{
  "abstract": "While a range of interventions exists for tuberculosis (TB), their potential impact and cost-effectiveness are seldom directly compared across settings with different TB epidemiologies and structural drivers. Here we calibrated a deterministic TB model to epidemiological indicators from Brazil, India and South Africa. We implemented seven interventions across countries focusing on prevention, screening and diagnosis and treatment, as well as prison screening (Brazil) and nutritional supplementation (India). We standardized scale-up (2025–2030), coverage (80% of the target population) and strength of evidence using published efficacy data. We estimated the epidemiological impact and incremental cost-effectiveness ratios (ICERs), expressed as costs per disability-adjusted life year (DALY) averted, through 2050. Only three interventions prevented >10% of incident TB episodes by 2050: vaccination (median 15–28% across countries), symptom-agnostic community-wide screening (31–38%) and prison screening (23%). Other interventions had limited impact, ranging from 0% (shorter drug-susceptible treatment) to 5% (nutritional supplementation). ICERs varied widely by intervention and setting. Shorter drug-resistant treatment was cost-saving across settings, with the next lowest ICERs for prison screening (US$146 per DALY) and nutritional supplementation (US$281 per DALY). Interventions with meaningful epidemiological impact can be cost-effective but must target populations beyond clinic-diagnosed individuals and their households. Achieving such potential requires a shift in priorities regarding funding, policy and product development.",
  "abstract_shown": true,
  "affiliations": [
    "TB Modelling Group, TB Centre, LSHTM, London, UK",
    "Department of Infectious Disease Epidemiology, LSHTM, London, UK",
    "Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru",
    "Global Health Economics Centre, LSHTM, London, UK",
    "Institute for Global Health, University College London, London, UK",
    "Department of Epidemiology, Biostatistics and Occupational Health, School of Population and Global Health, McGill University, Montreal, Quebec Canada",
    "KNCV Tuberculosis Foundation, The Hague, Netherlands",
    "SEICHE Center for Health and Justice, Yale University School of Medicine, New Haven, CT USA",
    "Justice Collaboratory, Yale Law School, New Haven, CT USA",
    "Health Economics and Epidemiology Research Office, Wits Health Consortium, University of the Witwatersrand, Johannesburg, South Africa",
    "French Institute for Research in Sustainable Development (IRD), Montpellier, France",
    "FAST-TB, CRDF Global, Arlington, VA USA"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 17,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Katherine C. Horton"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Alvaro Schwalb",
      "orcid": "0000-0002-6518-9719"
    },
    {
      "affs": [
        0,
        1,
        3
      ],
      "name": "Martin J. Harker",
      "orcid": "0000-0001-6154-3517"
    },
    {
      "affs": [
        0,
        1,
        4
      ],
      "name": "Lara Goscé",
      "orcid": "0000-0003-2392-6271"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Elena Venero-Garcia"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Lily O’Brien"
    },
    {
      "affs": [
        0,
        1,
        5
      ],
      "name": "Arkaprabha Gun",
      "orcid": "0000-0001-9166-8361"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Tom Sumner"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "C. Finn McQuaid"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Rebecca A. Clark"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Tomos O. Prys-Jones"
    },
    {
      "affs": [
        0,
        1,
        6
      ],
      "name": "Roel Bakker"
    },
    {
      "affs": [
        7,
        8
      ],
      "name": "Yiran E. Liu"
    },
    {
      "affs": [
        9
      ],
      "name": "Mmamapudi Kubjane"
    },
    {
      "affs": [
        10,
        11
      ],
      "name": "Christian Lienhardt"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Richard G. White"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Rein M. G. J. Houben",
      "orcid": "0000-0003-4132-7467"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ata7q4h1p7dg9.bib",
  "cited_by": 2,
  "doi": "10.1038/s44360-026-00171-5",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13727693/",
  "id": "ata7q4h1p7dg9",
  "issns": [
    "3005-0693"
  ],
  "landing_url": "https://doi.org/10.1038/s44360-026-00171-5",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Article"
    ],
    [
      "openalex",
      "2725|Tuberculosis Research and Epidemiology"
    ]
  ],
  "openalex": "W7169830077",
  "pdf_url": null,
  "pmcid": "PMC13727693",
  "pmid": "42978875",
  "published": "2026-07-21",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/ata7q4h1p7dg9.ris",
  "sources": [
    {
      "first_seen": "2026-11-06T12:23:31Z",
      "native_id": "PMC13727693",
      "source": "pmc",
      "url": "https://doi.org/10.1038/s44360-026-00171-5"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2725|Tuberculosis Research and Epidemiology",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Global impact and cost-effectiveness of tuberculosis interventions",
  "title_text": "Global impact and cost-effectiveness of tuberculosis interventions",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:20:50Z",
  "url": "https://research.draconitic.com/paper/ata7q4h1p7dg9",
  "venue": "Nature Health",
  "versions": []
}