British Medical Journal
Published March 11, 2026
TB surge: Is England About to Lose its Low Incidence Status?
Once considered a disease consigned to the past, tuberculosis is making a resurgence in the United Kingdom.
In 2024 England saw its largest annual increase in tuberculosis (TB) cases since national surveillance began in the late 1990s. The 13.5% increase (from 4831 cases in 2023 to 5490 in 2024), which continued an upward trend since 2020, prompted the UK Health Security Agency (UKHSA) to warn that the country was on the brink of losing its low incidence status. While the UKHSA describes the current situation as “stable,” with 5424 cases reported in 2025, England’s TB notification rate remains high at 9.4 per 100 000 people. This is only just under the 10 per 100 000 threshold set by the World Health Organization.
In early 2026 the ongoing threat was highlighted by an outbreak at a warehouse in Coventry, where at least 10 people tested positive for latent TB. The national figures are also on the rise. Doctors working in TB services say that without additional resources to screen and treat people it is only a matter of time before the scales tip and the WHO threshold is surpassed.
What’s driving the trend?
Just over 80% of reported TB cases in England are in people born outside and immigrated to the UK. There has also been an increase, albeit to a lesser extent, in people born in the UK. This trend suggests there’s “definitely something happening that is outside of, or additional to, migration patterns.
Globally, TB remains a significant public health concern. In 2024 alone, an estimated 920 000 new TB cases and nearly 85 000 deaths occurred in the Region. A third of TB cases go undetected, many in fragile and high-burden countries such as Djibouti, Somalia, Sudan, Libya, Afghanistan and Pakistan. Every 34 seconds, a person in the Region falls ill with TB. Every 6 minutes, a life is lost to the disease. High loss to follow-up contributes to drug resistance, limited access to services hampers progress and TB-affected patients and their households face catastrophic costs to access the TB prevention and care. Yet despite challenges, there are signs of progress. Between 2020 to 2024, over 2.8 million TB cases were diagnosed and successfully treated – treatment success rates exceeded 90% – contributing to a significant reduction in the TB burden across the Region.