Country faces a tuberculosis epidemic as health experts warn of a lack of reliable information

The number of tuberculosis cases is surging and health experts claim the government has not provided the statistical and demographic data necessary to confront what they say is an epidemic. According to Ministry of Health data, TB cases increase from 5,475 in 2024 to 9,600 in 2025.

Inmates suffering from tuberculosis at Litoral Prison in Guayaquil.

The government reports 600 deaths from the disease but other estimates put the number above 1,000.

The National Observatory of Health Information, which includes former health ministry officials, claims the government has failed to provide “complete data and the corresponding interpretation,” and says the increase of case numbers alone requires an acknowledgement of an epidemic.

The health ministry, so far, has refused to declare an epidemic, saying it must first collect and evaluate more information. Andrés Carrazco, Undersecretary of Health Surveillance, Protection and Control, says that a “complicating factor” is that more than 25% of TB cases, or 2,649, have been recorded in the country’s prisons. “Those infected within the institutions are confined, which restricts the spread of the disease to the public,” he said.

Observatory member Ricardo Cañizares claims Carrazco’s position is one of “political damage control” and not one that considers public health. “It is embarrassing for the government to admit that a disease that was controlled 75 years ago in most of the world is making a comeback in Ecuador,” he says. “On the other hand, protecting the population must always come first and that is not happening in this case.”

Cañizares says the government’s contention that a large percentage of TB cases are confined to prisons should not be a factor in declaring a health emergency. “There are two criteria for determining an epidemic, first that there is an unusual, abrupt, and unexpected increase in the number of cases and second, that there is a rapid increase in cases from the previous months and years.”

Former health ministry deputy director Esteban Ortiz-Prado disputes Carrazco’s suggestion that the concentration of TB in the prisons protects the public. “In fact, the prisons have become an incubator for the disease close to population centers,” he says. “Last year, more than 100 prison employees were infected with TB, which means the disease is spreading outside the prisons. It is impossible to completely isolate prisoners from the general population.”

Ortiz-Prado adds that the health ministry is ignoring the conditions inside the prisons that contribute to TB cases. “The ministry should be focusing on the living conditions and health conditions within the prisons that allow the spread of a deadly disease,” he says. “What is going on in these facilities that allows this contagion? Maybe this requires an investigation of prison management.”

In a press conference last week, Carrazco said the health ministry will provide more information about TB cases in the “coming days.”