Stop TB Canada 2025 Federal Budget Response
Ottawa, November 24 – Stop TB Canada expresses deep concern over the 2025 Federal Budget, which signals a retreat from Canada’s commitment to global health and development.
Budget 2025 includes a $2.7 billion cut to Canada’s International Assistance Envelope (IAE) and a 16% reduction in Canada’s contribution to the Global Fund to Fight AIDS, TB and Malaria, despite Prime Minister Carney’s campaign promise against such cuts. While Canada contributed $1.02 billion to the Global Fund replenishment (with $11.34 billion pledged overall by contributing partners), this contribution is small (representing just 0.03% of our over $3 trillion GDP) relative to the impact of this program, which reports 70 million lives saved since its launch. At a time when global solidarity is weak and progress on critical global health milestones is in jeopardy, global health spending and international assistance require significant boosts to ensure pandemic preparedness, AMR prevention, and innovative systems of care. These divestments therefore undermine Canada’s role as a leader in global health at a time when its leadership is most needed.
TB remains the leading infectious disease killer globally and TB incidence in Canada is rising, counter to commitments made by national representatives to meet the 2016 End TB targets for elimination. Nationally, the disease disproportionately affects Indigenous communities and newcomers. Cuts to foreign aid along with a lack of domestic investment in TB-specific programs jeopardizes efforts to reverse these worrisome trends. While the budget’s $5 billion investment for health infrastructure upgrades is welcome, it fails to address severe healthcare staffing shortages — a challenge noted by the government's own Tuberculosis Response plan for 2025. Investing in infrastructure but not personnel is short-sighted, particularly as understaffed TB programs report growing difficulty maintaining their essential services.
Linked to the issue of healthcare staff shortages in the long-term are also the cuts to Canada Student Grants (CGS). Although the value of scholarship awards is finally increasing for the top most competitive trainees, the overall amount dedicated to CGS is substantially reduced. As the CGS provides aid to low and middle-income post-secondary students, this cut raises concerns about fundamental rights to education and the resulting impact such cuts will have on diversity in the student body and future cohorts of healthcare workers.
Further, although the 2025 budget does outline a plan for the assessment of northern healthcare needs by the Ministries of Health, National Defence, Indigenous Services, and Northern and Arctic Affairs, this plan lacks clarity. Given that significant barriers to healthcare access persist in the North, and that these barriers represent a major contributor to sustaining the TB epidemic, this assessment is urgent and we hope it is followed up with dedicated capital and human resources to ensure the successful and timely implementation of co-determined solutions.
As TB is a disease tightly linked to social determinants of health (such as access to healthcare, nutritious food, and adequate housing), investments in these areas are critical to addressing long-standing inequities in health that give rise to the unequal burden of TB in the country. To that end, the new Build Canada Homes initiative is a welcome development, as is the $2.8 billion to support urban, rural, and northern Indigenous housing. As TB thrives in conditions of poverty, overcrowding, and poor ventilation, investments in affordable and safe housing are an important part of broader TB elimination efforts. Unfortunately, unlike in previous Federal Budgets, however, funds to support affordable housing and other initiatives to address the social determinants of health in Indigenous communities are not described in an Indigenous-specific chapter, and significant gaps in areas such as language, training, and Truth and Reconciliation are evident. This lack of focus on the social determinants of health, especially in relation to Indigenous health, and how these determinants are differentially addressed between populations, is a significant missed opportunity for efforts towards TB elimination.
On a positive note, Budget 2025 invests in research: $400 million allocated to research infrastructure, $134 million to attract international trainees, $120 million to attract international professors, and $1 billion for Research Chairs. These investments are critical as many TB tools remain outdated, including diagnostics and a vaccine that are over a century old. However, the value of such investments should be ensured by also mandating affordable access conditions for all innovations that are developed with public money, so that the fruits of publicly-funded research are indeed accessible to the public.
Conclusively, although offering some promise through investment in research, budget 2025 largely disappoints as it cuts vital international assistance while also falling short of meaningfully addressing domestic health and wellbeing through investments in the healthcare workforce and in the underlying factors that give rise to health inequities and the unequal burden of diseases such as TB. Without urgent action to restore its contributions to international assistance and address the human resource crisis in healthcare, Canada risks losing ground in the fight against TB both at home and abroad.