Tuberculosis Health Financing Research in Low Middle Income Countries: Are Global Priorities Truly Reflected? Arih Diyaning Intiasari
Universitas Jenderal Soedirman
Abstract
Background: Tuberculosis (TB) remains a critical global health threat, disproportionately affecting low- and middle-income countries (LMICs). While international declarations continue to position financing as a linchpin for TB elimination, scholarly contributions that critically examine the scope, equity, and effectiveness of such financing remain uneven. This study investigates whether recent global research on TB health financing meaningfully aligns with the stated priorities of sustainability, innovation, and social justice-or whether it reproduces donor-centered paradigms without systemic recalibration.
Objectives: This study systematically maps the global research landscape on TB health financing from 2020 to 2025. It analyzes temporal trends, publishing platforms, key actors, thematic orientations, and the extent to which current scholarship reflects transformative versus status quo approaches in financing research.
Methods: A bibliometric analysis was conducted using 434 Scopus-indexed publications identified through a structured search protocol. Data were analyzed using Biblioshiny and VOSviewer, focusing on publication trends, journal visibility, keyword co-occurrences, collaboration networks, and acknowledged funding sources. The analysis employed frequency mapping and network visualization to identify dominant structures and gaps in the literature.
Results: The overall research output increased modestly during the post-pandemic period but remained dominated by high-income countries, elite academic institutions, and philanthropic funders such as the Bill & Melinda Gates Foundation and The Global Fund. The most frequent themes centered on cost-effectiveness, budget impact, and donor transition assessments-indicating a continued emphasis on value-for-money frameworks. Conversely, critical themes such as equity-focused financing, political economy, domestic resource mobilization, and community-based approaches were markedly underrepresented. Keyword clustering and funding acknowledgment analysis further revealed a mismatch between the normative rhetoric of equity and innovation and the actual structure of research investment and authorship networks.
Conclusion: Despite rhetorical shifts toward equity and sustainability in TB control, the bibliometric evidence suggests that global TB health financing research remains anchored in donor priorities and technocratic paradigms. The field exhibits limited thematic diversification and underrepresents voices from TB-affected communities and LMIC scholars. Without intentional redirection-toward inclusive funding structures, alternative financing models, and political-economic inquiry-research efforts risk reinforcing the very inequities they aim to solve. The findings raise a critical question for the global health community: Are we truly putting our money where our mouth is, or merely publishing promises without structural transformation?
Keywords: : Tuberculosis, health financing, bibliometric analysis, global health equity, donor dominance, sustainability, LMICs
