been updated for the period 2026–2030 (Annex 3 of the core report document).


Box 1.1.1 provides a summary of the methods used to produce estimates of TB incidence for the period 2010–2025.

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 2010–2025 are shown in Fig. 1.1.13 below; additional details are provided in Table 1.1.2. These methods adhere to global guidelines for accurate and transparent reporting of health estimates (4) 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 the use of a new approach to estimate TB incidence in Mongolia and Thailand, using a combination of TB mortality data from a national vital registration system, TB case notification data and results from national TB prevalence surveys.

In addition, updates to estimates based on values of the Universal Health Coverage Service Coverage Index (UHC SCI) and TB case notification data were made for 123 countries, using the latest time series of UHC SCI estimates; these were previously available for 2000–2021 but have now been extended to cover the period 2000–2023.


Fig. 1.1.13 Main methods used to estimate TB incidence, 2010–2025

A country-specific dynamic model has been used in Brazil, Indonesia, India, Kenya, Myanmar, Nepal, Pakistan, the Philippines and Ukraine to account for COVID-19 disruptions.
Fig. 1.1.13 Main methods used to estimate TB incidence, 2010–2025


Table 1.1.2 Main methods used to estimate TB incidence, 2010–2025

Estimation method Description Number of countries Share of total TB incidence
National TB prevalence survey Results from national TB prevalence surveys combined with estimates of the duration of disease; this includes India where 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 was used. 27 64%
National TB inventory study Measured level of underreporting of detected TB cases. 16 17%
Case notifications and UHC SCI with statistical model TB notifications upward adjusted according to an incidence:notification ratio derived from a UHC SCI-based statistical model. 32 7.3%
Country-specific customized approach Customized approach used for countries where UHC SCI methods did not work well. 6 5%
Case notifications and UHC SCI TB notifications upward adjusted according to country-specific values for the UHC SCI. 91 3.5%
National TB prevalence survey combined with VR data Results from national TB prevalence surveys combined with TB mortality data from a national vital registration system and TB case notifications. 2 1%
Case notifications combined with TB mortality data TB notifications combined with TB mortality data from a national vital registration system (used for Brazil). 1 1%
Case notifications with no adjustment 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). 3 0.5%
Case notifications with standard adjustment TB notifications and a standard upward adjustment to account for underreporting, overdiagnosis and underdiagnosis, used until 2024 and retained for use in 2025 and 2026 based on bilateral discussions with national TB programmes. 5 0.5%
Case notifications with no adjustment (<10 episodes of TB) TB notifications with no adjustment, used for countries that reported fewer than 10 cases of TB. 32 <0.1%


For 9 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 2020–2025 were based on country-specific dynamic models: Brazil, Indonesia, India, Kenya, Myanmar, Nepal, Pakistan, the Philippines and Ukraine. These methods are described in detail in a technical appendix. For all other countries, the same methods as those used for the period 2010–2019 continued to be applied.

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

  1. 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/).

  2. 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).

  3. Mafirakureva N, Cartledge A, Bradshaw I et al. Global estimates of tuberculosis incidence during pregnancy and postpartum: a rapid review and modelling analysis. The Lancet Global Health, 2026; 14, e337–e346.

  4. Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) [website] ( http://gather-statement.org/).

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