According to experts, the impacts of poverty, migration, and the COVID-19 pandemic are likely to be the main factors behind the rise in TB cases in England. The majority of individuals with TB in 2024 (81.5%) were born outside the UK, which is consistent with previous years. The TB notification rate among people born in the UK, compared with the previous year, rose by 3.9% in 2024. The present paper deals with England-Scotland TB comparison.
TB cases are rising in England but falling in Scotland
Dr Andy Whittamore, clinical lead at Asthma + Lung UK, linked the increase in TB cases in the UK to rising poverty. “With increasing poverty in the UK, particularly child poverty, the rise in tuberculosis cases is unfortunately not surprising,” he explained to Medscape News UK.
The TB action plan includes actions linked to the outcomes of the Collaborative TB Strategy for England 2015 to 2020, particularly the challenges and recommendations outlined in the TB strategy end-of-programme report. At the highest level, this action plan intends to ensure some factors. For example, it intends to ensure that Scotland provides the best quality clinical, laboratory, and public health services for tuberculosis.
Why is there less TB in Scotland?
Regarding England-Scotland TB comparison, Scotland has managed to maintain its TB-free status. This is partly due to the lower density of cattle in the country.
There is a law that anyone who keeps cattle must take their animals for a bovine tuberculosis test. They test cattle at intervals (one or four years), depending on which region the herd is located. They consider the disease risk for that area. The testing program checks the TB disease status of a herd, and it is important to:
- Identify which cattle are infected with bovine TB
- prevent bovine TB from spreading to other cattle and animals
- prevent cattle suffering as a result of infection
- protect public health
The End TB strategyEngland-Scotland TB comparison
The new End TB Strategy considers a world free of tuberculosis, with no deaths, disease, or suffering because of the disease. Moreover, the strategy aspiringly proposes to “end the global TB epidemic” by 2035. The strategy targets a 90% reduction in patients suffering from TB and a 95% reduction in deaths from TB by 2035. It protects families from disastrous costs that push them more into poverty. To facilitate the adoption of the strategy, the Western Pacific Regional Framework to End TB, 2021-2030 was developed. WHO provides technical backing to Member States in adapting and applying the Regional Framework.
Why is TB increasing in the UK?
Regarding England-Scotland TB comparison, we should note that TB is related to social issues. Dr Patrick Lillie, consultant in infectious disease at NHS Humber Health Partnership, said London and the West Midlands had already seen a spike in cases, but the risk elsewhere had increased, too. However, TB is linked to deprivation and social issues. Because of this, it’s possible that other cities, including Hull, could see more cases, too. Among UK-born individuals, TB is more common in those experiencing homelessness, drug or alcohol dependency.
The government doesn’t give the BCG vaccine routinely as part of the NHS vaccination program. It is only recommended for individuals at higher risk of getting tuberculosis. These individuals include some babies and children, some passengers, and people at risk through their work. This is despite the fact that people need the BCG vaccine only once. We can mention this as another reason for the rise of TB cases in England.
Some 80% of reported cases of TB in 2023 were from people born outside of the UK. This is despite the number of people being screened for infection before entry doubling between 2021 and 2023.
Concerning England-Scotland TB comparison, the UK Health Security Agency said the Humber and Yorkshire saw an annual 18.2% rise in the number of individuals diagnosed with TB in 2024.
Public health risks and tuberculosis in the UK
Each year, 10 million people deal with tuberculosis. However, it is a preventable and curable disease; 1.5 million people die from this disease every year. It is the world’s top infectious killer. TB is the leading cause of death among people with HIV and is also a major contributor to antimicrobial resistance.
Thought TB was just a Victorian problem? Well, yes, it was a lot more serious back then. It caused one in eight of all deaths in the UK at the time. Moreover, London was supposedly the tuberculosis capital of Europe. TB became less threatening over the 20th century. Thanks to better nutrition, housing, early detection, and effective treatments.
Is Scotland free of TB?
Concerning England-Scotland TB comparison, an important fact is that Scotland has been officially Tuberculosis Free ( OTF ) since 2009. This means that Scotland has sustained a low and stable occurrence of tuberculosis. Maintaining this status is a priority.
The OTF status has significant economic benefits for the Scottish cattle industry:
- fewer and more targeted risk-based TB tests (some herds are exempt from testing if they meet the low-risk criteria)
- greater export opportunities
- reduced risk of TB infecting wildlife
If the number of TB breakdowns exceeds certain levels in any year, OTF status may be lost.
TB can usually be cured, and most people will need a course of antibiotics, typically for 6 months. Vaccination is also available for those most at risk.
Why is TB less common now? During the past century, different factors have reduced tuberculosis in developed countries. These factors include improvements in living and social conditions and, more recently, effective treatment.
ways to prevent tuberculosis
TB is a serious disease that spreads through the air. Immune health and hygiene are also important ways to stop the spread. Some other measures can be useful in reducing the spread of the illness:
- The BCG vaccination
- Early diagnosis
- Case finding
- Managing your environment
Two TB-related conditions exist:
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- Inactive TB and
- Active TB disease
People with active TB disease spread TB germs to people they meet every day, such as:
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- Family members,
- Friends,
- Coworkers,
Is TB on the rise in 2025 in the UK?
In (quarter 1) of 2025, the proportion of people with social risk factors is similar to January to March (quarter 1) of 2024, at 15.4%. For pulmonary TB, the biggest changes in culture confirmation between October to December (quarter 4) of 2024 compared with October to December (quarter 4) of 2023 were in:
- West Midlands and East of England, where both decreased
East Midlands, South West, North East, and Yorkshire and the Humber, where all increased
