TB Rates in England Remain Steady in 2025, Urgent Action Required for Further Reduction

Recent annual statistics released by the UK Health Security Agency (UKHSA) indicate that tuberculosis (TB) notifications in England for 2025 have stabilised, with 5,449 notifications reported, a slight decrease from 5,485 in 2024. This follows a period of significant increases in preceding years, with notifications recorded as follows:

• 2022: 4,380 notifications
• 2023: 4,831 notifications

The TB notification rate for England in 2025 was 9.26 per 100,000 population, closely mirroring the rate of 9.36 per 100,000 observed in 2024. Despite this apparent stability, there is still a pressing need for substantial reductions in TB cases to address this public health challenge effectively.

Emerging Trends and Early Data for 2026

Provisional data for the initial three quarters of 2026 suggest a downward trend in notifications, with an 8.2% decrease compared to the same period in 2025. Demographic patterns in TB notifications for 2025 reflected those of previous years:

• 82.3% of TB notifications involved individuals born outside the UK, an increase from 82% in 2024.
• Rates remained highest in urban areas, particularly in London, which reported 20.2 cases per 100,000.
• A growing disparity was noted between socioeconomic groups; the notification rate among the 10% of individuals residing in the most deprived areas of England increased from 14.5 per 100,000 in 2019 to 19.4 per 100,000 in 2025.
• Individuals in the most deprived areas were 6.9 times more likely to receive a TB diagnosis compared to those in the least deprived regions.
• Among UK-born individuals, TB rates remained relatively stable within populations experiencing homelessness, substance dependency, and interactions with the criminal justice system, all of which are recognised risk factors for TB.

Importance of Targeted Efforts

Efforts to reduce notifications among at-risk populations are imperative. This includes targeted testing and awareness campaigns as part of the ongoing TB Action Plan. The proportion of notifications for multi-drug resistant TB was also consistent, with 2.1% of cases in 2025 identified as such, compared to 2.2% in 2024. Multi-drug resistant TB necessitates longer and more complex treatment, thereby imposing additional demands on healthcare services.

In addressing the issue, a representative from the TB Unit at UKHSA emphasized the critical nature of awareness regarding TB symptoms to ensure timely testing and treatment, which are essential for reducing TB incidence significantly.

Continued Commitment to TB Control

Individuals who have relocated to England from regions where TB is more prevalent are encouraged to familiarise themselves with the symptoms of TB to seek prompt testing and treatment through their general practitioner. A persistent cough accompanied by a fever may not always be attributed to flu or COVID-19; a cough that produces mucus and lasts longer than three weeks could indicate TB, and those at risk should consult their GP.

TB remains the leading cause of death from a single infectious agent globally. This bacterial infection primarily targets the lungs, making it infectious in that state. Work is underway to formulate a new TB National Action Plan, which will concentrate on enhancing the prevention, detection, and management of TB in England, prioritising effective interventions and addressing health inequalities. In the interim, the existing TB Action Plan remains available for organisations to support ongoing commitments.