{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:21:29Z","timestamp":1790619689512,"version":"4.1.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007219","name":"Shanghai Natural Science Foundation","doi-asserted-by":"publisher","award":["23ZR1464000"],"award-info":[{"award-number":["23ZR1464000"]}],"id":[{"id":"10.13039\/100007219","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010876","name":"Shanghai University of Traditional Chinese Medicine","doi-asserted-by":"publisher","award":["24BZH07"],"award-info":[{"award-number":["24BZH07"]}],"id":[{"id":"10.13039\/501100010876","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010876","name":"Shanghai University of Traditional Chinese Medicine","doi-asserted-by":"publisher","award":["LH001.007"],"award-info":[{"award-number":["LH001.007"]}],"id":[{"id":"10.13039\/501100010876","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010876","name":"Shanghai University of Traditional Chinese Medicine","doi-asserted-by":"publisher","award":["21410750200"],"award-info":[{"award-number":["21410750200"]}],"id":[{"id":"10.13039\/501100010876","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["2022CX010"],"award-info":[{"award-number":["2022CX010"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Program of Shanghai Science and Technology Commission","award":["22XD1423500"],"award-info":[{"award-number":["22XD1423500"]}]},{"DOI":"10.13039\/501100005893","name":"China Academy of Traditional Chinese Medicine","doi-asserted-by":"publisher","award":["ZYYCXTD-D-202208"],"award-info":[{"award-number":["ZYYCXTD-D-202208"]}],"id":[{"id":"10.13039\/501100005893","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The global macroeconomic impact of Tuberculosis (TB) lacks comprehensive quantification using standardized economic frameworks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This analysis utilized data from the Global Burden of Disease (GBD) 2021 to assess the economic burden of TB through the lens of the Value of a Statistical Life Year (VSLY) framework, integrating willingness-to-pay-based economic measures. The study monetized the total disability-adjusted life years (DALYs) associated with TB to estimate overall welfare losses. Country-specific gross domestic product (GDP) data, adjusted for purchasing power parity (PPP), were sourced from the World Bank and integrated with DALY estimates to calculate the Value of Lost Welfare (VLW).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2021, the global economic cost of TB, expressed as VLW, was estimated at US$1.98 trillion (95% uncertainty interval [UI]: 1.62, 2.45), representing 1.29% (95% UI: 1.05, 1.60) of global GDP. The economic impact of TB was disproportionately distributed across regions, with countries of low Socio-Demographic Index (SDI) facing the most severe burden, where VLW represented 7.83% (95% UI: 5.70, 11.20) of GDP. Lower-middle SDI regions experienced a VLW impact of 5.28% (95% UI: 4.30, 6.58). Sub-Saharan Africa (US$406.2 billion; 8.40% of GDP) and South Asia (US$822.5 billion; 5.70% of GDP) were identified as the most economically affected super-regions. India bore the highest absolute economic burden (US$477.5 billion). In contrast, high-SDI countries demonstrated a VLW-to-GDP ratio of just 0.10% (95% UI: 0.09, 0.12).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prioritizing TB control in economic policy is urgently needed. Equitable resource allocation to high-burden regions is vital to alleviate the disease's economic consequences and improve global health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag014","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T12:48:24Z","timestamp":1767962904000},"source":"Crossref","is-referenced-by-count":3,"title":["The Global Economic Burden of Tuberculosis: Regional Disparities and Implications"],"prefix":"10.1093","volume":"13","author":[{"given":"Ji-Chun","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Science and Technology, Chinese Center for Disease Control and Prevention , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin-Yan","family":"Zuo","sequence":"additional","affiliation":[{"name":"Department of Science and Technology, Chinese Center for Disease Control and Prevention , Beijing ,","place":["China"]},{"name":"Clinical Research Center, Longhua Hospital, Shanghai University of Traditional Chinese Medicine , Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Xin","family":"Zheng","sequence":"additional","affiliation":[{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, National Institute of Parasitic Diseases of Chinese Center for Disease Control and Prevention , Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Wen","family":"Lv","sequence":"additional","affiliation":[{"name":"Quality Control Center, Clinical Medicine Research Institute, Shanghai Jiao Tong University School of Medicine , Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Editorial Office, National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Key Laboratory of Jiangsu Province on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases , Wuxi, Jiangsu ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8929-4433","authenticated-orcid":false,"given":"Shun-Xian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Longhua Hospital, Shanghai University of Traditional Chinese Medicine , Shanghai ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"2026012901363078500_ofag014-B1","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1016\/S0140-6736(24)02479-6","article-title":"Tuberculosis","volume":"405","author":"Trajman","year":"2025","journal-title":"Lancet"},{"key":"2026012901363078500_ofag014-B2","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s40249-025-01299-4","article-title":"Association of urbanization-related factors with tuberculosis incidence among 1992 counties in China from 2005 to 2019: a nationwide observational study","volume":"14","author":"Wang","year":"2025","journal-title":"Infect Dis Poverty"},{"key":"2026012901363078500_ofag014-B3","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s40249-025-01283-y","article-title":"Spatial autocorrelation with environmental factors related to tuberculosis prevalence in Nepal, 2020\u20132023","volume":"14","author":"Mahato","year":"2025","journal-title":"Infect Dis Poverty"},{"key":"2026012901363078500_ofag014-B4","author":"World Health Organization"},{"key":"2026012901363078500_ofag014-B5","doi-asserted-by":"crossref","first-page":"220044","DOI":"10.1183\/16000617.0044-2022","article-title":"End-point definition and trial design to advance tuberculosis vaccine development","volume":"31","author":"Garcia-Basteiro","year":"2022","journal-title":"Eur Respir Rev"},{"key":"2026012901363078500_ofag014-B6","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1016\/S1473-3099(24)00223-8","article-title":"Bedaquiline-pretomanid-moxifloxacin-pyrazinamide for drug-sensitive and drug-resistant pulmonary tuberculosis treatment: a phase 2c, open-label, multicentre, partially randomised controlled trial","volume":"24","author":"Cevik","year":"2024","journal-title":"Lancet Infect Dis"},{"key":"2026012901363078500_ofag014-B7","volume-title":"WHO Consolidated guidelines on tuberculosis: module 4: treatment\u2014drug-resistant tuberculosis treatment, 2022 update [internet]","year":"2022"},{"key":"2026012901363078500_ofag014-B8","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1056\/NEJMoa2119430","article-title":"Bedaquiline-pretomanid-linezolid regimens for drug-resistant Tuberculosis","volume":"387","author":"Conradie","year":"2022","journal-title":"N Engl J Med"},{"key":"2026012901363078500_ofag014-B9","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1016\/S0140-6736(23)01379-X","article-title":"Scientific advances and the end of tuberculosis: a report from the lancet commission on Tuberculosis","volume":"402","author":"Reid","year":"2023","journal-title":"Lancet"},{"key":"2026012901363078500_ofag014-B10","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1186\/s40249-024-01248-7","article-title":"Out-of-pocket payment and catastrophic health expenditure of tuberculosis patients in accessing care at public-private mix clinics in Myanmar, 2022","volume":"13","author":"Khaing","year":"2024","journal-title":"Infect Dis Poverty"},{"key":"2026012901363078500_ofag014-B11","doi-asserted-by":"crossref","first-page":"840225","DOI":"10.3389\/fimmu.2022.840225","article-title":"It takes a village: the multifaceted immune response to Mycobacterium tuberculosis infection and vaccine-induced immunity","volume":"13","author":"Larsen","year":"2022","journal-title":"Front Immunol"},{"key":"2026012901363078500_ofag014-B12","doi-asserted-by":"crossref","first-page":"2204","DOI":"10.1016\/S0140-6736(24)00685-8","article-title":"Burden of disease scenarios for 204 countries and territories, 2022\u20132050: a forecasting analysis for the global burden of disease study 2021","volume":"403","author":"GBD 2021 Forecasting Collaborators","year":"2024","journal-title":"Lancet"},{"key":"2026012901363078500_ofag014-B13","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","article-title":"Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990\u20132021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"403","author":"GBD 2021 Diseases and Injuries Collaborators","year":"2024","journal-title":"Lancet"},{"key":"2026012901363078500_ofag014-B14","doi-asserted-by":"crossref","first-page":"100075","DOI":"10.1016\/j.soh.2024.100075","article-title":"Global burden of enteric infections related foodborne diseases, 1990\u20132021: findings from the Global Burden of Disease Study 2021","volume":"3","author":"Li","year":"2024","journal-title":"Sci One Health"},{"key":"2026012901363078500_ofag014-B15","doi-asserted-by":"crossref","first-page":"100072","DOI":"10.1016\/j.soh.2024.100072","article-title":"Global burden of HIV-negative multidrug- and extensively drug-resistant tuberculosis based on Global Burden of Disease Study 2021","volume":"3","author":"Chen","year":"2024","journal-title":"Sci One Health"},{"key":"2026012901363078500_ofag014-B16","doi-asserted-by":"crossref","first-page":"100086","DOI":"10.1016\/j.soh.2024.100086","article-title":"Trends in epidemiological characteristics and etiologies of diarrheal disease in children under five: an ecological study based on Global Burden of Disease study 2021","volume":"3","author":"Chu","year":"2024","journal-title":"Sci One Health"},{"key":"2026012901363078500_ofag014-B17","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1186\/s40249-024-01252-x","article-title":"Global burden of zoonotic infectious diseases of poverty, 1990\u20132021","volume":"13","author":"Lv","year":"2024","journal-title":"Infect Dis Poverty"},{"key":"2026012901363078500_ofag014-B18","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1186\/s40249-024-01265-6","article-title":"Global, regional and national disease burden of food-borne trematodiases: projections to 2030 based on the global burden of disease study 2021","volume":"13","author":"Liu","year":"2024","journal-title":"Infect Dis Poverty"},{"key":"2026012901363078500_ofag014-B19","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1186\/s40249-024-01260-x","article-title":"Prevalence and attributable health burdens of vector-borne parasitic infectious diseases of poverty, 1990\u20132021: findings from the Global Burden of Disease Study 2021","volume":"13","author":"Zhu","year":"2024","journal-title":"Infect Dis Poverty"},{"key":"2026012901363078500_ofag014-B20","doi-asserted-by":"crossref","first-page":"2380","DOI":"10.1161\/STROKEAHA.123.043131","article-title":"Global, regional, and national economic consequences of stroke","volume":"54","author":"Gerstl","year":"2023","journal-title":"Stroke"},{"key":"2026012901363078500_ofag014-B21","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1001\/jamaoncol.2022.7826","article-title":"Estimates and projections of the global economic cost of 29 cancers in 204 countries and territories from 2020 to 2050","volume":"9","author":"Chen","year":"2023","journal-title":"JAMA Oncol"},{"key":"2026012901363078500_ofag014-B22","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1111\/ene.14085","article-title":"Global macroeconomic burden of epilepsy and the role for neurosurgery: a modelling study based upon the 2016 Global Burden of Disease data","volume":"27","author":"O'Donohoe","year":"2020","journal-title":"Eur J Neurol"},{"key":"2026012901363078500_ofag014-B23","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1186\/s12916-025-04109-8","article-title":"Economic burden attributable to high BMI-caused cancers: a global level analysis between 2002 and 2021","volume":"23","author":"Zheng","year":"2025","journal-title":"BMC Med"},{"key":"2026012901363078500_ofag014-B24","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1097\/SLA.0000000000003662","article-title":"The global macroeconomic burden of breast cancer: implications for oncologic surgery","volume":"274","author":"Ranganathan","year":"2021","journal-title":"Ann Surg"},{"key":"2026012901363078500_ofag014-B25","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s40249-025-01330-8","article-title":"Estimation and prediction on the economic burden of schistosomiasis in 25 endemic countries","volume":"14","author":"Chen","year":"2025","journal-title":"Infect Dis Poverty"},{"key":"2026012901363078500_ofag014-B26","doi-asserted-by":"crossref","first-page":"101560","DOI":"10.1016\/j.siny.2024.101560","article-title":"Assessment of Global Burden due to neonatal encephalopathy: an economic evaluation","volume":"29","author":"Vidavalur","year":"2024","journal-title":"Semin Fetal Neonatal Med"},{"key":"2026012901363078500_ofag014-B27","doi-asserted-by":"crossref","first-page":"e077602","DOI":"10.1136\/bmjopen-2023-077602","article-title":"Cost of the COVID-19 pandemic versus the cost-effectiveness of mitigation strategies in EU\/UK\/OECD: a systematic review","volume":"13","author":"Vardavas","year":"2023","journal-title":"BMJ Open"},{"key":"2026012901363078500_ofag014-B28","doi-asserted-by":"crossref","first-page":"e390","DOI":"10.1016\/S2542-5196(19)30170-6","article-title":"The global macroeconomic burden of road injuries: estimates and projections for 166 countries","volume":"3","author":"Chen","year":"2019","journal-title":"Lancet Planet Health"},{"key":"2026012901363078500_ofag014-B29","doi-asserted-by":"crossref","first-page":"e1183","DOI":"10.1016\/S2214-109X(23)00217-6","article-title":"The global economic burden of chronic obstructive pulmonary disease for 204 countries and territories in 2020\u201350: a health-augmented macroeconomic modelling study","volume":"11","author":"Chen","year":"2023","journal-title":"Lancet Glob Health"},{"key":"2026012901363078500_ofag014-B30","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1016\/S2214-109X(15)70088-4","article-title":"Global economic consequences of selected surgical diseases: a modelling study","volume":"3","author":"Alkire","year":"2015","journal-title":"Lancet Glob Health"},{"key":"2026012901363078500_ofag014-B31","doi-asserted-by":"crossref","first-page":"e2129742","DOI":"10.1001\/jamanetworkopen.2021.29742","article-title":"Estimated cost-effectiveness of genetic testing in siblings of newborns with cancer susceptibility gene variants","volume":"4","author":"O'Brien","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2026012901363078500_ofag014-B32","doi-asserted-by":"crossref","first-page":"e1372","DOI":"10.1016\/S2214-109X(21)00299-0","article-title":"Economic impact of tuberculosis mortality in 120 countries and the cost of not achieving the Sustainable Development Goals tuberculosis targets: a full-income analysis","volume":"9","author":"Silva","year":"2021","journal-title":"Lancet Glob Health"},{"key":"2026012901363078500_ofag014-B33","author":"KPMJ"},{"key":"2026012901363078500_ofag014-B34","doi-asserted-by":"crossref","first-page":"e000059","DOI":"10.1136\/bmjgh-2016-000059","article-title":"Economic valuation of the impact of a large surgical charity using the value of lost welfare approach","volume":"1","author":"Corlew","year":"2016","journal-title":"BMJ Glob Health"},{"key":"2026012901363078500_ofag014-B35","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/S2213-2600(17)30468-X","article-title":"The global cost of tuberculosis","volume":"6","author":"Burki","year":"2018","journal-title":"Lancet Respir Med"},{"key":"2026012901363078500_ofag014-B36","doi-asserted-by":"crossref","first-page":"e080969","DOI":"10.1136\/bmj-2024-080969","article-title":"Discrepancies in neglected tropical diseases burden estimates in China: comparative study of real-world data and Global Burden of Disease 2021 data (2004\u20132020)","volume":"388","author":"Yang","year":"2025","journal-title":"BMJ"},{"key":"2026012901363078500_ofag014-B37","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/s40249-024-01227-y","article-title":"Global, regional, and national burden of HIV-negative tuberculosis, 1990\u20132021: findings from the global burden of disease study 2021","volume":"13","author":"Zhang","year":"2024","journal-title":"Infect Dis Poverty"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofag014\/66538279\/ofag014.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/13\/1\/ofag014\/66538279\/ofag014.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/13\/1\/ofag014\/66538279\/ofag014.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T06:36:43Z","timestamp":1769668603000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofag014\/8437971"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,26]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,12,26]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofag014","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1]]},"published":{"date-parts":[[2025,12,26]]},"article-number":"ofag014"}}