Many Americans think of tuberculosis (TB) as a distant problem that happens on the other side of the world. But people and pathogens move across borders every day, and in a connected world, global health is local health. TB primarily affects the lungs and spreads through the air by cough, sneeze, or spit. In the U.S., TB still remains as one of the deadliest infectious diseases, with cases rising in recent years, reaching 10,388 in 2024.
World Tuberculosis Day is observed on March 24 to commemorate the day in 1882 when Robert Koch, MD, announced his discovery of the bacterium that causes the disease, paving the way for diagnosis and treatment. Despite advances, it remains the most lethal infectious disease on the planet, claiming 1.4 million lives every year worldwide.
TB is particularly prevalent in low and middle-income countries, where healthcare resources are limited, and the disease burden is compounded by HIV infection, malnutrition, and poor living conditions. Today, the global fight against TB faces significant challenges, including drug-resistance and the need for more effective vaccines and treatments.
Meet University of Utah tuberculosis researchers Katharine Walter, PhD, and Allison Carey, MD, PhD, and discover their motivations for researching TB and how they’re tackling the disease.
Why do you study tuberculosis (TB)?
Katharine Walter: Today, tuberculosis kills more people than any other infectious disease. In 2026, at a time when antibiotics are effective against most infections, and diagnostic tests can accurately identify people who are infected and who have active disease, this is unacceptable and outrageous.
Allison Carey: Tuberculosis has long been the leading infectious cause of death and has killed more humans than any other pathogen in history. I am driven to understand what makes Mycobacterium tuberculosis such a successful pathogen, with the hope that this knowledge will contribute to TB eradication.
How can people best protect themselves from catching TB?
Walter: In the US, incidence of TB is extremely low. However, congregate settings like prisons, jails, and detention centers are high-risk environments for TB transmission, even in the US. In those settings, routine TB screenings and access to primary healthcare are essential to protecting against the spread of TB.
Carey: TB is a respiratory disease transmitted from person-to-person through close contact. Public health measures, such as identifying and treating individuals with active and asymptomatic (latent) TB are important to prevent transmission.
What are the biggest challenges we face in the eradication of TB?
Walter: We still don’t have a vaccine that is effective at preventing TB disease in adults. The best available vaccine—BCG—is over a century old. We also urgently need to expand access to TB diagnostics and antibiotics. TB is a disease of neglect, of poverty, incarceration, and social exclusion. Funding public health and prioritizing neglected populations is critical in the global fight against TB.
Carey: In my view, prevention and treatment are the biggest challenges in TB eradication. We need a better vaccine to prevent new TB infections and improved diagnostics to rapidly identify those already infected to prevent ongoing transmission. While current antibiotic treatments are effective for most TB infections, they consist of 3 to 4 antibiotics that must be taken for at least 4 to 6 months, which is onerous, and antibiotic resistance frequently emerges. We need improved antibiotics that don’t have these limitations.
How can your research help eliminate TB?
Walter: To reduce the burden of TB, we urgently need to prevent new infections. My lab studies the transmission of the TB bacteria, Mycobacterium tuberculosis, using bacterial genomes and spatial information. Our goal is to identify where transmission occurs, and between whom, in order to design strategies to prevent transmission, focusing on high-incidence settings in Brazil and Paraguay. We are also studying how increasing global air pollution—the most significant environmental cause of mortality—impacts TB infection and disease. Air pollution impacts every cell in our bodies, and we predict that it increases susceptibility and the onward transmission of TB.
Carey: My lab uses advanced genetic techniques to understand how Mycobacterium tuberculosis survives the pressures imposed by antibiotic exposure and vaccine-induced immunity. Through these studies, we hope to inform the development of improved TB treatments and vaccines.
What gives you hope in the fight against tuberculosis?
Walter: What gives me hope is the incredible grassroots activism around expanding access to diagnostics and treatment for TB and other diseases.
Carey: The shift towards more collaborative, cross-disciplinary research across countries gives me hope. This kind of global coordination is required for transformative change in the TB field.
(Newswise/HG)
