Tuberculosis and the Research Workforce Renewal Crisis in Brazil: How Can We Prevent a Future Without New...

Tuberculosis (TB) is among the oldest and deadliest infectious diseases, particularly when associated with human immunodeficiency virus (HIV) and antimicrobial resistance. Despite the progress in prevention, diagnosis, and treatment, global elimination remains elusive and is driven largely by socioeconomic inequalities and systemic challenges. Although scientific research is a cornerstone of the WHO End TB Strategy, it has been chronically underfunded and undervalued in Brazil's health agenda. One critical consequence is the weakening of pipelines for future TB research. Funding shortages, lack of incentives, and the shifting attention toward s other emerging diseases have made it increasingly difficult to recruit and retain scientists in the field of TB. This opinion paper aimed to explore the historical role of Brazilian science in advancing TB control while addressing the emerging crisis of renewing the country's TB scientific workforce. We conducted a narrative synthesis of the available literature, reviewing impactful peer-reviewed articles produced by Brazilian scientists in the field of TB science, alongside official documents from the Brazilian Ministry of Health. This was complemented by a bibliometric analysis of the output of TB-related PhD theses (2016-2024) and PubMed-indexed publications (2001-2024) from Brazilian institutions. Finally, we discuss the systemic barriers affecting early career researchers and outline strategies for revitalizing interest and sustaining scientific progress. These include targeted TB research funds through public-private partnerships, structured mentorship programs, and competitive early career fellowships. Such interventions are essential for reversing the current decline in TB research engagement and ensuring that Brazil continues to contribute to global TB elimination efforts while preserving its scientific legacy.