NURS FPX 8024 Assessment 2 Global Issue Investigation
Student Name
Capella University
NURS-FPX 8024
Professor Name
Submission Date
Global Issue Investigation
Tuberculosis (TB) has become the leading deadly infectious disease in the world, and it replaced COVID-19 in 2023. The World Health Organization (WHO) revealed that the rate of tuberculosis all over the world was 10.8 million new cases in 2023, which is a record since the global surveillance of TB was established (Lee et al., 2025). About 1.25 million individuals lost their lives to the disease in 2023 alone, and only 40 percent of those with drug-resistant tuberculosis could get the right treatment (World Health Organization, 2025). The current state of emergency in public health unequally affects poorer countries, which produce major healthcare inequalities and economic pressure on the most vulnerable populations worldwide.
Description of the Problem
Global Prevalence and Scope
Tuberculosis remains a significant health menace of unfathomable magnitude to the world. In 2023, the disease continues to have a wide distribution among the populations, affecting millions of people worldwide (World Health Organization, 2025a). WHO statistics show that about 10.8 million people were infected by tuberculosis in 2023, and the distribution of the cases attacked 6.0 million men, 3.6 million women, and 1.3 million children (World Health Organization, 2025a).
NURS FPX 8024 Assessment 2 Global Issue Investigation
The infection cuts across all countries and demographics universally. Geographic distributions have a high caseload, with the South-East Asia WHO Region as the major contributor at 45 percent in 2023, followed by the African Region with 24 percent of the global cases and the Western Pacific Region with 17 percent of the international cases (World Health Organization, 2025a). The thirty nations with the highest burden include 87 percent of all newly reported tuberculosis cases, and more than two-thirds of them are in eight countries, including Bangladesh, China, Democratic Republic of Congo, India, Indonesia, Nigeria, Pakistan, and the Philippines (Silva et al., 2021). This widespread international distribution stresses the dire need for worldwide coordination of tuberculosis control.
Disproportionately Affected Nations
The tuberculosis burden in the whole world is concentrated in particular regions and countries. The burden of tuberculosis in the world is mainly concentrated in five countries that represent 79.5% of the total global burden of tuberculosis, namely India, Indonesia, China, Nigeria, and South Africa (Silva et al., 2021). Thirty high-burden countries have been disproportionately affected by the disease, most of which are in low- and middle-income parts of the globe. The economic burden would total $7.3 trillion, with almost a trillion of the burden caused by TB deaths linked to HIV (Silva et al., 2021). The disparities are pronounced with regional differences showing that sub-Saharan Africa is the most affected economically and health-wise due to the death of tuberculosis. The trends indicate the great significance of specific interventions in the most affected areas.
Regional Inequities
The effects of tuberculosis differ radically in various socioeconomic settings and levels of society. The countries with a high level of income are characterized by a low rate of morbidity and mortality due to health systems that are well developed, and countries with a low level of income cannot boast of a stable low level of disease (Al-Worafi, 2023). Economic deprivation is one of the major factors that contribute to the spread of TB, as overpopulation, poor ventilation in housing, and other factors promote the spread of the disease (World Health Organization, 2025a). Personally, the disastrous medical costs are more than the household income ratios, stigma, and shortened life expectancy. Community impacts include the disruption of social systems, losses in economic terms, and the continuation of intergenerational patterns of poverty. The complex implications show that tuberculosis is a factor and an effect of social inequality.
Social Determinants That Impact the Problem
Population Most Affected and Socioeconomic Determinants
The group of people who are mostly affected by tuberculosis are people who are socioeconomically deprived due to poverty, malnutrition, and overcrowding. Economic deprivation is another major driver of the spread of tuberculosis, where poor housing ventilation and overcrowding conditions form direct channels of the disease transmission (Najafizada et al., 2020). Persons with socioeconomic deprivation have a higher risk of exposure to tuberculosis due to interaction with infected individuals, increased chances of living in under-ventilated premises, increased vulnerability to malnutrition, and barriers to access to medical services (Wu et al., 2023). The rates of tuberculosis diseases and deaths are considerably high in lower and middle-income countries compared to their rich counterparts due to disparities in the healthcare infrastructure (Msoka et al., 2021). The poverty at the family level introduces a variety of routes to tuberculosis susceptibility by providing poor nutrition, poor housing, and poor access to medical care.
Cultural Beliefs and Geographic Factors
Cultural beliefs have a significant influence on the health-seeking behaviors of tuberculosis, whereby in most cultures, people believe tuberculosis is a result of supernatural causes and not a bacterial infection. According to qualitative studies, the members of the community believe that tuberculosis is related to witchcraft and spiritual attacks, and the germ theory of infections is doubted (Smith et al., 2021). The stigma of tuberculosis and social isolation influences the desire of people to receive testing and seek healthcare after the development of symptoms (Adeoye et al., 2024). Poor air circulation and congested conditions in residential, occupational, and community environments increase the likelihood of exposure of healthy individuals to tuberculosis bacteria (Hayward et al., 2024). Place-based challenges multiply the challenges through limited health amenities in remote areas, transportation barriers, and concentration of vulnerable populations in urban slums.
Political Systems and Healthcare Access
The governmental structures influence the outcomes of tuberculosis through medical policy decisions, allocation of funds, and safety nets. Cultural factors and communication barriers increase the risk of tuberculosis among certain populations, including language barriers and a lack of culturally appropriate care (Woldesemayat, 2021). The control of tuberculosis program is limited by political instability and poor governance systems in the regions where it occurs. Poor awareness of the causes of the disease, misguided ideologies, stigma, and prohibitive costs of treatment are some of the core impediments that can be applied to other types of diseases (Zimmerman et al., 2020). The structure of healthcare systems, i.e., the existence of private versus public sector relationships, influences diagnostic delays and completion of treatment to a substantial degree in various political settings.
Nongovernment Funding Organization Involvement
Partners In Health: Drug-Resistant Tuberculosis Patients
New strategies in treatment are transforming the care of tuberculosis in the world. Partners In Health is involved in the endTB partnership and focuses on multidrug-resistant and extensively drug-resistant TB patients in seventeen countries. The endTB project involved 754 patients in seven countries, namely, Georgia, India, Kazakhstan, Lesotho, Pakistan, Peru, and South Africa, with specific consideration of previously excluded groups, such as adolescents and patients with comorbidities (Partners In Health, 2024). The PIH also introduces new nine-month bedaquiline- and delamanid-based regimens in treating MDR-TB. The endTB clinical trial identified three new drug regimens that had positive results in the participants, being non-inferior to the traditional treatments and shortening the treatment time by up to two-thirds (Partners In Health, 2024). The advances are a major step toward easier and better treatment of tuberculosis globally.
Médecins Sans Frontières: Pediatric Tuberculosis Populations
The project of Médecins Sans Frontières involves children and adolescents with tuberculosis in various countries in Africa and Asia. The WHO estimates that 1.25 million children and young adolescents become ill with tuberculosis each year, of which half are diagnosed and treated. The MSF also carries out the WHO-revised 2022 guidelines on the management of pediatric tuberculosis by community-based screening and treatment services (World Health Organization, 2025b). A six-month all-oral regimen was shown to have 89 percent cure rates and fewer side effects than the standard treatment in the TB-PRACTECAL clinical trial (MSF Access Campaign, 2024), which compared results with 52 percent cure rates. The intervention of MSF has recorded a rise in the diagnosis and the commencement of treatment of pediatric tuberculosis in the program locations.
Stop TB Partnership: High-Burden Country Populations
Stop TB Partnership focuses on the populations living in high tuberculosis-burden countries using the Global Plan to End TB and advocacy campaigns. The Challenge Facility for Civil Society of the Partnership enables tuberculosis-affected communities and grassroots organizations, which are frequently neglected in the fight to combat tuberculosis, by funding innovative interventions (World Health Organization, 2025b). Stop TB conducts global advocacy activities and coordinates multi-stakeholder responses in more than 2,000 partner organizations worldwide. The TB Strategic Initiative, which was executed by Stop TB Partnership and WHO at the end of 2019, led to 1,014,000 more people with tuberculosis (Global Fund, 2024). The Global Drug Facility of the Partnership has changed the face of tuberculosis care by enhancing access to and management of the drug supply chain around the world.
Culturally Sensitive Intervention
The intervention that will be proposed is the incorporation of trained traditional healers in the community as case-finding partners of tuberculosis in the current health systems. The traditional healers can be trained to identify presumptive symptoms of tuberculosis and then refer patients to health care facilities, and it has been shown that twenty-two trained traditional healers referred twenty-four tuberculosis suspects, with thirteen confirmed cases (Najafizada et al., 2020). This would be implemented by one-week training programs to traditional healers on recognition of the symptoms of tuberculosis, proper referral procedures, and mechanisms of working together with formal health facilities. The intervention also overcomes cultural barriers, as local people are hired to work as health workers so that cultural and language differences can be overcome and traditional healers can be trained to identify the symptoms of tuberculosis and refer patients to healthcare facilities (Woldesemayat, 2021). Intervention shows cultural sensitivity because it recognizes the trust that traditional healers have built in the community and establishes non-competing relationships between the traditional and biomedical healthcare systems.
Conclusion
The disease of tuberculosis remains a significant challenge to health worldwide, with a disproportionate burden on vulnerable groups due to the multiple interplays of poverty, cultural, and healthcare disparities. The review shows that the successful management of tuberculosis involves complex measures that should include evidence-based medical practices and culturally competent community outreach. Partners In Health, Médecins Sans Frontières, and the Stop TB Partnership show that NGO specific interventions can reach high levels of treatment success and can increase access to treatment for marginalized groups. Nonetheless, sustainable elimination of tuberculosis requires thorough incorporation of the social determinants of health interventions, collaborations with traditional healers, and community-based health approaches that accommodate cultural settings without compromising the provision of contemporary medical care. The imperative to boost funding, political dedication, and creative integration of biomedical and traditional healthcare systems is still crucial to the realization of the lofty objective of eliminating tuberculosis as a public health menace.
References
Adeoye, B. D., Michael, T. O., & Agbana, R. D. (2024). Insights, beliefs, and myths surrounding tuberculosis among pulmonary patients with delayed healthcare access in a high-burden TB state in Nigeria – A qualitative inquiry. Frontiers in Sociology, 9. https://doi.org/10.3389/fsoc.2024.1378586
Al-Worafi, Y. M. (2023). Tuberculosis management in developing countries. Springer International Publishing, 1–40. https://doi.org/10.1007/978-3-030-74786-2_52-1
Global Fund. (2024). Tuberculosis. Theglobalfund.org. https://www.theglobalfund.org/en/tuberculosis/
Hayward, S. E., Vanqa, N., Makanda, G., Tisile, P., Ngwatyu, L., Foster, I., Mcinziba, A. A., Biewer, A., Mbuyamba, R., Galloway, M., Bunyula, S., van, Friedland, J. S., Marino, A. M., Viljoen, L., Schoeman, I., Hoddinott, G., & Nathavitharana, R. R. (2024). “As a patient I do not belong to the clinic, I belong to the community”: Co-developing multi-level, person-centred tuberculosis stigma interventions in Cape Town, South Africa. BioMed Central Global and Public Health, 2(1), 55. https://doi.org/10.1186/s44263-024-00084-z
Lee, H., Kim, J., Kim, J., & Park, Y.-J. (2025). Review of the global burden of tuberculosis in 2023: Insights from the WHO global tuberculosis report 2024. Public Health Weekly Report, 18(11), 55–69. https://doi.org/10.56786/phwr.2025.18.11suppl.5
NURS FPX 8024 Assessment 2 Global Issue Investigation
MSF Access Campaign. (2024). TB-PRACTECAL: Groundbreaking MSF trial finds better treatment for people with drug-resistant tuberculosis. Msfaccess.org https://msfaccess.org/tb-practecal-groundbreaking-msf-trial-finds-better-treatment-people-drug-resistant-tuberculosis
MSF Access Campaign. (2025). MSF calls for sustained investments to fight against tuberculosis in children. Msfaccess.org. https://msfaccess.org/msf-calls-sustained-investments-fight-against-tuberculosis-children
Msoka, E. F., Orina, F., Sanga, E. S., Miheso, B., Mwanyonga, S., Meme, H., Kiula, K., Liyoyo, A., Mwebaza, I., Aturinde, A., Joloba, M., Mmbaga, B., Amukoye, E., Ntinginya, N. E., Gillespie, S. H., & Sabiiti, W. (2021). Qualitative assessment of the impact of socioeconomic and cultural barriers on uptake and utilisation of tuberculosis diagnostic and treatment tools in East Africa: a cross-sectional study. British Medical Journal Open, 11(7), e050911. https://doi.org/10.1136/bmjopen-2021-050911
Najafizada, M., Rahman, A., Taufique, Q., & Sarkar, A. (2020). Social determinants of multidrug-resistant tuberculosis: A scoping review and research gaps. Indian Journal of Tuberculosis, 68(1), 99–105. https://doi.org/10.1016/j.ijtb.2020.09.016
Partners In Health. (2024). Landmark clinical trial redefines multidrug-resistant tuberculosis treatment options, Pih.org. https://www.pih.org/article/landmark-clinical-trial-redefines-multidrug-resistant-tuberculosis-treatment-options
NURS FPX 8024 Assessment 2 Global Issue Investigation
Silva, S., Arinaminpathy, N., Atun, R., Goosby, E., & Reid, M. (2021). Economic impact of tuberculosis mortality in 120 countries and the cost of not achieving the Sustainable Development Goals tuberculosis targets: A full-income analysis. The Lancet Global Health, 9(10), 1372–1379. https://doi.org/10.1016/s2214-109x(21)00299-0
Smith, A., Herington, E., & Loshak, H. (2021, July 16). Tuberculosis stigma and racism, colonialism, and migration: A rapid qualitative review. National Institutes of Health. https://www.ncbi.nlm.nih.gov/books/NBK571944/
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World Health Organization. (2025b, March 14). Tuberculosis. Who.int. https://www.who.int/news-room/fact-sheets/detail/tuberculosis
Woldesemayat, E. M. (2021). Tuberculosis in migrants is among the challenges of tuberculosis control in high-income countries. Risk Management and Healthcare Policy, 14, 2965–2970. https://doi.org/10.2147/rmhp.s314777
Wu, S., Litvinjenko, S., Magwood, O., & Wei, X. (2023). Defining tuberculosis vulnerability based on an adapted social determinants of health framework: A narrative review. Global Public Health, 18(1). https://doi.org/10.1080/17441692.2023.2221729
Zimmerman, E., Smith, J., Banay, R., Kau, M., & Garfin, A. M. C. G. (2020). Behavioural barriers and perceived trade-offs to care-seeking for tuberculosis in the Philippines. Global Public Health, 17(2), 1–13. https://doi.org/10.1080/17441692.2020.1855460
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