Additional Context: Of countries receiving both U.S. and Global Fund grants in 2024, Zambia was the most reliant on USAID bilateral funding at around 35% of its national tuberculosis response budget. Global Fund grants made up 46% of its response. According to the World Health Organization, or WHO, this left Zambia the "most exposed to an immediate impact in 2025" regarding tuberculosis prevention, diagnostic and treatment services. Between 2020 and 2024, ACF activities had been scaled up, resulting in annual tuberculosis case notifications reaching 93% of estimated incidence in 2023. That is expected to drop.

Devex Researcher Note: Apeer-reviewed survey of 34 healthcare facilities in three districts of Zambia in April and May 2025 confirms, though not tuberculosis-specific, that in addition to layoffs of USAID-supported staff, external partnerships and receipt of monetary donations for local programs had decreased. According to theStopTB Partnership, 9.6 months of stock of tuberculosis diagnostic testing supplies went unfunded and unprocured as of March 2025, compounding preexisting stockouts. They also report disrupted case finding, contact tracing, and data collection due to the halt of USAID-funded and partner-supported community programs.

Source: WHO