TB researchers are hopeful about new vaccines, but trials may extend to 2029. Funding is insufficient, and the disease burdens developing and middle-income countries most. India, Indonesia, China, the Philippines, and Pakistan account for 60% of global cases. TB rates are declining globally except in the Americas and Western Pacific, driven by Latin America's prison overcrowding. In the US, rates have risen to 2013 levels, affecting immigrants, Black people, and Native Americans.