The Silent Struggle: How TB Is Spreading Unseen Across Africa
Princess-Ekwi Ajide
When Amina Ibrahim, a 28-year-old mother of two, strolls through the bustling market in Lagos Nigeria each morning, selling vegetables to feed her family, her mind is on survival.
She feels healthy, energetic, and grateful for each day’s work. What Amina does not know is that she could be carrying tuberculosis (TB) and unknowingly passing it on to those closest to her.
Amina is part of a growing group health experts call “the silent spreaders”: people living with asymptomatic TB, a form of the disease where infected individuals does not show the tell-tale symptoms like coughing, fever, or night sweats.
They go about their lives unaware, yet still capable of infecting others.
A Hidden Crisis in Plain Sight
TB is often seen as an illness that announces itself loudly. But the latest WHO 2024 Global Tuberculosis Report reveals a disturbing truth that up to half of TB cases detected in community surveys are symptom-free, quietly driving Africa’s epidemic.
“This is the invisible threat we’ve underestimated,” says a Senior lecturer at the Department of Health Policy, Management and Economics, School of Public health of the Kwame Nkrumah University of Science and Technology (KNUST), Dr. Kofi Mensah, “People like Amina, who have no symptoms, don’t seek care.
They slip through the cracks of the healthcare system, and that’s where TB continues to spread silently.”
In 2023, 404,000 people across Africa lost their lives to TB, a grim reminder that the disease remains one of the continent’s deadliest killers and claiming a life every minute.
While TB deaths have dropped by 42% since 2015, Africa is still off course to meet the 75% reduction target by 2025.
The Faces Behind the Numbers
For families like Amina’s, TB is not just a distant threat but personal.
Her neighbor, Chidi, lost his sister to TB after her illness was detected too late. “We did not think it was TB because she wasn’t coughing much,” he recalls. “By the time we got her to the hospital, it was already severe.”
Chidi’s story incidentally is far from rare. Across the continent, 26% of TB cases go undiagnosed, leaving thousands untreated and vulnerable to serious illness or death.
A Perfect Storm of Poverty and Poor Access
The financial burden makes things even harder. According to the WHO report, nearly seven in ten TB-affected families in Africa face catastrophic costs during treatment. Some lose their livelihoods, others drop out of treatment altogether.
“If you’re poor and you get TB, it’s like being trapped,” Dr. Mensah says. “You lose income while trying to stay alive.”
The situation worsens with drug-resistant TB (DR-TB), a form of the disease that is harder and costlier to treat.
In 2023, nearly 38,000 DR-TB cases in Africa went undetected, largely because access to fast diagnostic tools is limited, reaching only 54% of those who need them.
A New Frontline: The Search for the Invisible
For this, the WHO is urging African governments to rethink how they fight TB. One major step is to expand screening beyond just those showing symptoms. This could include mass chest X-rays or community-based programmes that would catch the hidden carriers.
For Amina, the thought of being part of the problem without even knowing it; is shocking. “I had no idea someone could have TB without feeling sick,” she says. “I thought as long as I’m fine, I can’t give anyone sickness.”
Though Time is Running Out, There’s Hope on the Horizon
There have been bright spots. In 2023, 2.83 million people received preventive TB treatment, including over 1.7 million people living with HIV, a group particularly vulnerable to TB. Yet, experts warn that more must be done and quickly to retain the gain.
With a staggering $3.6 billion funding gap for TB services in Africa, communities like Amina’s may remain on the frontline of this silent epidemic unless urgent action is taken.
“TB is no longer just about treating who is sick,” Dr. Mensah stresses. “It’s about finding the ones who don’t know they’re sick yet.”
For Amina and millions like her, the fight against TB is as much about awareness as it is about medicine. And until the silent spreaders are reached, Africa’s TB battle will continue to play out quietly, hidden in the everyday lives of ordinary people.
