Beyond metrics: relational dynamics and impacts of TB community funding.

Global funding for tuberculosis (TB) falls far short of estimated needs, often prioritizing commodities and service delivery. TB communities, including people affected by TB, remain underfunded and underrepresented in programme planning. Despite this TB-affected communities have, over the past decade, driven significant progress in becoming recognized actors in national and global TB responses. These gains have been largely supported by the Stop TB Partnership Challenge Facility for Civil Society (CFCS), a funding mechanism which supports people affected by TB and community organizations and their partnerships with National TB Programmes. This model now faces a critical funding shortage. This analysis draws on final reports from 99 country-specific projects funded under CFCS 12 (2023-2025). In final reporting partners responded to three open-ended reflection questions on unexpected impacts, challenges, and lessons learned in. Responses were analyzed inductively using NVivo 12, with themes iteratively developed. Three key relational themes emerged. First, TB stigma was reported not only as a barrier to care but also as an operational barrier to programme delivery. Second, the value of meaningful community engagement and collaboration were identified as the most important lesson from programme implementation. Third, expanded recognition and influence were the most important unexpected outcome of programme delivery. These reflections highlight the relational challenges and value of TB community funding, directing us to consider what is included in funding considerations and project planning, while also pointing toward how much-beyond programmatic outcomes-will be lost if funding is reduced further.