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Tuberculosis is an infectious disease that is both curable and preventable – a reality that should be within reach for everyone, now and for future generations. Yet each year, more than one million people — including children — continue to lose their lives to TB. Over half of those affected remain beyond the reach of national health systems, unable to access timely diagnosis, treatment, or support. In response to these global challenges, community-led approaches have emerged that are rooted in lived experience and designed to identify and dismantle systemic barriers across the entire continuum of TB care.

Due to undergoing significant and rapid change in the external financing landscape for global health, the Global Fund announced a set of measures to adjust the implementation plans for the current country grants. There is a risk that community-led monitoring (CLM) programs will be excluded from the Global Fund support. We note that CLM programs were developed to document systemic barriers and work in partnership with national TB programs to address them. At its core, CLM centers the voices of people affected by TB — ensuring they are not only heard, but actively involved in designing and improving services, from diagnosis to cure.

CLM restores agency to people affected by TB. No longer passive recipients of care, they become active participants – evaluating services, identifying challenges, and shaping solutions. This fundamentally shifts the logic of the system: from treating disease to upholding human dignity. By capturing real-time, ground-level data, CLM exposes not only medical gaps – such as access to diagnostics and treatment – but also social and structural determinants that traditional systems often overlook: transportation challenges, stigma, unemployment, housing insecurity, and more. In doing so, CLM reframes TB not just as a health issue, but as a matter of human rights.

Through platforms like OneImpact, communities have evolved into trusted accountability partners, identifying service gaps and driving timely, targeted responses. CLM also enables integrated, multisectoral support – connecting people to psychosocial, legal, nutritional, and informational resources that are essential for treatment adherence and better health outcomes. Most importantly, advocacy powered by CLM data has led to meaningful change – from national budget reallocations to global policy reforms and the adoption of more person-centered, responsive TB services.

We, the TBpeople Global network — a coalition of TB survivors and community leaders from 26 countries — are also increasingly concerned by the growing trend of leaving communities most impacted by the diseases outside of the Global Fund grants reprioritization and revisions processes. While CCM, government leadership and cross-sector collaboration are essential, TB funding decisions must be guided by inclusive, multisectoral engagement that directly involves affected communities and civil society organizations. This approach is critical to ensure that investments effectively address real-life barriers and reach the people who need them most. Without sustained, independent investment in community-led programs — including TB survivor networks like TBpeople — we risk losing the hard-won, life-saving structures that have been built over many years.

We call on all stakeholders to recognize community-led monitoring as a life-saving intervention. The Stop TB Partnership Life-Saving Interventions document and the Global Fund Essentials toolkit explicitly identifies TB community-led monitoring as an essential service, on par with: 

• Universal access to rapid molecular diagnostic 
• Access to all WHO-recommended drug regimens for both drug-sensitive and drug-resistant TB
• Psychosocial support and community-based care
• Legal aid and anti-discrimination mechanisms
  
  

Community-led responses are not a luxury — they are critical infrastructure. In crises such as the war in Ukraine or the COVID-19 pandemic, community networks have consistently demonstrated their ability to reach further and act faster than formal systems.

We urge the Global Fund, donors, and governments to take the following actions to strengthen and sustain community-led TB responses:

• Ensure meaningful, inclusive consultations with TB-affected communities in setting national priorities and making funding decisions, recognizing their lived experience as essential expertise
• Protect and expand funding for TB survivor-led organizations and community-led monitoring mechanisms as integral pillars of an effective and equitable TB response.
• Establish dedicated, independent investment streams for community-led programs that complement – but are not dependent on – government systems.
• Promote strategic, non-competitive collaboration across the TB, HIV, and malaria communities, acknowledging the shared challenges and interconnected nature of these epidemics.
  
  

We are united in one mission: to continue saving lives and end a curable and preventable disease — tuberculosis — for generations to come.

TBpeople Global Network

Secretariat and representatives from:

Azerbaijan, Botswana, Cambodia, Cameroon, Côte d’Ivoire, DRC, Eswatini, Georgia, Ghana, Guinea, India, Indonesia, Kazakhstan, Kenya, Kyrgyzstan, Moldova, Nepal, Nigeria, Pakistan, Philippines, Tajikistan, Uganda, Ukraine, Uzbekistan, Zimbabwe, Vietnam

YOUNITE Global – A Global Youth Network for TB