Tuberculosis (TB) remains one of the leading causes of infectious disease death globally. In 2023, over 10.8 million people fell ill with TB and more than 1.25 million died, underscoring the continued urgency to end this preventable and curable disease.
As the global health community marks World TB Day this year, the call to action is clear: we must accelerate efforts, even as shrinking health budgets threaten hard-won gains.
But ending TB is not just about delivering more of the same. It’s about doing things differently. It’s about integrating TB services into broader primary healthcare systems and addressing the disease alongside other respiratory conditions that often share common risk factors and symptoms. This shift is not only more efficient, but also essential.
Integration at the Frontline
At PSI, we are committed to reimagining how health services are delivered—integrating TB and chronic lung health interventions at the primary care level and putting people at the center of the response.
In over 40 countries, PSI collaborates with governments, communities, and the private sector to ensure TB and lung health services are affordable, accessible, and responsive to clients’ needs. We design delivery models that are grounded in real-world contexts and that make the most of each opportunity to reach and serve clients across the care continuum.
This means strengthening prevention, screening, and early detection; equipping frontline providers to deliver better care at first contact; and improving long-term disease management and follow-up.
Connecting the Dots Between TB and Lung Health
TB often overlaps with other acute and chronic respiratory conditions such as chronic bronchitis, asthma, pneumonia and other lower respiratory infections. Together, these diseases cause 11% of all early deaths worldwide. They disproportionately affect people in low- and middle-income countries, especially those facing poverty, indoor and outdoor air pollution, tobacco exposure, and other social and environmental risks.
These shared risk factors and overlapping symptoms mean that fragmented services leave gaps in care. Clients may go undiagnosed or misdiagnosed, or they may struggle to navigate multiple systems for the care they need. In contrast, an integrated approach can diagnose TB and chronic lung diseases sooner, connect individuals to appropriate care more efficiently, and ultimately reduce the burden on patients and health systems.
Spotlight on Zimbabwe: A Model for Integration
In Zimbabwe, where the TB and HIV burdens remain high, the COVID-19 pandemic significantly disrupted TB services, resulting in a 25% drop in reported cases. At the same time, the country experienced a 73% rise in the chronic obstructive lung disease burden, with an estimated 168,000 new cases annually.
In response, PSI Zimbabwe and local partner Population Solutions for Health are implementing an integrated model for TB and chronic lung disease that strengthens service delivery and brings care closer to communities.
Key elements of the approach include:
- Joint screening and diagnostic services for TB and chronic lung diseases, ensuring respiratory symptoms are assessed holistically.
- Leveraging private sector clinics and pharmacies to extend reach, improve convenience, and offer multiple points of access to care.
- Client-centered service design, including flexible hours and community outreach, to better match how and when people seek care.
These integrated services are designed not only to increase detection and improve outcomes but also to optimize the use of resources and build more resilient health systems.
Integration as a Global Imperative
Zimbabwe’s experience offers lessons for other countries facing similar challenges. In an era of constrained funding and growing demand, integration is not optional; it’s essential. By embedding TB and chronic lung health services into primary healthcare and working through public and private sector networks, countries can expand access, reduce duplication, and deliver more comprehensive care.
However, integration alone is not enough. It must be backed by sustained investment, political will, and a commitment to innovation that puts people—not diseases—at the center of care.
At PSI, we are proud to be advancing this agenda. By working across sectors and geographies, we are helping to build the future of TB and lung health—one that is integrated, inclusive, and effective.
