Speeches Shim

Tuberculosis (TB) has long been the world’s deadliest infectious disease and remains so in low- and middle-income countries —sickening 10 million and killing 1.4 million people every year. The risk of developing TB among the millions of people living with HIV (PLHIV) is 18 times higher than in the rest of the global population. An estimated 815,000 — more than eight percent — of the reported TB cases are among PLHIV, and 208,000 TB deaths were among HIV-positive people. TB remains not only the world’s leading infectious-disease killer in low- and middle-income countries, but also the overall leading cause of death among PLHIV, accounting for around 30 percent of AIDS-related deaths.1 HIV and multidrug-resistant TB (MDR-TB) are a particularly deadly combination. Even with early diagnosis and treatment initiation, PLHIV with MDR-TB are more likely to die.

Because of the significant risk presented to both individuals and programs, addressing the dual TB and HIV epidemics is a top priority for the United States Agency for International Development (USAID), the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), and for national TB and HIV programs globally. Ensuring that HIV-positive patients are screened, tested, and, as necessary, referred for and started on treatment or preventative therapy for TB is key to simultaneously combating these epidemics.


Since 2000, USAID and partners have saved more than 60 million lives globally, including 11 million lives of people living with TB and HIV.

USAID leads the U.S. Government’s global TB efforts, working with agencies and partners around the world to reach every person with TB, cure those in need of treatment, prevent the spread of new infections, and stop the progression to active TB disease. USAID is a key implementer of PEPFAR programs to address the specific challenges presented by TB/HIV by implementing collaborative TB/HIV activities to make progress on:

  • Assisting with establishing and strengthening the mechanisms for coordination of TB and HIV activities and services;
  • Decreasing the burden of TB in PLHIV;
  • Decreasing the burden of HIV in individuals with active TB; and
  • Initiating early antiretroviral treatment for PLHIV with active TB disease to increase survival and improve quality of life.

USAID also works closely with the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and National TB and HIV Programs to further maximize the impact of the Global Fund’s TB and TB/HIV grant portfolio.

USAID works with partners and local governments in all PEPFAR-funded countries to implement interventions that scale-up effective TB/HIV interventions aimed at reducing the burden of TB for PLHIV.

USAID’s TB program focuses on reducing the HIV burden among TB patients. Our efforts ensure that individuals with TB know their HIV status via testing during TB clinic visits and that HIV-positive TB patients are linked to care and to receive antiretroviral therapy (ART) as appropriate.

2020 Achievements

In FY 2020, PEPFAR-funded TB/HIV activities through USAID programs contributed to reducing the burden of TB among PLHIV via:

Graphic: PEPFAR-funded TB/HIV activities
  • TB screening of 4,976,484 PLHIV on ART;
  • Detection of 29,435 new clinically diagnosed TB cases among PLHIV:
  • TB treatment initiation for 57,975 TB/HIV patients;
  • TB Preventive Treatment initiation among 1,302,399 PLHIV; and
  • TB Preventive Treatment completion among 1,001,873 PLHIV.

USAID PEPFAR TPT and TB Screening Cascade for PLHIV PEPFAR, FY 2020

Bar graph: In FY 2020, USAID Programs contributed to reducing the burden of HIV among TB patients by: Ensuring that 95% of the individuals with TB were tested for HIV; Linking 94% of individuals with TB and HIV to ART regimens.
Source: DATIM

In FY 2020, USAID Programs contributed to reducing the burden of HIV among TB patients by:

  • Ensuring that 95% of the individuals with TB were tested for HIV;
  • Linking 94% of individuals with TB and HIV to ART regimens.


To learn more about how USAID works closely with host countries, other U.S. Government agencies, and international partners to reduce the morbidity and mortality associated with TB and TB/HIV, please visit:

1 UNAIDS Global HIV & AIDS statistics — 2020 fact sheet

Last updated: April 20, 2021

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