VOLUME 5, ISSUE 9, September 2025

THE MONTHLY DOSE

WHAT’S NEW AT THE MUELLER HEALTH FOUNDATION:


Our HeroRat Tamasha is getting new co-workers in Addis Ababa, Ethiopia! Five newly trained HeroRATs named Bieber, Kenenisa, Gea, Tirunesh, and Mayele have just arrived from APOPO’s Training and Innovation Center in Tanzania, where Tamasha works, and are now settling in with their handlers under the guidance of the Ethiopian National TB Program and local partners. With these new arrivals, APOPO now has nine working rats in Ethiopia, all ready to screen thousands of sputum samples for tuberculosis. By helping health systems detect TB earlier and more efficiently, these little heroes are reducing transmission and ensuring patients can start treatment as soon as possible. We are proud to see the team growing and excited for the lifesaving impact they will make in Ethiopia’s fight against TB.

Picture Credit: APOPO

LATEST NEWS: SHOWCASING STORIES OF TB SURVIVORS

We at The Mueller Health Foundation continue to be deeply committed to sharing personal stories and giving a voice to TB patients, TB survivors, TB practitioners, and all the friends and family members of the people who have been affected by the disease. We are also proud to continue our support of our new HeroRat Tamasha, who has been trained by APOPO, a charity focused on training rats to detect TB in sputum samples across Africa. APOPO has put together a wonderful collection of success stories from TB survivors, and this month we would like to highlight Zerihun’s story:

Zerihun, a 42-year-old father from Addis Ababa, Ethiopia, has endured hardship since losing his wife three years ago, becoming the sole provider for his two children. His first experience with tuberculosis came nine years ago, when he delayed care and relied on home remedies before finally being diagnosed and treated. Life moved on, but about a year ago the symptoms returned. This time, recognizing them immediately, he went to the clinic immediately, determined not to risk his children’s health. While undergoing treatment, Zerihun took every precaution by wearing masks at home and on public transport, separating dishes, and creating space within their small one-room home. He continued working in furniture sales near Piassa, supported by friends who brought food to help him regain strength. The memory of his wife’s illness and death still troubles him, but he remains focused on providing for his family and keeping them safe. Zerihun now shares his story to raise awareness, often urging fellow passengers to protect themselves and others from TB. What surprised him most during his second diagnosis was learning that his sample had been tested with the help of APOPO’s HeroRats, something he had never heard of before. Grateful to both the staff and the rats, he credits them with saving his life. Today, Zerihun is back at work, hopeful for his children’s future, and determined to advocate for early care and openness about TB in his community. To read his full story, please follow the link here: https://apopo.org/tb-detection-ethiopia-beneficiary-zerihun/?v=0b3b97fa6688/

For more news, please also take a look at our top 3 picks for September in this newsletter, where we highlight novel research findings and news about the prevention and treatment of tuberculosis around the world.

MHF TOP PICKS FOR September

Every month, we at the Mueller Health Foundation like to showcase interesting news and updates in the field of tuberculosis (TB). Below are our top 3 picks for September:

  1. Malawi Faces Critical TB Drug Shortage Amid Aid Cuts and Supply Disruptions

Malawi is on the brink of a severe tuberculosis drug shortage, with supplies expected to be depleted by the end of September 2025. The country’s supply is now critically low due to a combination of global pharmaceutical ingredient disruptions and significant cuts in aid from international donors, including the US and UK. Despite having reduced TB cases by 40% over the past decade and achieving high treatment success rates, Malawi’s health system is now under threat. In Blantyre, pharmacies have completely run out of RHZE, a crucial four-drug TB regimen, forcing staff to borrow supplies and ration dosages. Diagnostic services have also been disrupted, as testing cartridges are unavailable. Similar shortages are emerging in surrounding districts, such as Rumphi and Machinga, where facilities are struggling to manage the limited supplies. Health activists are calling on the government to take urgent action, with some even suggesting the need to invest in local drug manufacturing to prevent future supply crises. To learn more, you can access the article here: https://www.theguardian.com/global-development/2025/aug/28/health-malawi-tuberculosis-tb-drugs-shortages-poverty-aid-cuts-who

  1. Butterfly Network to Test AI-Assisted Ultrasound for Early TB Detection in Sub-Saharan Africa

Butterfly Network, a U.S.-based digital health company, has joined the CAD LUS4TB international research consortium, involving 10 African and European institutions, to evaluate the impact of AI‑assisted point‑of‑care ultrasound (POCUS) for early detection of tuberculosis in resource-limited settings. The study will launch in September and enroll approximately 3,000 adult patients across sub‑Saharan Africa.

DID YOU KNOW?


As summarized in a recent publication from the Kaiser Family Foundation (KFF), the Trump administration’s foreign aid review has placed U.S. global tuberculosis programs at risk, with funding cuts and program suspensions creating significant uncertainty. Analyses suggest that the withdrawal of U.S. support could reverse hard-won gains, strain health systems, and accelerate TB transmission worldwide. Multiple assessments provide insight into the potential scope of impact:

  • An internal USAID memo projected that ending U.S. TB control programs could increase global TB incidence by 28–32%, with similar effects on drug-resistant TB.
  • WHO reported that 30 high-burden countries are already experiencing disruptions, including the loss of health workers, drug supply chain breakdowns, and lab service interruptions.
  • A rapid survey of 108 WHO country offices found 40% faced moderate or severe TB service disruptions linked to the U.S. aid freeze and supply shortages.
  • In South Africa, funding cuts could result in 580,000 fewer TB tests and 35,000 fewer patients receiving treatment in 2025.
  • One modeling study estimated 10.7 million new TB cases and 2.2 million additional deaths in 26 high-burden countries by 2030.
  • Another study projected nearly 69 million additional TB cases and 2.2 million more deaths globally by 2040 if U.S. TB funding is halted.

The administration could soon release results of its 90-day foreign aid review, including for TB. It is unknown whether it will recommend any further changes to TB efforts, including further reductions, and how or if Congress will respond to its recommendations.

Using Butterfly’s portable ultrasound devices and software platform, frontline non‑radiologist healthcare workers will be supported by a new AI algorithm that automates TB image classification, helping them identify TB more quickly and accurately. The consortium also aims to produce evidence-driven policy recommendations for integrating AI‑enabled lung ultrasound into TB management, with the ultimate goal of embedding this technology into national healthcare systems. To learn more, you can access the article here: https://www.auntminnieeurope.com/clinical-news/ultrasound/news/15753825/butterfly-network-collaborates-on-tb-detection-initiative

  1. Malnutrition Undermines TB Recovery and Prevention in Mumbai

In Mumbai, many TB patients in vulnerable communities suffer from poor nutrition, a significant barrier to effective treatment. Government schemes like the Nikshay Poshan Yojana offer monthly stipends for nutrition support, but delays and insufficient amounts mean patients often cannot afford nutrient-rich food essential for recovery, thereby compromising treatment outcomes and increasing the risk of drug-resistant TB. Research such as the RATIONS trial in Jharkhand, alongside a Lancet Global Health model, demonstrates that providing macronutrient-rich food significantly improves recovery and could prevent hundreds of thousands of deaths and new cases if scaled up nationwide. Efforts like the Ni‑kshay Mitra donor program offer supplementary food baskets, but distribution remains uneven, highlighting that nutritious food must be considered a core component of TB care, not a luxury. You can read the article here: https://www.hindustantimes.com/cities/mumbai-news/in-fight-against-tb-poor-nutrition-a-silent-killer-101747164117075.html