Dr Bam added: The core problem is structural. Health systems stay reactive. They wait for people to fall ill, seek care, and then treat them. Screening strategies in many settings remain too narrow, missing opportunities for population-level detection. Root causes go largely unaddressed. Social and economic determinants - poverty, overcrowding, undernutrition - continue to fuel transmission. Universal health coverage is incomplete in many high-burden countries, leaving TB services under-protected by broader financing systems. Prevention programmes that tackle major risk factors receive too little investment.
Those risk factors are well known and collectively responsible for millions of cases each year: tobacco use, diabetes, undernutrition, harmful alcohol consumption, and HIV infection. Tobacco and alcohol control, in particular, remain underfunded relative to their impact. The result is a cycle in which new TB cases continually replenish the pool that TB programmes must then chase, said Dr Bam.
Those risk factors are well known and collectively responsible for millions of cases each year: tobacco use, diabetes, undernutrition, harmful alcohol consumption, and HIV infection. Tobacco and alcohol control, in particular, remain underfunded relative to their impact. The result is a cycle in which new TB cases continually replenish the pool that TB programmes must then chase, said Dr Bam.
He pointed out that failure to address TB risk factors also causes epidemic proportion of other preventable diseases such as cardiovascular diseases, cancers, diabetes, or other health problems that often lead to untimely deaths.
Dr Bam is a former Asia Pacific Director of International Union Against Tuberculosis and Lung Disease (The Union) and now leads Vital Strategies as Asia Pacific Director (Tobacco Control) and Asia Pacific Cities Alliance for Health and Development (APCAT) as Board Director. Dr Bam was the keynote speaker at Session-15th at 160 Global Village Networking Zone of 26th International AIDS Conference (AIDS 2026) in Rio de Janeiro, Brazil. CNS is an official media partner of AIDS 2026.
Dr Bam is a former Asia Pacific Director of International Union Against Tuberculosis and Lung Disease (The Union) and now leads Vital Strategies as Asia Pacific Director (Tobacco Control) and Asia Pacific Cities Alliance for Health and Development (APCAT) as Board Director. Dr Bam was the keynote speaker at Session-15th at 160 Global Village Networking Zone of 26th International AIDS Conference (AIDS 2026) in Rio de Janeiro, Brazil. CNS is an official media partner of AIDS 2026.
Tax Health-Risks, Empower Local Leaders: Dual path to close funding gap
Funding shortfalls compound the problem. Many national TB and HIV programmes still depend heavily on external donors or constrained domestic budgets. The gap is real. Yet practical domestic options exist. Raising health taxes on tobacco, alcohol, and sugary drinks delivers a double benefit: lower consumption of products that drive disease, and new revenue that can be directed to primary healthcare, universal health coverage, and TB elimination efforts. Governments that treat these taxes as both public-health tools and fiscal instruments gain resources without solely relying on aid or general taxation, said Dr Tara Singh Bam.
Political will at the local level is equally decisive and often underused. In decentralised systems, local leaders understand community realities better than distant national or international planners. They can identify practical solutions, mobilise media, civil society, and community groups, and enforce innovative approaches such as mass community screening. When local governments are held accountable for results - rather than treated as implementers of top-down plans - programmes gain traction. Untapped local leadership remains one of the clearest reasons progress has stalled.
The long wait for strategic shift from TB control to elimination
The strategic shift required is clear: from TB control to TB elimination. That goal must become a political priority at global, national, and local levels. Success depends on people-centered, prevention-first, multi-sectoral action. Early and timely diagnosis and right treatment remain essential. They are not enough. Prevention must become the first line of defence too - stopping infection before it occurs, finding every case early and accurately, and treating every patient effectively to cure. Achieving this demands strong political leadership, genuine engagement of local authorities, and sustained community involvement, said Dr Bam.
He emphasised that the science and tools exist. The evidence on risk factors is solid. Revenue options through health taxes are available. Local capacity is present in many places if activated. What is missing is the consistent decision to treat TB not as a chronic management problem but as an eliminable disease that requires prevention, accountability, and political ownership at every level. Until that shift occurs, TB will continue to claim lives that could have been spared.
Best time to Rethink-Rebuild-Rise to end TB was years back. Next best time is now.
(Citizen News Service)
3 August 2026
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