Skills of the Future

Learning ecosystems, empowering learners.

  • Subscribe to our newsletter

Global education trends and research to follow in 2022

Subscribe to the center for universal education bulletin, emily gustafsson-wright , emily gustafsson-wright senior fellow - global economy and development , center for universal education helen shwe hadani , helen shwe hadani former brookings expert kathy hirsh-pasek , kathy hirsh-pasek senior fellow - global economy and development , center for universal education maysa jalbout , maysa jalbout nonresident fellow - global economy and development , center for universal education elizabeth m. king , elizabeth m. king nonresident senior fellow - global economy and development , center for universal education jennifer l. o’donoghue , jennifer l. o’donoghue deputy director - center for universal education , senior fellow - global economy and development brad olsen , brad olsen senior fellow - global economy and development , center for universal education jordan shapiro , jordan shapiro nonresident fellow - global economy and development , center for universal education emiliana vegas , and emiliana vegas former co-director - center for universal education , former senior fellow - global economy and development rebecca winthrop rebecca winthrop director - center for universal education , senior fellow - global economy and development.

January 24, 2022

  • 12 min read

As the third calendar year of the pandemic begins, 2022 promises to be an important one—especially for education. Around the world, education systems have had to contend with sporadic closures, inequitable access to education technology and other distance learning tools, and deep challenges in maintaining both students’ and teachers’ physical and emotional health. At the same time, not all of the sudden changes precipitated by the pandemic have been bad—with some promising new innovations, allies, and increased attention on the field of global education emerging over the past three years. The key question is whether 2022 and the years ahead will lead to education transformation or will students, teachers, and families suffer long-lasting setbacks?

In the Center for Universal Education, our scholars take stock of the trends, policies, practices, and research that they’ll be closely keeping an eye on this year and likely in the many to come.

wrighte_portrait.jpg?crop=0px%2C44px%2C640px%2C640px&w=120&ssl=1

More than ever, in 2022 it will be critical to focus on strengthening the fabric of our global education system in order to achieve positive outcomes—particularly through an increased focus on data-informed decisionmaking. We have seen a renewed focus on different forms of data that are critical to enhanced education outcomes, such as real-time performance data, which allow teachers and other decisionmakers to course-adjust to the needs of learners to better support their educational journeys. Additionally, high-quality program cost data are needed for decisionmakers to plan, budget, and choose the most cost-effective interventions.

One way we are seeing these areas strengthened is through innovative financing for education, such as impact bonds , which require data to operate at full potential. This year, pooled funding through outcomes funds—a scaled version of impact bonds—should make a particularly big splash. The Education Outcomes Fund organization is slated to launch programs in Ghana and Sierra Leone, and we also expect to see the launch of country-specific outcomes funds for education such as OFFER (Outcome Fund For Education Results) in Colombia, the Back-to-School Outcomes Fund in India, and another fund in Chile. At the Center for Universal Education, we will be following these innovations closely and look forward to the insights that they will bring to the education sector.

Helen_Hadani.jpg?crop=0px%2C2px%2C427px%2C427px&w=120&ssl=1

As we look ahead to 2022, one continued challenge for many families is navigating the uncharted territory of supporting children’s learning with a growing number of school closures . But while the pandemic forced an abrupt slowdown in modern life, it also provided an opportunity to reexamine how we can prioritize learning and healthy development both in and out of school. Moreover, the cascading effects of the pandemic are disproportionally affecting families living in communities challenged by decades of discrimination and disinvestment—and are very likely to widen already existing educational inequities in worrisome ways.

One innovative approach to providing enriching learning opportunities beyond school walls that address the inequities in our current systems is Playful Learning Landscapes (PLL) —installations and programming that promote children and families’ learning through play in the public realm. A current focus for PLL at Brookings is measuring the impact of these spaces to show that PLL works and to garner greater investment in them. To that end, Brookings and its partners developed a framework and an initial set of indicators from both the learning science and placemaking perspectives to help assess the positive effects of PLL on learning outcomes , as well as its potential to enhance social interaction and public life in revitalized spaces. The framework will continue to evolve as we learn from communities that are testing the expansion and adaptation of PLL—this important work is just beginning.

pasekk_portrait1.jpg?crop=0px%2C32px%2C2471px%2C2471px&w=120&ssl=1

The pandemic highlighted several trends in education that promise to be the focus of future policy and practice in 2022 and beyond: the importance of skills that supplement the learning of content, systemic inequities in education systems, and the role of digital technology in the education of the future. It has become increasingly clear that the memorization of content alone will not prepare children for the jobs and society of the future. As noted in a Brookings report “ A new path for education reform, ” in an automated world, manufacturing jobs and even preliminary medical diagnoses or legal contracts can be performed by computers and robots. Students who can work collaboratively—with strong communication skills, critical thinking, and creative innovation—will be highly valued. Mission statements from around the globe are starting to promote a “whole child” approach to education that will encourage the learning of a breadth of skills better aligning the education sector with needs from the business sector.

The past year also demonstrated weaknesses and inequalities inherent in remote learning that I’ll be closely tracking in the years to come. In fact, the Centers for Disease Control and Prevention suggested that virtual learning presents risks to social-emotional learning . Further, research suggests that academic progress during the pandemic slowed such that students demonstrated only 35 to 50 percent of the gains they normally achieve in mathematics and 60 to 68 percent in reading. The losses are not experienced uniformly , with children from underresourced environments falling behind their more resourced peers.

The failure of remote learning also raises questions about the place of digital learning in the classroom. Learning will become more and more hybrid over time, and keeping an eye on advances in technology—especially regarding augmented reality and the metaverse—will be particularly important, as both have real consequences for the classrooms.

maysa_jalbout_2019.jpg?crop=0px%2C0px%2C2828px%2C2828px&w=120&ssl=1

In 2022, I’ll be focusing on one group of children in particular–refugees–who are among those children who have historically had the least access to preprimary education. The pandemic has affected them disproportionally , as it pushed them and their families into poverty and deprived them from most forms of education during the school closures.

While much more investment in early childhood education research and evaluation is needed to improve evidence and channel scarce resources effectively, there are a few important efforts to watch. A report commissioned by Theirworld last year provided an overview of the sector and focused on a critical gap and opportunity to address the inequity of access to early childhood education in refugee settings by better supporting teachers and community workers. This year, Theirworld and partners will pursue two of the report’s recommendations–making the science of early childhood brain development widely accessible in refugee communities and building the evidence base on what works in supporting early childhood education teachers and the young refugee children they teach.

The report was informed by existing initiatives including Ahlan Simsim, which in 2017 received the largest known grant to early education in a humanitarian context. While the evaluation of Ahlan Simsim will not be complete until two more years, the Global Ties for Children research center, Sesame Workshop, and the International Rescue Committee will share critical insights into their learning to date in a forthcoming episode of the podcast the Impact Room .

kingb_portrait.jpg?w=120&crop=0%2C23px%2C100%2C120px&ssl=1

This coming year I’ll be focused on how education systems can prepare for future disruptions, whatever the cause, with more deliberateness. The past two years of the COVID pandemic have seen education systems throughout the globe struggle to find ways to continue schooling. Additionally, there have been other public health crises, natural disasters such as earthquakes, floods, and severe storms, and wars and terrorism in different parts of the world that have gravely tested school systems’ ability to minimize the cost of catastrophes on students and teachers. Finding safer temporary learning places outside the school and using technologies such as radio, TV broadcasts, and online learning tools have helped, but quick fixes with little preparation are not effective approaches for sustaining and advancing learning gains.

In the age of broadcast and digital technologies, there are many more ways to meet the challenges of future emergency situations, but life- and education-saving solutions must be part of the way school systems operate—built into their structures, their staffing, their budgets, and their curricula. By preparing for the emergencies that are likely to happen, we can persevere to reach learning goals for all children.

Jennifer_ODonoghue.jpeg?w=120&crop=0%2C0px%2C100%2C120px&ssl=1

By the close of 2021, a number of studies began to document the impact of COVID-19 on girls’ educational trajectories across the Global South. These studies point to promising trends –lower than expected dropout rates and reenrollment rates similar to (if not greater than) those of boys–while still highlighting the particular challenges faced by adolescent girls and girls living in poverty , conflict, and crisis .

In 2022, it will be critical to continue to generate more nuanced evidence—carefully considering questions such as “for which girls,” “where,” “when,” and “why.” And then we must put this knowledge to use to protect and promote girls’ and young women’s rights not just to education, but to participate and thrive in the world around them. Ensuring that marginalized girls and young women become transformative agents in improving their lives and livelihoods—as well as those of their families and communities—requires us to develop new strategies for learning and acting together.

At the Center for Universal Education, this means strengthening our work with local leaders in girls’ education: promoting gender-transformative research through the Echidna Global Scholars Program ; expanding the collective impact of our 33 Echidna alumni; and co-constructing a learning and action community to explore together how to improve beliefs, practices, programs, and policies so that marginalized adolescent girls’ can develop and exercise agency in pursuing their own pathways.

brad_olsen_2021.jpg?crop=0px%2C685px%2C1625px%2C1625px&w=120&ssl=1

Going into year three of COVID-19, in 2022 I’m interested to see whether countries will transform their education systems or largely leave them the way they are. Will leaders of education systems tinker around the edges of change but mostly attempt a return to a prepandemic “normal,” or will they take advantage of this global rupture in the status quo to replace antiquated educational institutions and approaches with significant structural improvement?

In relation to this, one topic I’ll be watching in particular is how countries treat their teachers. How will policymakers, the media, parent councils, and others frame teachers’ work in 2022? In which locations will teachers be diminished versus where will they be defended as invaluable assets? How will countries learn from implications of out-of-school children (including social isolation and child care needs)? Will teachers remain appreciated in their communities but treated poorly in the material and political conditions of their work? Or will countries hold them dear—demanding accountability while supporting and rewarding them for quality work?

JordanShapiro.jpg?w=120&crop=0%2C0px%2C100%2C120px&ssl=1

I’m interested in learning more about how pandemic lockdowns have impacted students. So far, we’ve only gotten very general data dealing with questions that are, in my opinion, too simple to be worthwhile. It’s all been about good and bad, positive and negative, learning loss and achievement. But I’ll be watching for more nuanced studies, which ask about specific ways increased time away from school has impacted social-emotional development. How do those results differ between gender, race, socioeconomic status, and geographic location? I suspect we’re going to learn some things about the relationship between home environment and school environment that will challenge a lot of our taken-for-granted assumptions.

emiliana_vegas_portrait.jpg?crop=83px%2C35px%2C667px%2C668px&w=120&ssl=1

In 2022, I’ll be tracking emerging evidence on the impact of the COVID-19 school closures on children and youth. Several researchers, including my co-authors and me , have provided estimates of the school closures’ impact on student learning losses, unemployment, future earnings, and productivity globally. But only recently are researchers analyzing actual evidence of learning losses , and an early systematic review finds that “Although robust and empirical research on COVID-19-related student learning loss is limited, learning loss itself may not be.”

Likewise, there is little rigorous reviews of remote learning tools’ and platforms’ impact on student learning during the school closures. After the pandemic, it is almost certain that remote and hybrid learning will continue—at a minimum occasionally and often periodically—in primary, secondary, and post-secondary education. It is urgent that we build the evidence base to help education decisionmakers and practitioners provide effective, tailored learning experiences for all students.

Finally, a key issue for education is how to redesign curricula so that this generation (and future generations) of students gain a key set of skills and competencies required for technologically-advancing labor markets and societies. While foundational literacy and numeracy skills continue to be essential for learning, a strong foundational knowledge of science, technology, engineering, and mathematics is ever more important in the 21st century, and I look forward to contributing research this year to help make the case for curricula redesign efforts.

winthropr2.jpg?crop=0px%2C24px%2C533px%2C533px&w=120&ssl=1

I will be interested to see how parent-teacher relationships progress after the pandemic has (hopefully) faded into the background. COVID-19 has had an inescapable impact on the way we deliver education globally, but none more so than on how education leaders and teachers interact with students and their families.

For the past three years, I have been studying family-school collaboration. Together with my colleagues and partners, we have surveyed nearly 25,000 parents and 6,000 teachers in 10 countries around the world and found that the vast majority of teachers, parents, and caregivers want to work together more closely. Quality family-school collaboration has the potential to significantly improve educational outcomes, spur important discussions on the overall purpose of school, and smooth the path for schools and families to navigate change together. From community schools in New Mexico  to text message updates from teachers in India , new innovations are popping up every day—in every corner of the world. I’m excited to see what the future holds for family-school collaboration!

Education Technology Global Education

Global Economy and Development

Center for Universal Education

August 2, 2024

Modupe (Mo) Olateju, Grace Cannon, Kelsey Rappe

July 29, 2024

Sweta Shah, Donald Wertlieb, Charlotte Vuyiswa McClain-Nhlapo, Ruchi Kulbir Singh, Kathy Hirsh-Pasek

July 24, 2024

OECD iLibrary logo

  • My Favorites

You have successfully logged in but...

... your login credentials do not authorize you to access this content in the selected format. Access to this content in this format requires a current subscription or a prior purchase. Please select the WEB or READ option instead (if available). Or consider purchasing the publication.

  • Trends Shaping Education

Trends Shaping Education 2022

Global trends and the future of education.

image of Trends Shaping Education 2022

Did you ever wonder what the impact of climate change will be on our educational institutions in the next decade? What does it mean for schools that our societies are becoming more individualistic and diverse?

Trends Shaping Education is a triennial report examining major economic, political, social and technological trends affecting education. While the trends are robust, the questions raised in this book are suggestive, and aim to inform strategic thinking and stimulate reflection on the challenges facing education.

This 2022 edition covers a rich array of topics related to economic growth, living and working, knowledge and power, identity and belonging and our physical world and human bodies and interactions. It includes a specific focus on the impact of COVID‑19 on global trends, and new futures thinking sections inviting readers to reflect on how the future might differ from our current expectations.

This book is designed to give policy makers, researchers, educational leaders, administrators and teachers a robust, non-specialist source of international comparative trends shaping education, whether in schools, universities or in programmes for older adults. It will also be of interest to students and the wider public, including parents.

English Also available in: French

  • https://doi.org/10.1787/6ae8771a-en
  • Click to access:
  • Click to access in HTML WEB
  • Click to download PDF - 3.23MB PDF
  • Click to download EPUB - 14.67MB ePUB

What impact will climate change have on our educational institutions in the next decade? Are our research and innovation systems prepared for an era of global, open and internet intensive science? What does it mean for schools that our societies are becoming more individualistic and diverse?

arrow down

  • Click to download PDF - 513.23KB PDF

close

Cite this content as:

Author(s) OECD

18 Jan 2022

global education future

  • Announcements

UNESCO’s Futures of Education report

global education future

UNESCO unveiled the much-awaited Futures of Education report entitled Reimagining our futures together: A new social contract for education. The new global report, prepared by an International Commission , explores how education can best shape the future of humanity and the planet as we look to 2050: What should we keep? What should we abandon? And what should we creatively reinvent afresh? The report aims to catalyze a global debate and movement to forge a new social contract for education. Over a million people have taken part in the global consultation process that informed this flagship publication which calls for a major transformation in education to repair past injustices and enhance our capacity to act together for a more sustainable and just future.

Read more about the report

Oxford Martin School logo

Global Education

By: Hannah Ritchie , Veronika Samborska , Natasha Ahuja , Esteban Ortiz-Ospina and Max Roser

A good education offers individuals the opportunity to lead richer, more interesting lives. At a societal level, it creates opportunities for humanity to solve its pressing problems.

The world has gone through a dramatic transition over the last few centuries, from one where very few had any basic education to one where most people do. This is not only reflected in the inputs to education – enrollment and attendance – but also in outcomes, where literacy rates have greatly improved.

Getting children into school is also not enough. What they learn matters. There are large differences in educational outcomes : in low-income countries, most children cannot read by the end of primary school. These inequalities in education exacerbate poverty and existing inequalities in global incomes .

On this page, you can find all of our writing and data on global education.

Key insights on Global Education

The world has made substantial progress in increasing basic levels of education.

Access to education is now seen as a fundamental right – in many cases, it’s the government’s duty to provide it.

But formal education is a very recent phenomenon. In the chart, we see the share of the adult population – those older than 15 – that has received some basic education and those who haven’t.

In the early 1800s, fewer than 1 in 5 adults had some basic education. Education was a luxury; in all places, it was only available to a small elite.

But you can see that this share has grown dramatically, such that this ratio is now reversed. Less than 1 in 5 adults has not received any formal education.

This is reflected in literacy data , too: 200 years ago, very few could read and write. Now most adults have basic literacy skills.

What you should know about this data

  • Basic education is defined as receiving some kind of formal primary, secondary, or tertiary (post-secondary) education.
  • This indicator does not tell us how long a person received formal education. They could have received a full program of schooling, or may only have been in attendance for a short period. To account for such differences, researchers measure the mean years of schooling or the expected years of schooling .

Despite being in school, many children learn very little

International statistics often focus on attendance as the marker of educational progress.

However, being in school does not guarantee that a child receives high-quality education. In fact, in many countries, the data shows that children learn very little.

Just half – 48% – of the world’s children can read with comprehension by the end of primary school. It’s based on data collected over a 9-year period, with 2016 as the average year of collection.

This is shown in the chart, where we plot averages across countries with different income levels. 1

The situation in low-income countries is incredibly worrying, with 90% of children unable to read by that age.

This can be improved – even among high-income countries. The best-performing countries have rates as low as 2%. That’s more than four times lower than the average across high-income countries.

Making sure that every child gets to go to school is essential. But the world also needs to focus on what children learn once they’re in the classroom.

Featured image

Millions of children learn only very little. How can the world provide a better education to the next generation?

Research suggests that many children – especially in the world’s poorest countries – learn only very little in school. What can we do to improve this?

  • This data does not capture total literacy over someone’s lifetime. Many children will learn to read eventually, even if they cannot read by the end of primary school. However, this means they are in a constant state of “catching up” and will leave formal education far behind where they could be.

legacy-wordpress-upload

Children across the world receive very different amounts of quality learning

There are still significant inequalities in the amount of education children get across the world.

This can be measured as the total number of years that children spend in school. However, researchers can also adjust for the quality of education to estimate how many years of quality learning they receive. This is done using an indicator called “learning-adjusted years of schooling”.

On the map, you see vast differences across the world.

In many of the world’s poorest countries, children receive less than three years of learning-adjusted schooling. In most rich countries, this is more than 10 years.

Across most countries in South Asia and Sub-Saharan Africa – where the largest share of children live – the average years of quality schooling are less than 7.

  • Learning-adjusted years of schooling merge the quantity and quality of education into one metric, accounting for the fact that similar durations of schooling can yield different learning outcomes.
  • Learning-adjusted years is computed by adjusting the expected years of school based on the quality of learning, as measured by the harmonized test scores from various international student achievement testing programs. The adjustment involves multiplying the expected years of school by the ratio of the most recent harmonized test score to 625. Here, 625 signifies advanced attainment on the TIMSS (Trends in International Mathematics and Science Study) test, with 300 representing minimal attainment. These scores are measured in TIMSS-equivalent units.

Hundreds of millions of children worldwide do not go to school

While most children worldwide get the opportunity to go to school, hundreds of millions still don’t.

In the chart, we see the number of children who aren’t in school across primary and secondary education.

This number was around 244 million in 2023.

Many children who attend primary school drop out and do not attend secondary school. That means many more children or adolescents are missing from secondary school than primary education.

Featured image

Access to basic education: almost 60 million children of primary school age are not in school

The world has made a lot of progress in recent generations, but millions of children are still not in school.

The gender gap in school attendance has closed across most of the world

Globally, until recently, boys were more likely to attend school than girls. The world has focused on closing this gap to ensure every child gets the opportunity to go to school.

Today, these gender gaps have largely disappeared. In the chart, we see the difference in the global enrollment rates for primary, secondary, and tertiary (post-secondary) education. The share of children who complete primary school is also shown.

We see these lines converging over time, and recently they met: rates between boys and girls are the same.

For tertiary education, young women are now more likely than young men to be enrolled.

While the differences are small globally, there are some countries where the differences are still large: girls in Afghanistan, for example, are much less likely to go to school than boys.

Research & Writing

Featured image

Talent is everywhere, opportunity is not. We are all losing out because of this.

Access to basic education: almost 60 million children of primary school age are not in school, interactive charts on global education.

This data comes from a paper by João Pedro Azevedo et al.

João Pedro Azevedo, Diana Goldemberg, Silvia Montoya, Reema Nayar, Halsey Rogers, Jaime Saavedra, Brian William Stacy (2021) – “ Will Every Child Be Able to Read by 2030? Why Eliminating Learning Poverty Will Be Harder Than You Think, and What to Do About It .” World Bank Policy Research Working Paper 9588, March 2021.

Cite this work

Our articles and data visualizations rely on work from many different people and organizations. When citing this topic page, please also cite the underlying data sources. This topic page can be cited as:

BibTeX citation

Reuse this work freely

All visualizations, data, and code produced by Our World in Data are completely open access under the Creative Commons BY license . You have the permission to use, distribute, and reproduce these in any medium, provided the source and authors are credited.

The data produced by third parties and made available by Our World in Data is subject to the license terms from the original third-party authors. We will always indicate the original source of the data in our documentation, so you should always check the license of any such third-party data before use and redistribution.

All of our charts can be embedded in any site.

Our World in Data is free and accessible for everyone.

Help us do this work by making a donation.

for Education

  • Google Classroom
  • Google Workspace Admin
  • Google Cloud

The Future of Education

Google for Education collaborated with research partner Canvas8 to conduct a study across 24 countries on the future of education. The result is a three-part global report highlighting insights from around the world.

Global nonprofit American Institutes for Research (AIR) served as an advisor and consultant to this research.

Illustration

Preparing for a new future

As educators work to equip students with the skills and mindsets they’ll need to navigate massive change, the experts we interviewed discussed how and why they’re rethinking the role of education.

  • Download Part 1

What's inside

Rising demand for global problem solvers

Change in the skill sets required for work

Shift to a lifelong learning mindset

Illustration

Evolving how we teach and learn

Find out how recent technological advances are evolving how we think about teaching and learning from a one-to-many model to a more personal approach to learning.

  • Download Part 2

Making learning personal

Reimagining learning design

Elevating the teacher

Illustration

Reimagining learning ecosystems

Learn how educators are taking a more systemic approach to transformation, by reimagining the education ecosystem around the learner.

  • Download Part 3

Upgrading learning environments

Empowering educators with data

Re-evaluating student progress

Building the report

This report contains insights from interviews with education thought leaders from around the world, including experts in policy, academic researchers covering education, district-level representatives, school principals and teachers and edtech leaders.

FROM THE EXPERTS

“There is a need to develop human beings who are internally strong and resilient. The importance of knowledge transmission will decline in order to place a greater emphasis on fundamental and higher thinking skills, including children's socio-affective spheres.”

Sylvia Schmelkes, researcher at Universidad Iberoamericana, Mexico

“The education system has to enable young people to be great career navigators, to learn transferable skills that enable them to change fields and not just change jobs. And, to be alert to the changing workforce needs in ways that were probably less apparent previously.”

Valerie Hannon, co-founder, Innovation Unit, United Kingdom

“The power of technology in education [is a major force shaping it], changing learning experiences, changing the role and nature of educators — your work in knowledge transmission is no longer that relevant. You have to instead become a great coach, a great mentor, a social worker, and career advisor.”

Andreas Schleicher, director for education and skills, and special advisor on education policy to the secretary-general at the Organisation for Economic Co-operation and Development (OECD), Global

Teaching for tomorrow

A new Google for Education YouTube series, featuring conversations with thought leaders shaping the future of education.

  • See the full playlist

Card 1

Teaching for tomorrow trailer

What might education look like in the next 5-10 years? Check out the trailer for our new YouTube series, Teaching for tomorrow, which features expert insights on topics from teaching and learning, to digital literacy and more.

  • Watch video

Card 2

Teaching for tomorrow with Tony Wagner

Join Tony Wagner (he/him), Ed.D., Senior Research Fellow at the Learning Policy Institute, to learn about the skills students will need in tomorrow’s workplace, the promise of education technology, and more.

Card 3

Teaching for tomorrow with Jan Owen

Join Jan Owen (she/her), Co-chair of Learning Creates Australia, for insights on how education can empower students to help solve the global problems of today and tomorrow.

edit form roi

Local reports from around the world.

Explore how education is evolving around the world in each regional report by country.

Australia report

Brazil report in english Australia report Australia report

You're now viewing content for a different region.

For content more relevant to your region, we suggest:

Sign up here for updates, insights, resources, and more.

Trends Shaping Education 2022

Global trends and the future of education.

Exploring the future of education with experts around the world

Nov 17, 2022

[[read-time]] min read

MagieraHeadshot

Students and teachers around the world have returned to the classroom, and the familiar signs of school are back: hallways are full, as are social calendars. But a lot has changed, too. Overcoming the challenges of the last few years meant that leaders and educators had to do things differently — and quickly. As the world continues to evolve, driven in part by pressing global issues and the accelerated rate of technological innovation, what should the role of education be, and how might it look?

To begin to answer this question, Google for Education collaborated with research partner Canvas8 and advisor and consultant American Institutes for Research to conduct a global study in 24 countries. Our report uses 94 educational expert interviews, two years of peer-reviewed academic literature and a media narrative analysis across the education sector.

The result is a three-part report on the future of education that brings together a diversity of perspectives from policy experts, academic researchers, district-level representatives, school principals, teachers and education technology leaders. Today we launched Part 1: Preparing for a new future , which discusses the role education plays in equipping students with the skills and mindsets they’ll need to navigate massive change.

We discuss three key trends:

  • There’s a rising demand for global problem solvers. As the world faces a new set of global challenges, such as equitable access to education, digital literacy, sustainability and economic volatility, education systems will become a central part of the solution, helping future generations embrace global mindsets and skill sets.
  • The skill sets required for work will change. As technology advances, education will focus on equipping students with the high-demand skills they’ll need to thrive in a new world of work.
  • We must shift to a lifelong learning mindset. As lifespans increase and societal change accelerates, the idea of lifelong learning is gaining traction, with more tools available for developing skills and advancement.

To hear directly from some of the experts who informed this report, check out Teaching for tomorrow , a new series on the Google for Education YouTube channel. We kick off with the series trailer and insights from Tony Wagner, Ed.D., Senior Research Fellow at the Learning Policy Institute and Jan Owen, Co-chair of Learning Creates Australia. They discuss topics like the future of work, education technology and moving education beyond the classroom.

Teaching for Tomorrow series trailer and insights from Tony Wagner, Ed.D., Senior Research Fellow at the Learning Policy Institute and Jan Owen, Co-chair of Learning Creates Australia.

With the Future of Education, we aim to provide educators and education leaders with insight into the trends shaping the future, and to spark ideas and discussion on how we can work together to help all learners — and those who help them — succeed.

Visit edu.google.com/future-of-education to read Part 1 and preview Parts 2 and 3: Evolving how we teach and learn and Reimagining learning ecosystems.

Related stories

Blog Hero-1

A new effort to support teen mental health

education-keyword-hero

3 things parents and students told us about how generative AI can support learning

005-EDU _  ISTE - Workspace Blog (Design) v3-01 (1)

New AI tools for Google Workspace for Education

Main Blog

Updates on how we're using AI to support students and educators

EDU _  Edu Navigator Blog Header

Get more out of Google’s education tools with Education Navigator

2303-EDU _  Keyword Blog - Chromebook Plus_UPDATED

New Chromebook Plus for educators, powered by AI

Let’s stay in touch. Get the latest news from Google in your inbox.

The World Bank

The World Bank Group is the largest financier of education in the developing world, working in 94 countries and committed to helping them reach SDG4: access to inclusive and equitable quality education and lifelong learning opportunities for all by 2030.

Education is a human right, a powerful driver of development, and one of the strongest instruments for reducing poverty and improving health, gender equality, peace, and stability. It delivers large, consistent returns in terms of income, and is the most important factor to ensure equity and inclusion.

For individuals, education promotes employment, earnings, health, and poverty reduction. Globally, there is a  9% increase in hourly earnings for every extra year of schooling . For societies, it drives long-term economic growth, spurs innovation, strengthens institutions, and fosters social cohesion.  Education is further a powerful catalyst to climate action through widespread behavior change and skilling for green transitions.

Developing countries have made tremendous progress in getting children into the classroom and more children worldwide are now in school. But learning is not guaranteed, as the  2018 World Development Report  (WDR) stressed.

Making smart and effective investments in people’s education is critical for developing the human capital that will end extreme poverty. At the core of this strategy is the need to tackle the learning crisis, put an end to  Learning Poverty , and help youth acquire the advanced cognitive, socioemotional, technical and digital skills they need to succeed in today’s world. 

In low- and middle-income countries, the share of children living in  Learning Poverty  (that is, the proportion of 10-year-old children that are unable to read and understand a short age-appropriate text) increased from 57% before the pandemic to an estimated  70%  in 2022.

However, learning is in crisis. More than 70 million more people were pushed into poverty during the COVID pandemic, a billion children lost a year of school , and three years later the learning losses suffered have not been recouped .  If a child cannot read with comprehension by age 10, they are unlikely to become fluent readers. They will fail to thrive later in school and will be unable to power their careers and economies once they leave school.

The effects of the pandemic are expected to be long-lasting. Analysis has already revealed deep losses, with international reading scores declining from 2016 to 2021 by more than a year of schooling.  These losses may translate to a 0.68 percentage point in global GDP growth.  The staggering effects of school closures reach beyond learning. This generation of children could lose a combined total of  US$21 trillion in lifetime earnings  in present value or the equivalent of 17% of today’s global GDP – a sharp rise from the 2021 estimate of a US$17 trillion loss. 

Action is urgently needed now – business as usual will not suffice to heal the scars of the pandemic and will not accelerate progress enough to meet the ambitions of SDG 4. We are urging governments to implement ambitious and aggressive Learning Acceleration Programs to get children back to school, recover lost learning, and advance progress by building better, more equitable and resilient education systems.

Last Updated: Mar 25, 2024

The World Bank’s global education strategy is centered on ensuring learning happens – for everyone, everywhere. Our vision is to ensure that everyone can achieve her or his full potential with access to a quality education and lifelong learning. To reach this, we are helping countries build foundational skills like literacy, numeracy, and socioemotional skills – the building blocks for all other learning. From early childhood to tertiary education and beyond – we help children and youth acquire the skills they need to thrive in school, the labor market and throughout their lives.

Investing in the world’s most precious resource – people – is paramount to ending poverty on a livable planet.  Our experience across more than 100 countries bears out this robust connection between human capital, quality of life, and economic growth: when countries strategically invest in people and the systems designed to protect and build human capital at scale, they unlock the wealth of nations and the potential of everyone.

Building on this, the World Bank supports resilient, equitable, and inclusive education systems that ensure learning happens for everyone. We do this by generating and disseminating evidence, ensuring alignment with policymaking processes, and bridging the gap between research and practice.

The World Bank is the largest source of external financing for education in developing countries, with a portfolio of about $26 billion in 94 countries including IBRD, IDA and Recipient-Executed Trust Funds. IDA operations comprise 62% of the education portfolio.

The investment in FCV settings has increased dramatically and now accounts for 26% of our portfolio.

World Bank projects reach at least 425 million students -one-third of students in low- and middle-income countries.

The World Bank’s Approach to Education

Five interrelated pillars of a well-functioning education system underpin the World Bank’s education policy approach:

  • Learners are prepared and motivated to learn;
  • Teachers are prepared, skilled, and motivated to facilitate learning and skills acquisition;
  • Learning resources (including education technology) are available, relevant, and used to improve teaching and learning;
  • Schools are safe and inclusive; and
  • Education Systems are well-managed, with good implementation capacity and adequate financing.

The Bank is already helping governments design and implement cost-effective programs and tools to build these pillars.

Our Principles:

  • We pursue systemic reform supported by political commitment to learning for all children. 
  • We focus on equity and inclusion through a progressive path toward achieving universal access to quality education, including children and young adults in fragile or conflict affected areas , those in marginalized and rural communities,  girls and women , displaced populations,  students with disabilities , and other vulnerable groups.
  • We focus on results and use evidence to keep improving policy by using metrics to guide improvements.   
  • We want to ensure financial commitment commensurate with what is needed to provide basic services to all. 
  • We invest wisely in technology so that education systems embrace and learn to harness technology to support their learning objectives.   

Laying the groundwork for the future

Country challenges vary, but there is a menu of options to build forward better, more resilient, and equitable education systems.

Countries are facing an education crisis that requires a two-pronged approach: first, supporting actions to recover lost time through remedial and accelerated learning; and, second, building on these investments for a more equitable, resilient, and effective system.

Recovering from the learning crisis must be a political priority, backed with adequate financing and the resolve to implement needed reforms.  Domestic financing for education over the last two years has not kept pace with the need to recover and accelerate learning. Across low- and lower-middle-income countries, the  average share of education in government budgets fell during the pandemic , and in 2022 it remained below 2019 levels.

The best chance for a better future is to invest in education and make sure each dollar is put toward improving learning.  In a time of fiscal pressure, protecting spending that yields long-run gains – like spending on education – will maximize impact.  We still need more and better funding for education.  Closing the learning gap will require increasing the level, efficiency, and equity of education spending—spending smarter is an imperative.

  • Education technology  can be a powerful tool to implement these actions by supporting teachers, children, principals, and parents; expanding accessible digital learning platforms, including radio/ TV / Online learning resources; and using data to identify and help at-risk children, personalize learning, and improve service delivery.

Looking ahead

We must seize this opportunity  to reimagine education in bold ways. Together, we can build forward better more equitable, effective, and resilient education systems for the world’s children and youth.

Accelerating Improvements

Supporting countries in establishing time-bound learning targets and a focused education investment plan, outlining actions and investments geared to achieve these goals.

Launched in 2020, the  Accelerator Program  works with a set of countries to channel investments in education and to learn from each other. The program coordinates efforts across partners to ensure that the countries in the program show improvements in foundational skills at scale over the next three to five years. These investment plans build on the collective work of multiple partners, and leverage the latest evidence on what works, and how best to plan for implementation.  Countries such as Brazil (the state of Ceará) and Kenya have achieved dramatic reductions in learning poverty over the past decade at scale, providing useful lessons, even as they seek to build on their successes and address remaining and new challenges.  

Universalizing Foundational Literacy

Readying children for the future by supporting acquisition of foundational skills – which are the gateway to other skills and subjects.

The  Literacy Policy Package (LPP)   consists of interventions focused specifically on promoting acquisition of reading proficiency in primary school. These include assuring political and technical commitment to making all children literate; ensuring effective literacy instruction by supporting teachers; providing quality, age-appropriate books; teaching children first in the language they speak and understand best; and fostering children’s oral language abilities and love of books and reading.

Advancing skills through TVET and Tertiary

Ensuring that individuals have access to quality education and training opportunities and supporting links to employment.

Tertiary education and skills systems are a driver of major development agendas, including human capital, climate change, youth and women’s empowerment, and jobs and economic transformation. A comprehensive skill set to succeed in the 21st century labor market consists of foundational and higher order skills, socio-emotional skills, specialized skills, and digital skills. Yet most countries continue to struggle in delivering on the promise of skills development. 

The World Bank is supporting countries through efforts that address key challenges including improving access and completion, adaptability, quality, relevance, and efficiency of skills development programs. Our approach is via multiple channels including projects, global goods, as well as the Tertiary Education and Skills Program . Our recent reports including Building Better Formal TVET Systems and STEERing Tertiary Education provide a way forward for how to improve these critical systems.

Addressing Climate Change

Mainstreaming climate education and investing in green skills, research and innovation, and green infrastructure to spur climate action and foster better preparedness and resilience to climate shocks.

Our approach recognizes that education is critical for achieving effective, sustained climate action. At the same time, climate change is adversely impacting education outcomes. Investments in education can play a huge role in building climate resilience and advancing climate mitigation and adaptation. Climate change education gives young people greater awareness of climate risks and more access to tools and solutions for addressing these risks and managing related shocks. Technical and vocational education and training can also accelerate a green economic transformation by fostering green skills and innovation. Greening education infrastructure can help mitigate the impact of heat, pollution, and extreme weather on learning, while helping address climate change. 

Examples of this work are projects in Nigeria (life skills training for adolescent girls), Vietnam (fostering relevant scientific research) , and Bangladesh (constructing and retrofitting schools to serve as cyclone shelters).

Strengthening Measurement Systems

Enabling countries to gather and evaluate information on learning and its drivers more efficiently and effectively.

The World Bank supports initiatives to help countries effectively build and strengthen their measurement systems to facilitate evidence-based decision-making. Examples of this work include:

(1) The  Global Education Policy Dashboard (GEPD) : This tool offers a strong basis for identifying priorities for investment and policy reforms that are suited to each country context by focusing on the three dimensions of practices, policies, and politics.

  • Highlights gaps between what the evidence suggests is effective in promoting learning and what is happening in practice in each system; and
  • Allows governments to track progress as they act to close the gaps.

The GEPD has been implemented in 13 education systems already – Peru, Rwanda, Jordan, Ethiopia, Madagascar, Mozambique, Islamabad, Khyber Pakhtunkhwa, Sierra Leone, Niger, Gabon, Jordan and Chad – with more expected by the end of 2024.

(2)  Learning Assessment Platform (LeAP) : LeAP is a one-stop shop for knowledge, capacity-building tools, support for policy dialogue, and technical staff expertise to support student achievement measurement and national assessments for better learning.

Supporting Successful Teachers

Helping systems develop the right selection, incentives, and support to the professional development of teachers.

Currently, the World Bank Education Global Practice has over 160 active projects supporting over 18 million teachers worldwide, about a third of the teacher population in low- and middle-income countries. In 12 countries alone, these projects cover 16 million teachers, including all primary school teachers in Ethiopia and Turkey, and over 80% in Bangladesh, Pakistan, and Vietnam.

A World Bank-developed classroom observation tool, Teach, was designed to capture the quality of teaching in low- and middle-income countries. It is now 3.6 million students.

While Teach helps identify patterns in teacher performance, Coach leverages these insights to support teachers to improve their teaching practice through hands-on in-service teacher professional development (TPD).

Our recent report on Making Teacher Policy Work proposes a practical framework to uncover the black box of effective teacher policy and discusses the factors that enable their scalability and sustainability.

 Supporting Education Finance Systems

Strengthening country financing systems to mobilize resources for education and make better use of their investments in education.

Our approach is to bring together multi-sectoral expertise to engage with ministries of education and finance and other stakeholders to develop and implement effective and efficient public financial management systems; build capacity to monitor and evaluate education spending, identify financing bottlenecks, and develop interventions to strengthen financing systems; build the evidence base on global spending patterns and the magnitude and causes of spending inefficiencies; and develop diagnostic tools as public goods to support country efforts.

Working in Fragile, Conflict, and Violent (FCV) Contexts

The massive and growing global challenge of having so many children living in conflict and violent situations requires a response at the same scale and scope. Our education engagement in the Fragility, Conflict and Violence (FCV) context, which stands at US$5.35 billion, has grown rapidly in recent years, reflecting the ever-increasing importance of the FCV agenda in education. Indeed, these projects now account for more than 25% of the World Bank education portfolio.

Education is crucial to minimizing the effects of fragility and displacement on the welfare of youth and children in the short-term and preventing the emergence of violent conflict in the long-term. 

Support to Countries Throughout the Education Cycle

Our support to countries covers the entire learning cycle, to help shape resilient, equitable, and inclusive education systems that ensure learning happens for everyone. 

The ongoing  Supporting  Egypt  Education Reform project , 2018-2025, supports transformational reforms of the Egyptian education system, by improving teaching and learning conditions in public schools. The World Bank has invested $500 million in the project focused on increasing access to quality kindergarten, enhancing the capacity of teachers and education leaders, developing a reliable student assessment system, and introducing the use of modern technology for teaching and learning. Specifically, the share of Egyptian 10-year-old students, who could read and comprehend at the global minimum proficiency level, increased to 45 percent in 2021.

In  Nigeria , the $75 million  Edo  Basic Education Sector and Skills Transformation (EdoBESST)  project, running from 2020-2024, is focused on improving teaching and learning in basic education. Under the project, which covers 97 percent of schools in the state, there is a strong focus on incorporating digital technologies for teachers. They were equipped with handheld tablets with structured lesson plans for their classes. Their coaches use classroom observation tools to provide individualized feedback. Teacher absence has reduced drastically because of the initiative. Over 16,000 teachers were trained through the project, and the introduction of technology has also benefited students.

Through the $235 million  School Sector Development Program  in  Nepal  (2017-2022), the number of children staying in school until Grade 12 nearly tripled, and the number of out-of-school children fell by almost seven percent. During the pandemic, innovative approaches were needed to continue education. Mobile phone penetration is high in the country. More than four in five households in Nepal have mobile phones. The project supported an educational service that made it possible for children with phones to connect to local radio that broadcast learning programs.

From 2017-2023, the $50 million  Strengthening of State Universities  in  Chile  project has made strides to improve quality and equity at state universities. The project helped reduce dropout: the third-year dropout rate fell by almost 10 percent from 2018-2022, keeping more students in school.

The World Bank’s first  Program-for-Results financing in education  was through a $202 million project in  Tanzania , that ran from 2013-2021. The project linked funding to results and aimed to improve education quality. It helped build capacity, and enhanced effectiveness and efficiency in the education sector. Through the project, learning outcomes significantly improved alongside an unprecedented expansion of access to education for children in Tanzania. From 2013-2019, an additional 1.8 million students enrolled in primary schools. In 2019, the average reading speed for Grade 2 students rose to 22.3 words per minute, up from 17.3 in 2017. The project laid the foundation for the ongoing $500 million  BOOST project , which supports over 12 million children to enroll early, develop strong foundational skills, and complete a quality education.

The $40 million  Cambodia  Secondary Education Improvement project , which ran from 2017-2022, focused on strengthening school-based management, upgrading teacher qualifications, and building classrooms in Cambodia, to improve learning outcomes, and reduce student dropout at the secondary school level. The project has directly benefited almost 70,000 students in 100 target schools, and approximately 2,000 teachers and 600 school administrators received training.

The World Bank is co-financing the $152.80 million  Yemen  Restoring Education and Learning Emergency project , running from 2020-2024, which is implemented through UNICEF, WFP, and Save the Children. It is helping to maintain access to basic education for many students, improve learning conditions in schools, and is working to strengthen overall education sector capacity. In the time of crisis, the project is supporting teacher payments and teacher training, school meals, school infrastructure development, and the distribution of learning materials and school supplies. To date, almost 600,000 students have benefited from these interventions.

The $87 million  Providing an Education of Quality in  Haiti  project supported approximately 380 schools in the Southern region of Haiti from 2016-2023. Despite a highly challenging context of political instability and recurrent natural disasters, the project successfully supported access to education for students. The project provided textbooks, fresh meals, and teacher training support to 70,000 students, 3,000 teachers, and 300 school directors. It gave tuition waivers to 35,000 students in 118 non-public schools. The project also repaired 19 national schools damaged by the 2021 earthquake, which gave 5,500 students safe access to their schools again.

In 2013, just 5% of the poorest households in  Uzbekistan  had children enrolled in preschools. Thanks to the  Improving Pre-Primary and General Secondary Education Project , by July 2019, around 100,000 children will have benefitted from the half-day program in 2,420 rural kindergartens, comprising around 49% of all preschool educational institutions, or over 90% of rural kindergartens in the country.

In addition to working closely with governments in our client countries, the World Bank also works at the global, regional, and local levels with a range of technical partners, including foundations, non-profit organizations, bilaterals, and other multilateral organizations. Some examples of our most recent global partnerships include:

UNICEF, UNESCO, FCDO, USAID, Bill & Melinda Gates Foundation:  Coalition for Foundational Learning

The World Bank is working closely with UNICEF, UNESCO, FCDO, USAID, and the Bill & Melinda Gates Foundation as the  Coalition for Foundational Learning  to advocate and provide technical support to ensure foundational learning.  The World Bank works with these partners to promote and endorse the  Commitment to Action on Foundational Learning , a global network of countries committed to halving the global share of children unable to read and understand a simple text by age 10 by 2030.

Australian Aid, Bernard van Leer Foundation, Bill & Melinda Gates Foundation, Canada, Echida Giving, FCDO, German Cooperation, William & Flora Hewlett Foundation, Conrad Hilton Foundation, LEGO Foundation, Porticus, USAID: Early Learning Partnership

The Early Learning Partnership (ELP) is a multi-donor trust fund, housed at the World Bank.  ELP leverages World Bank strengths—a global presence, access to policymakers and strong technical analysis—to improve early learning opportunities and outcomes for young children around the world.

We help World Bank teams and countries get the information they need to make the case to invest in Early Childhood Development (ECD), design effective policies and deliver impactful programs. At the country level, ELP grants provide teams with resources for early seed investments that can generate large financial commitments through World Bank finance and government resources. At the global level, ELP research and special initiatives work to fill knowledge gaps, build capacity and generate public goods.

UNESCO, UNICEF:  Learning Data Compact

UNESCO, UNICEF, and the World Bank have joined forces to close the learning data gaps that still exist and that preclude many countries from monitoring the quality of their education systems and assessing if their students are learning. The three organizations have agreed to a  Learning Data Compact , a commitment to ensure that all countries, especially low-income countries, have at least one quality measure of learning by 2025, supporting coordinated efforts to strengthen national assessment systems.

UNESCO Institute for Statistics (UIS):   Learning Poverty Indicator

Aimed at measuring and urging attention to foundational literacy as a prerequisite to achieve SDG4, this partnership was launched in 2019 to help countries strengthen their learning assessment systems, better monitor what students are learning in internationally comparable ways and improve the breadth and quality of global data on education.

FCDO, Bill & Melinda Gates Foundation:  EdTech Hub

Supported by the UK government’s Foreign, Commonwealth & Development Office (FCDO), in partnership with the Bill & Melinda Gates Foundation, the EdTech Hub is aimed at improving the quality of ed-tech investments. The Hub launched a rapid response Helpdesk service to provide just-in-time advisory support to 70 low- and middle-income countries planning education technology and remote learning initiatives.

MasterCard Foundation

Our Tertiary Education and Skills  global program, launched with support from the Mastercard Foundation, aims to prepare youth and adults for the future of work and society by improving access to relevant, quality, equitable reskilling and post-secondary education opportunities.  It is designed to reframe, reform, and rebuild tertiary education and skills systems for the digital and green transformation.

Image

Bridging the AI divide: Breaking down barriers to ensure women’s leadership and participation in the Fifth Industrial Revolution

Image

Common challenges and tailored solutions: How policymakers are strengthening early learning systems across the world

Image

Compulsory education boosts learning outcomes and climate action

Areas of focus.

Data & Measurement

Early Childhood Development

Financing Education

Foundational Learning

Fragile, Conflict & Violent Contexts

Girls’ Education

Inclusive Education

Skills Development

Technology (EdTech)  

Tertiary Education

Initiatives

  • Show More +
  • Invest in Childcare
  • Global Education Policy Dashboard
  • Global Education Evidence Advisory Panel
  • Show Less -

Collapse and Recovery: How the COVID-19 Pandemic Eroded Human Capital and What to Do About It

BROCHURES & FACT SHEETS

Flyer: Education Factsheet - May 2024

Publication: Realizing Education's Promise: A World Bank Retrospective – August 2023

Flyer: Education and Climate Change - November 2022

Brochure: Learning Losses - October 2022

STAY CONNECTED

Education

Human Development Topics

Around the bank group.

Find out what the Bank Group's branches are doing in education

Newsletter

Global Education Newsletter - June 2024

What's happening in the World Bank Education Global Practice? Read to learn more.

The World Bank

Learning Can't Wait: A commitment to education in Latin America and the ...

A new IDB-World Bank report describes challenges and priorities to address the educational crisis.

Image

Human Capital Project

The Human Capital Project is a global effort to accelerate more and better investments in people for greater equity and economic growth.

Image

Impact Evaluations

Research that measures the impact of education policies to improve education in low and middle income countries.

Education

Education Videos

Watch our latest videos featuring our projects across the world

Additional Resources

Skills & Workforce Development

Technology (EdTech)

This site uses cookies to optimize functionality and give you the best possible experience. If you continue to navigate this website beyond this page, cookies will be placed on your browser. To learn more about cookies, click here .

More From Forbes

Educating digital natives: reshaping educational models for future generations.

Forbes Technology Council

  • Share to Facebook
  • Share to Twitter
  • Share to Linkedin

Geoffrey Alphonso, CEO of Alef Education .

In today's fast-paced, technology-driven world, we are witnessing a seismic shift in how people communicate, access information and conduct business. At the forefront of this change are digital natives—Gen-Z, a demographic cohort born between 1997–2012 into a world saturated with technology.

Gen-Z’s comfort and fluency with technology have forced educators and policy-makers to rethink traditional educational methods and adopt forward-thinking approaches to teaching and learning. According to a British Council report , 65% of today's students will work in jobs that don't exist yet.

Traditional teaching modes, characterized by teacher-centered learning and memorization, with books and classroom lectures as essential tools, have long been the cornerstones of education. However, these strategies can seem insufficient and lose their appeal to digital natives.

For example, these traditional methods, which emphasize repetition over critical thinking and creativity, still need to meet the needs of these tech-savvy learners. Today, technology must be integrated into the education system in practical and imaginative ways to support this generation's learning style and meet their needs.

Fostering digital literacy is a critical factor in rethinking teaching methods for digital natives. However, digital literacy goes beyond technical skills to include critical thinking, creativity and the ability to navigate and evaluate digital sources.

Digital Native Learning Patterns

Technology in education can further enhance learning for digital natives and potentially reshape education. Virtual reality, online learning platforms, gamification, the introduction of the metaverse and interactive 3-D applications can all foster immersive and engaging learning experiences. These technologies are designed to provide personalized learning pathways and redefine group learning, allowing students to learn at their own pace, following their interests and needs.

The World Economic Forum estimates the displacement of 85 million jobs by automation by 2025, while 97 million new roles could emerge by then. EdTech companies are leading the education evolution, using cutting-edge resources to prepare students for the modern world.

For example, companies use creative methods such as engaging videos and activities to break down complex lessons and foster students' creativity, analytical thinking and problem-solving skills. Technology is a powerful catalyst for learning, and these companies are using it to create more effective and engaging learning experiences.

To effectively teach digital natives, educators must understand their learning patterns. Generation-Z differs vastly from their predecessors—they prefer an independent learning style with less passive and more visual and kinesthetic learning.

One of the defining features of the digital age is the ubiquity of the internet. With continuous access to educational resources and other learning activities through their smart devices, students can learn at their own pace and on their own time. This on-the-go learning offers several benefits to digital natives, including flexibility, convenience and cost-effectiveness.

Another significant step in rethinking education models for Generation-Z is preparing educators to facilitate learning over teaching, which encourages active collaboration among digital natives. Online platforms and tools can enable better communication and cooperation, creating promising opportunities for students to learn from each other.

There are also compelling reasons for educators to move beyond teaching content to create learning experiences that meet the unique needs of digital natives. Rather than imparting facts, educators must challenge students to think critically and create, given their access to information. The goal is to nurture concerned and active citizens who can navigate the complex web of information in the digital age. In addition, teachers need adequate professional development to use technology and adapt traditional instruction effectively. It is not just about using technology as a tool but understanding how to harness it to create dynamic and engaging learning experiences.

Global Shifts In Education

Around the world, there are examples of educational institutions and systems that are redefining their focus to develop skills for the future. These shifts are driven by the realization that traditional education cannot prepare digital natives for the complexities of the modern world.

Students and teachers play a central role in innovating teaching and learning methods. The focus is on fostering creativity, collaboration and communication skills, which are indispensable in the digital age. These modern learning patterns primarily support the Organization for Economic Cooperation and Development (OECD) project "The Future of Education and Skills 2030." This initiative aims to equip students with the knowledge, skills and values they need to shape the world. The future of education also requires enhanced professional development programs that prepare educators to teach digital natives by seamlessly integrating technology into the classroom.

By embracing technology, promoting digital literacy, fostering collaboration and giving teachers more control over their classrooms, we can create an educational ecosystem that offers teachers and students the skills they need to succeed in the digital age. Modern educational tools are our allies in guiding students and teachers through an ever-evolving world and empowering them to contribute to society. Transforming conventional educational models and introducing active learning policies are the most effective ways to achieve this and successfully educate and inspire future generations.

Key Strategies For A Futuristic Education Landscape

To effectively execute the transformation of educational models, EdTech leaders should prioritize establishing robust privacy and security protocols to protect sensitive student and faculty data. In addition, it is critical to ensure accessibility and inclusion by designing user-friendly interfaces and integrating features that accommodate different learning styles.

Leaders should also advocate for integrating research and evidence-based practices and encourage collaboration among all stakeholders to develop and improve educational tools. By implementing these strategies, EdTech leaders can play an essential role in reshaping the educational landscape to meet the needs of future generations.

EdTech is playing a creative part in redefining teaching paradigms. The future of education lies in our ability to adapt and evolve with changing times. Education is ultimately the key to equipping students for the complex, unforeseen challenges of the future. By embracing this change, we lay the foundation for a more imaginative and adaptable future generation that can navigate and shape tomorrow’s world.

Forbes Technology Council is an invitation-only community for world-class CIOs, CTOs and technology executives. Do I qualify?

Geoffrey Alphonso

  • Editorial Standards
  • Reprints & Permissions

4 youth leaders from Brazil, Zambia, Nepal and Honduras tell us what type of education they want to ensure they can face the future with the skills they need to succeed.

Dorcas, 17, is a student at Nampundwe Secondary School in Zambia. Here she's participating in a science class. Credit: UNICEF/UNI297252/Schermbrucker

International Youth Day is a moment to reflect on the dynamic role of education and skills in shaping the future of our youth.

Read the perspectives of young individuals from around the globe on the urgency of educational reforms that foster creativity, inclusivity and practical learning, paving the way for generations of problem-solvers and innovators.

Raquel

To cultivate a generation of problem-solvers, we must give room to creative expression

Creativity is often hailed as a cornerstone of 21 st century skills: it is the road to all other important skills, the means through which we analyze information, apply previous knowledge and problem-solve. But I remember many occasions when my creativity was nipped in the bud by my educators.

This is not uncommon. A study by George Land based on a test used by NASA tracked imaginative thinking skills from childhood to adulthood. It identified school – more precisely, the way it teaches us to think – as the cause of decline in creativity.

Bursts of creativity are criticized if they diverge from the norm. We wonder how to foster creativity, but an equally good question might be: how do we stop suppressing it?

We cannot expect youth to become problem-solving citizens if they never have the space to explore doing it on their own terms. And we cannot create this space through occasional dynamics or sporadic words of encouragement – it takes making creativity a daily reality.

Lalita, Nepal

Support is critical to close the gender skills gap

We are still living in a patriarchal society where girls face barriers to acquiring and using skills. The barriers come from discrimination, education inequalities, cultural and societal norms and lack of role models, which prevent young women from making progress. And even where there are laws to promote gender equality, implementation is lagging.

However, since COVID-19, we are seeing more and more girls and boys using smartphones to explore different skills, learn about diverse platforms, and access education in local and global forums. Digital platforms have been introduced to girls from different regions of Nepal to increase their awareness and access to education.

To reduce the gender skills gap, I have been working across Nepal with the National Adolescent Girl's Network to empower girls with leadership skills and technological literacy through educational programs and initiatives in schools.

We are seeing awareness slowly increase, and with it the confidence of girls to advocate for themselves to their local leaders. These efforts are vital in creating a more inclusive and supportive educational environment for girls throughout Nepal.

Memory, Zambia

Curriculums and skills programs must be inclusive

As a young person in Zambia , I understand firsthand the challenges that we face in acquiring the skills and education needed to succeed in today's workforce. Many young Zambians finish school without any practical skills or experience, making it tough to find employment or start a business.

According to the Zambia National Human Resource Development Council, only 10% of Zambia's youth have access to technical and vocational education and training (TVET) programs, and many young people are underemployed or working in low-paying jobs due to lack of experience or skills.

This highlights the need for more effective education and skills programs to help young people enter the workforce. Young people with disabilities also face significant barriers to accessing education and skills development opportunities.

One potential solution is to introduce vocational and technical education into the primary and secondary school curriculum. We must focus on increasing access to quality education, integrating skills development into the education system, and promoting inclusivity.

Amara, Honduras

Education must be holistic to build a strong foundation

Accessible and quality education is critical for young people to fully realize their potential, but it must be holistic. Education should not only provide academic knowledge such as mathematics and science, but it must also encompass soft skills like emotional intelligence and teamwork, as well as critical life skills such as financial literacy and gender education.

These competencies are crucial for youth to become well-rounded individuals capable of making informed decisions and respecting diversity and the environment. These skills are often overlooked, but they are very important for young people to lead healthy and active lives and contribute to their local communities and beyond.

Young people require quality education that prepares us for life, not just school. This means more investment in innovative teaching methods. This way, we can become capable adults, both at home and professionally—the true aim of education.

More and more young people are learning about their rights and advocating for them, understanding that access to education is crucial for personal, familial and societal growth.

Let’s listen to what young people want

To create education systems that truly work to equip young people with the skills they need to succeed, we must reimagine education systems that empower youth with the skills to innovate, lead, and address the challenges of our time.

By listening to the voices of young people and implementing inclusive, skill-focused educational reforms, we can unlock the potential of the next generation to forge a brighter, more equitable future.

Read other blogs in this series .

Related blogs

July 31, 2024 The urgent need to build green skills of the next generation Learn how young leaders in Kenya and Mexico are making a difference in their communities by addressing the impact of climate change through education. Through gardening and water-saving innovations, students...

July 24, 2024 Putting an end to female genital mutilation for girls’ education: Youth perspectives from Cameroon, Kenya and Somalia Stories and insights from GPE youth leaders on the practice of female genital mutilation within their cultural contexts, highlighting the connection between ending that practice and ensuring every girl’s...

July 10, 2024 Bangladesh: Learning skills for work rekindles dreams of a brighter future With the support of GPE and UNICEF, Urmi is now learning how to use the computer and picking up skills to build a better future for herself, her family, and her community.

Leave a comment

Your email address will not be published. All fields are required.

  • Global and entity tokens are replaced with their values. Browse available tokens.
  • No HTML tags allowed.
  • Lines and paragraphs break automatically.
  • Web page addresses and email addresses turn into links automatically.

global education future

High-Level Political Forum on Sustainable Development

  • SDG Reviews
  • ECOSOC & HLPF Reviews
  • UN and other IGOs
  • Stakeholders
  • Inputs to the HLPF
  • Secretariat
  • High-Level Political Forum 2024

Under the auspices of ECOSOC

  • Preparation
  • Documentation
  • Other Events
  • Registration & Participation

Special Event on Transforming Education

A Special Event on Transforming Education is being convened by the Secretary General at UN Headquarters on 11 July 2024, in collaboration with the President of the General Assembly and the President of the Economic and Social Council. The event will highlight progress made since the Transforming Education Summit, 2022, and spur greater action between now and 2030. It will place a strong focus on investing in education and on skills development for the future, as we look ahead to the Summit of the Future in September 2024, as well as other major high-level meetings in 2025.

Click for more information

HLPF Logo

  • Search Search
  • Skip to main content
  • Keyboard shortcuts for audio player

In the face of global warming, students are dreaming up a better climate future

Lee V. Gaines

Bloomington High School South science teacher Kirstin Milks leads a lesson on human-caused climate change and technologies that could help reduce greenhouse gas emissions.

Bloomington High School South science teacher Kirstin Milks leads a lesson on human-caused climate change and technologies that could help reduce greenhouse gas emissions. Chris Elberfeld/WFYI hide caption

High school freshman DeWayne Murphy has a big idea for a new green technology.

“There's going to be a tank and it should be like a big giant metal tank,” he explains to climate scientist Ben Kravitz on a school day in May. “You fill it up with water, and the tank is going to heat up.”

The water will turn to steam, which will power a car. But it has some potential drawbacks.

Startups want to cool Earth by reflecting sunlight. There are few rules and big risks

Startups want to cool Earth by reflecting sunlight. There are few rules and big risks

“It's not really designed to take any damage, like at all, so you have to be like really gentle with it,” Murphy says.

“What I really like about that is steam’s kind of an old tech,” Kravitz tells him. “Steam works. We know that. So, yeah, that's a really cool idea.”

This conversation is part of a larger lesson about developing technologies that reduce planet-heating pollution. The lesson was created by Kravitz, an assistant professor of earth and atmospheric sciences at Indiana University; his colleague Paul Goddard; and Kirstin Milks, DeWayne Murphy’s science teacher at Bloomington High School South in Bloomington, Ind.

With heat waves and extreme weather becoming more and more common, Milks wants to empower her students with information and the creative freedom to dream up big ideas for a better climate future.

“The fact is that climate change is the story of these young people's lives,” Milks says. “Our students need to know not just the stuff about it that is challenging and difficult, the stuff we hear about in the news, but also they need to see how change can happen. They need to feel like they understand and can actually make a difference in our shared future.”

Milks teaches her students the basic facts about human-caused climate change: that burning fossil fuels — like coal, oil and gas — is the biggest single driver of increased carbon dioxide in the atmosphere. Carbon dioxide heats the planet, which has led to more frequent droughts, hurricanes, floods and intense heat waves.

This oil company invests in pulling CO2 out of the sky — so it can keep selling crude

This oil company invests in pulling CO2 out of the sky — so it can keep selling crude

Kravitz says, “The only permanent solution to stopping that is reducing our greenhouse gas emissions.”

Scientists already know some technologies that could help. Solar and wind energy combined with big batteries are helping the world transition away from oil, coal and gas.

But Kravitz says the world isn’t moving fast enough. So he and other scientists are studying strategies to temporarily alter the Earth’s climate to reduce the effects of climate change. It’s known as climate engineering, or geoengineering .

Climate engineering covers a range of strategies, including reflecting sunlight back into space and removing carbon dioxide from the atmosphere . But these strategies can also pose significant risks — like disruptions to rain patterns and impacts on global crops. Meanwhile, there’s still little regulation over how these technologies might get used.

“The people who are going to be voting on whether to [pursue climate engineering], or even leading the charge, are sitting in high school classrooms right now,” Kravitz says. “So if they don’t know what this topic is, that’s a real problem. So that’s why we developed the lesson.”

Milks says she isn’t trying to persuade students to embrace climate engineering — rather, she wants to give them the knowledge they need to make informed decisions about it, if and when the time comes.

Students think up wild ideas, like covering the desert in glitter

Creativity is at the core of this lesson, Milks explains. After students learn the basics of climate engineering, they’re asked to “come up with interesting wild ideas” to slow global warming.

High school freshman DeWayne Murphy consults with Milks, his science teacher, on a classroom experiment.

High school freshman DeWayne Murphy consults with Milks, his science teacher, on a classroom experiment. Chris Elberfeld/WFYI hide caption

At first, no idea is too out there, says Goddard, an assistant research scientist at Indiana University who helped develop the lesson.

'It could just sweep us away': This school is on the front lines of climate change

'It could just sweep us away': This school is on the front lines of climate change

“As we progress along throughout the lessons, then we add more details, more constraints to their designs,” Goddard says.

In the first round of brainstorming, students imagined a solar-powered helicopter; artificial trees that store rainwater to help fight wildfires; and lots of ways to reflect light back into the atmosphere, like covering the desert in shiny glitter.

Next, students are asked to consider the potential limitations and risks to their ideas. Take glitter in the desert, for example:

“How are we going to make sure that the glitter doesn't get eaten by the rock pocket mouse … or like snakes and stuff?” Milks asks.

The student suggests making the glitter large and smooth enough so it won’t be eaten by animals or otherwise harm them.

For their final assignment, students present their concepts — including their anticipated benefits and risks — to Kravitz, Goddard and other scientists.

Montana youth climate ruling could set precedent for future climate litigation

Montana youth climate ruling could set precedent for future climate litigation

High school junior Campbell Brown has an idea for a flying air filter that sucks carbon dioxide out of the atmosphere and turns it into a harmless byproduct.

“It'll decrease the amount of greenhouse gases that are in the air,” she explains during her presentation. “The risks could be that it just doesn't work the way I want it to.”

Kravitz is impressed.

“So you want to know something? It does work,” he tells Brown. “The waste product that you get out of it is baking soda, essentially. So yeah, it works, it just can't be widely deployed right now because it's too expensive.”

Fostering climate optimism

Brown is thrilled that her idea is something scientists are currently studying, especially because she didn’t know much about climate change before this lesson.

Ben Kravitz, an assistant professor of Earth and atmospheric sciences at Indiana University, chats with high school students DeWayne Murphy and Emerald Yee during a class at Bloomington High School South.

Ben Kravitz, an assistant professor of earth and atmospheric sciences at Indiana University, chats with high school students DeWayne Murphy and Emerald Yee during a class at Bloomington High School South. Chris Elberfeld/WFYI hide caption

She was saddened to learn how humans have contributed to climate change and its effects on the planet, but she says she’s leaving this lesson with a newfound sense of hope.

“Because rather than the old generation leaving something broken for us to fix, we're also getting help from that generation. And so that way, we're all helping each other out and fixing what we have caused,” she says.

New Jersey requires climate change education. A year in, here's how it's going

New Jersey requires climate change education. A year in, here's how it's going

Emerald Yee, a senior in Milks’ class, has been concerned about climate change for a while. She has a family member with a chronic health condition that’s exacerbated by heat.

“So for me, I’m mainly just worried about [their] safety when it comes to climate change and global warming,” Yee says. She says this lesson gave her the tools to “really think about climate change and how we can change it and make it better for not just our generation, but the younger generations, our younger siblings, or even our kids and grandkids.”

For Kravitz, fostering climate optimism is a big part of this lesson. And he says hearing students’ ideas for solutions always makes him feel better.

“The neat thing about seeing all of these ideas come out of the classroom is it's not I can't do it . It's we can do it . Humans, when they get together, can do amazing things. And that's what gives me hope.”

  • climate change and kids

Russian cities and regions guide main page

  • Visit Our Blog about Russia to know more about Russian sights, history
  • Check out our Russian cities and regions guides
  • Follow us on Twitter and Facebook to better understand Russia
  • Info about getting Russian visa , the main airports , how to rent an apartment
  • Our Expert answers your questions about Russia, some tips about sending flowers

Russia panorama

Russian regions

  • Altay republic
  • Irkutsk oblast
  • Kemerovo oblast
  • Khakassia republic
  • Krasnoyarsk krai
  • Novosibirsk oblast
  • Omsk oblast
  • Tomsk oblast
  • Tuva republic
  • Map of Russia
  • All cities and regions
  • Blog about Russia
  • News from Russia
  • How to get a visa
  • Flights to Russia
  • Russian hotels
  • Renting apartments
  • Russian currency
  • FIFA World Cup 2018
  • Submit an article
  • Flowers to Russia
  • Ask our Expert

Omsk Oblast, Russia

The capital city of Omsk oblast: Omsk .

Omsk Oblast - Overview

Omsk Oblast is a federal subject of Russia located in the south-eastern part of Siberia, in the Siberian Federal District. Omsk is the capital city of the region.

The population of Omsk Oblast is about 1,879,500 (2022), the area - 141,140 sq. km.

Omsk oblast flag

Omsk oblast coat of arms.

Omsk oblast coat of arms

Omsk oblast map, Russia

Omsk oblast latest news and posts from our blog:.

10 November, 2019 / Tomsk - the view from above .

3 July, 2016 / Omsk - the view from above .

20 October, 2012 / The bear at the gate .

2 August, 2012 / Omsk city from bird's eye view .

14 December, 2011 / Time-lapse video of Omsk city .

More posts..

History of Omsk Oblast

Ancient people began to settle in the area of the middle reaches of the Irtysh River about 45,000 years ago. This region became the place of numerous migrations of different peoples, of interpenetration of forest and steppe cultures. In the Middle Ages, the territory of the present Omsk region was part of the Western Turkic Khanate and the Siberian Khanate. As a result, an ethnic group of the Siberian Tatars was formed. This region was also inhabited by Kazakhs and other peoples.

The history of the development of the Irtysh by Russians is connected first of all with the legendary Yermak. Although even before him, in the 15th century, Russian merchants from the Urals visited the Siberian Khanate.

In the early 18th century, major reforms carried out by Peter the Great required large expenses. The first Russian emperor turned his attention to the east. He sent a detachment of Cossacks under the command of the lieutenant-colonel I.D.Bukhgolts from the town of Tobolsk up the Irtysh River in search of gold deposits.

More Historical Facts…

The expedition failed because of resistance from the nomads Dzhungars. Russians were forced to take a step back. In 1716, they founded a fortress at the mouth of the Om River - future Omsk. Russian peasants began to settle in the land around the fortress. To the south of Omsk, a line of outposts was constructed for protection from the nomads.

In 1782, the fortress became a town. Omsk district was formed on the basis of the southern part of Tarsky district and, in 1785, the town of Omsk was given a coat of arms. Omsk became an important center for the study of Siberia and Central Asia. This region like other parts of Siberia was used as a place for political exile.

In the 19th century, the people exiled to Siberia were the Decembrists, Petrashevts, Narodniki, representatives of other revolutionary parties and organizations, participants of the Polish national movement. These people had a major cultural impact on the local population. The great Russian writer F.M.Dostoyevsky was one of the prisoners of the Omsk jail.

In the late 19th and early 20th century, Siberia experienced significant changes. Large-scale migration of peasants led to the rapid growth of the local economy, especially agriculture. Due to its favorable economic and geographical location, at the intersection of the Trans-Siberian Railway and the Irtysh River, Omsk rapidly turned into a large transport, trade and industrial center of Western Siberia, the largest city in Siberia.

During the Second World War, about 100 industrial plants were evacuated from the European part of the USSR to Omsk. They became the basis of the local engineering industry. In 1949, the first refinery in Siberia was constructed in Omsk. In 1954-1956, during development of virgin lands, several large agricultural enterprises were built in the southern part of Omsk Oblast. In the 1970s, Omsk oblast became one of the most economically developed regions of Siberia.

Pictures of Omsk Oblast

Wooden chapel in Omsk Oblast

Wooden chapel in Omsk Oblast

Author: Sedov Artem

Country house in Omsk Oblast

Country house in Omsk Oblast

Author: Heinrich Jena

Provincial life in the Omsk region

Provincial life in the Omsk region

Author: Baranov Pavel

Omsk Oblast - Features

Omsk Oblast is located in the south of the West Siberian Plain, in the middle reaches of the Irtysh River, with steppes in the south, which turn into forest steppes, forests and marshy tundra in the north. The territory of the region stretches for about 600 km from north to south and 300 km from west to east. In the south, Omsk Oblast borders with Kazakhstan.

The largest cities and towns of Omsk Oblast are Omsk (1,126,000), Tara (28,500), Kalachinsk (21,900), Isylkul (21,700). The main river is the Irtysh with its tributaries (the Ishim, Om, Osha, and Tara). The Trans-Siberian Railway is an important traffic artery. There is an international airport in Omsk.

The climate is continental and sharply continental. The average temperature in January is minus 19-20 degrees Celsius, in July - plus 17-18 degrees Celsius in the northern part and plus 19 degrees Celsius in the south.

Omsk Oblast has such natural resources as oil, natural gas, brown coal, iron ore, various construction materials. Main manufacturing, construction and trade are carried out in Omsk. Industrial sector is represented by military, aerospace and agricultural engineering, petrochemical, light and food industries.

Agriculture is represented by crops, dairy and beef cattle, pig and poultry farming. Cereals (wheat, rye, oats, barley), potatoes, vegetables, sunflower, and other crops are cultivated.

Attractions of Omsk Oblast

A lot of sights can be found in Omsk. The most interesting places located outside the city are:

  • Achairsky Convent in the upper reaches of the Irtysh River, 50 km from Omsk;
  • St. Nicholas Monastery in the village of Bolshekulache, 20 km from Omsk;
  • Nature reserve “Bairovsky” created for the preservation and reproduction of rare and valuable species of birds and animals;
  • Batakovo tract - a natural and archaeological park on the left bank of the Irtysh River, 150 km north of Omsk, in Bolsherechensky district;
  • Znamenskiy museum of local lore dedicated to the history and nature of Omsk oblast, located in one of the oldest settlements of the region - in the village of Znamenskoye;
  • Chudskaya mountain on the left bank of the Irtysh River, 3 km north of Znamenskoye;
  • Lake Ulzhay - a relict water reservoir in the northwest of Kurumbelskaya steppe, in Cherlaksky district, 160 km from Omsk;
  • Lake Ebeyty in the southwest of the region;
  • Lake Platovskoye located to the north-east of the village of Platovo in Polstavskiy district;
  • “Bird’s Haven” - a natural park located in Omsk;
  • “Devil’s finger” - a rock on the right bank of the Irtysh, 2 km from the village of Serebryanoye, on the territory of Gorky district.

Omsk oblast of Russia photos

Nature of omsk oblast.

Omsk Oblast landscape

Omsk Oblast landscape

Author: Vitali Ellert

Omsk Oblast scenery

Omsk Oblast scenery

Author: Yury Ermakov

Small river in Omsk Oblast

Small river in Omsk Oblast

Author: Andrey Genze

Wooden house in the Omsk region

Wooden house in the Omsk region

Winter in Omsk Oblast

Winter in Omsk Oblast

Wooden church in Omsk Oblast

Wooden church in Omsk Oblast

  • Currently 2.86/5

Rating: 2.9 /5 (137 votes cast)

We've detected unusual activity from your computer network

To continue, please click the box below to let us know you're not a robot.

Why did this happen?

Please make sure your browser supports JavaScript and cookies and that you are not blocking them from loading. For more information you can review our Terms of Service and Cookie Policy .

For inquiries related to this message please contact our support team and provide the reference ID below.

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • View all journals
  • Explore content
  • About the journal
  • Publish with us
  • Sign up for alerts
  • Review Article
  • Published: 22 March 2024

Drug-resistant tuberculosis: a persistent global health concern

  • Maha Farhat   ORCID: orcid.org/0000-0002-3871-5760 1 , 2 ,
  • Helen Cox 3   na1 ,
  • Marwan Ghanem 1   na1 ,
  • Claudia M. Denkinger 4 , 5 ,
  • Camilla Rodrigues 6 ,
  • Mirna S. Abd El Aziz 4 ,
  • Handaa Enkh-Amgalan 7 ,
  • Debrah Vambe 8 ,
  • Cesar Ugarte-Gil 9 ,
  • Jennifer Furin 10 &
  • Madhukar Pai   ORCID: orcid.org/0000-0003-3667-4536 11  

Nature Reviews Microbiology ( 2024 ) Cite this article

6157 Accesses

1 Citations

164 Altmetric

Metrics details

  • Antimicrobial resistance
  • Bacterial evolution
  • Clinical microbiology
  • Infectious-disease epidemiology

Drug-resistant tuberculosis (TB) is estimated to cause 13% of all antimicrobial resistance-attributable deaths worldwide and is driven by both ongoing resistance acquisition and person-to-person transmission. Poor outcomes are exacerbated by late diagnosis and inadequate access to effective treatment. Advances in rapid molecular testing have recently improved the diagnosis of TB and drug resistance. Next-generation sequencing of Mycobacterium tuberculosis has increased our understanding of genetic resistance mechanisms and can now detect mutations associated with resistance phenotypes. All-oral, shorter drug regimens that can achieve high cure rates of drug-resistant TB within 6–9 months are now available and recommended but have yet to be scaled to global clinical use. Promising regimens for the prevention of drug-resistant TB among high-risk contacts are supported by early clinical trial data but final results are pending. A person-centred approach is crucial in managing drug-resistant TB to reduce the risk of poor treatment outcomes, side effects, stigma and mental health burden associated with the diagnosis. In this Review, we describe current surveillance of drug-resistant TB and the causes, risk factors and determinants of drug resistance as well as the stigma and mental health considerations associated with it. We discuss recent advances in diagnostics and drug-susceptibility testing and outline the progress in developing better treatment and preventive therapies.

This is a preview of subscription content, access via your institution

Access options

Access Nature and 54 other Nature Portfolio journals

Get Nature+, our best-value online-access subscription

24,99 € / 30 days

cancel any time

Subscribe to this journal

Receive 12 print issues and online access

195,33 € per year

only 16,28 € per issue

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF

Prices may be subject to local taxes which are calculated during checkout

global education future

Similar content being viewed by others

global education future

Multidrug-resistant tuberculosis

global education future

Rifampicin Resistant Tuberculosis in Lesotho: Diagnosis, Treatment Initiation and Outcomes

global education future

Global burden of disease due to rifampicin-resistant tuberculosis: a mathematical modeling analysis

Peto, H. M., Pratt, R. H., Harrington, T. A., LoBue, P. A. & Armstrong, L. R. Epidemiology of extrapulmonary tuberculosis in the United States, 1993–2006. Clin. Infect. Dis. 49 , 1350–1357 (2009).

Article   PubMed   Google Scholar  

WHO Consolidated Guidelines on Tuberculosis. Module 4: Treatment — Drug-resistant Tuberculosis Treatment, 2022 Update. World Health Organization https://www.who.int/publications/i/item/9789240063129 (2022).

WHO Consolidated Guidelines on Tuberculosis. Module 4: Treatment — Drug-susceptible Tuberculosis Treatment. World Health Organization https://www.who.int/publications/i/item/9789240048126 (2022).

WHO Consolidated Guidelines on Tuberculosis. Module 3: Diagnosis — Rapid Diagnostics For Tuberculosis Detection, 2021 Update. World Health Organization https://www.who.int/publications/i/item/9789240029415 (2021).

Cohen, K. A., Manson, A. L., Desjardins, C. A., Abeel, T. & Earl, A. M. Deciphering drug resistance in Mycobacterium tuberculosis using whole-genome sequencing: progress, promise, and challenges. Genome Med. 11 , 45 (2019).

Article   PubMed   PubMed Central   Google Scholar  

Cohen, K. A. et al. Extensive global movement of multidrug-resistant Mycobacterium tuberculosis strains revealed by whole-genome analysis. Thorax 74 , 882–889 (2019).

Short-course chemotherapy in pulmonary tuberculosis: a controlled trial by the British Thoracic and Tuberculosis Association.  Lancet 305 , 119–124 (1975).

Zhang, Y. The magic bullets and tuberculosis drug targets. Annu. Rev. Pharmacol. Toxicol. 45 , 529–564 (2005).

Article   CAS   PubMed   Google Scholar  

Global Tuberculosis Report 2022. World Health Organization https://www.who.int/publications/i/item/9789240061729 (2022).

Global Tuberculosis Report 2021. World Health Organization https://www.who.int/publications/i/item/9789240037021 (2021).

Boehme, C. C. et al. Rapid molecular detection of tuberculosis and rifampin resistance. N. Engl. J. Med. 363 , 1005–1015 (2010).

Article   CAS   PubMed   PubMed Central   Google Scholar  

The Use of Molecular Line Probe Assay for the Detection of Resistance to Isoniazid and Rifampicin: Policy Update. World Health Organization https://www.who.int/publications/i/item/9789241511261 (2016).

Dixit, A. et al. Estimation of country-specific tuberculosis antibiograms using genomic data. Preprint at  medRxiv https://doi.org/10.1101/2021.09.23.21263991 (2021).

Article   Google Scholar  

O’Connor, C. & Brady, M. F. Isoniazid. StatPearls [Internet] https://pubmed.ncbi.nlm.nih.gov/32491549/ (updated 8 April 2022).

Yee, D. et al. Incidence of serious side effects from first-line antituberculosis drugs among patients treated for active tuberculosis. Am. J. Respir. Crit. Care Med. 167 , 1472–1477 (2003).

Murray, J. F., Schraufnagel, D. E. & Hopewell, P. C. Treatment of tuberculosis: a historical perspective. Ann. Am. Thorac. Soc. 12 , 1749–1759 (2015).

Jacobson, K. R. et al. Treatment outcomes of isoniazid-resistant tuberculosis patients, Western Cape Province, South Africa. Clin. Infect. Dis. 53 , 369–372 (2011).

Ahmad, N., Ahuja, S. & Akkerman, O. Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis. Lancet 392 , 821–834 (2018).

Stagg, H. R. et al. Fluoroquinolones and isoniazid-resistant tuberculosis: implications for the 2018 WHO guidance. Eur. Respir. J. 54 , 1900982 (2019).

WHO Treatment Guidelines for Isoniazid-resistant Tuberculosis: Supplement to the WHO Treatment Guidelines for Drug-resistant Tuberculosis. World Health Organization https://www.who.int/publications/i/item/9789241550079 (2018).

Meeting Report of the WHO Expert Consultation on the Definition of extensively Drug-Resistant Tuberculosis, 27-29 October 2020. World Health Organization https://www.who.int/publications/i/item/9789240018662 (2021).

Global Tuberculosis Report 2023. World Health Organization https://www.who.int/publications/i/item/9789240083851 (2023).

Murray, C. J. et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet 399 , 629–655 (2022).

Article   CAS   Google Scholar  

Knight, G. M., McQuaid, C. F., Dodd, P. J. & Houben, R. Global burden of latent multidrug-resistant tuberculosis: trends and estimates based on mathematical modelling. Lancet Infect. Dis. 19 , 903–912 (2019).

WHO Global Task Force on TB Impact Measurement: Report of a Subgroup Meeting on Methods Used by WHO to Estimate TB Disease Burden, 11-12 May 2022, Geneva, Switzerland. World Health Organization https://www.who.int/publications/i/item/9789240057647 (2022).

Global Tuberculosis Report 2015. World Health Organization https://www.who.int/publications/i/item/9789241565059 (2015).

Global Tuberculosis Report 2020. World Health Organization https://www.who.int/publications/i/item/9789240013131 (2020).

Villegas, L. et al. Prevalence, risk factors, and treatment outcomes of isoniazid- and rifampicin-mono-resistant pulmonary tuberculosis in Lima, Peru. PLoS ONE   11 , e0152933 (2016).

Sharling, L., Marks, S. M., Goodman, M., Chorba, T. & Mase, S. Rifampin-resistant tuberculosis in the United States, 1998-2014. Clin. Infect. Dis. 70 , 1596–1605 (2019).

Ismail, N. A. et al. Prevalence of drug-resistant tuberculosis and imputed burden in South Africa: a national and sub-national cross-sectional survey. Lancet Infect. Dis. 18 , 779–787 (2018).

Dean, A. S. Prevalence and genetic profiles of isoniazid resistance in tuberculosis patients: a multicountry analysis of cross-sectional data. PLoS Med. 17 , e1003008 (2020).

Subbaraman, R., Jhaveri, T. & Nathavitharana, R. R. Closing gaps in the tuberculosis care cascade: an action-oriented research agenda. J. Clin. Tuberc. Mycobact. Dis. 19 , 100144 (2020).

Google Scholar  

Subbaraman, R. et al. Constructing care cascades for active tuberculosis: a strategy for program monitoring and identifying gaps in quality of care. PLoS Med. 16 , e1002754 (2019).

Naidoo, P. et al. The South African tuberculosis care cascade: estimated losses and methodological challenges. J. Infect. Dis. 216 , S702–S713 (2017).

Subbaraman, R. et al. The tuberculosis cascade of care in India’s public sector: a systematic review and meta-analysis. PLoS Med. 13 , e1002149 (2016).

Migliori, G. B. et al. Gauging the impact of the COVID-19 pandemic on tuberculosis services: a global study. Eur. Respir. J. 58 , 2101786 (2021).

Daniels, B. et al. Use of standardised patients to assess quality of healthcare in Nairobi, Kenya: a pilot, cross-sectional study with international comparisons. BMJ Glob. Health 2 , e000333 (2017).

Daniels, B., Kwan, A. & Pai, M. Lessons on the quality of tuberculosis diagnosis from standardized patients in China, India, Kenya, and South. Afr. J. Clin. Tuberc. Mycobact. Dis. 16 , 100109 (2019).

Boffa, J. et al. Quality of care for tuberculosis and HIV in the private health sector: a cross-sectional, standardised patient study in South Africa. BMJ Glob. Health 6 , e005250 (2021).

Kwan, A. et al. Variations in the quality of tuberculosis care in urban India: a cross-sectional, standardized patient study in two cities. PLoS Med. 15 , e1002653 (2018).

Daniels, B. et al. Tuberculosis diagnosis and management in the public versus private sector: a standardised patients study in Mumbai, India. BMJ Glob. Health 7 , 009657 (2022).

Demers, A. M. et al. Drug susceptibility patterns of Mycobacterium tuberculosis from adults with multidrug-resistant tuberculosis and implications for a household contact preventive therapy trial. BMC Infect. Dis. 21 , 205 (2021).

Step up for TB 2020 report: Tuberculosis Policies in 37 Countries. Médecins Sans Frontières & Stop TB Partnership https://msfaccess.org/step-tb-tb-policies-37-countries-4th-ed (2020).

Omar, S. V., Ismail, F., Ndjeka, N., Kaniga, K. & Ismail, N. A. Bedaquiline-resistant tuberculosis associated with Rv0678 mutations. N. Engl. J. Med. 386 , 93–94 (2022).

Ismail, N. A. et al. Assessment of epidemiological and genetic characteristics and clinical outcomes of resistance to bedaquiline in patients treated for rifampicin-resistant tuberculosis: a cross-sectional and longitudinal study. Lancet Infect. Dis. 22 , 496–506 (2022).

Azimi, T. et al. Linezolid resistance in multidrug-resistant Mycobacterium tuberculosis : a systematic review and meta-analysis. Front. Pharmacol. 13 , 955050 (2022).

Chesov, E. et al. Emergence of bedaquiline resistance in a high tuberculosis burden country. Eur. Respir. J. 59 , 2100621 (2022).

Mallick, J. S., Nair, P., Abbew, E. T., Van Deun, A. & Decroo, T. Acquired bedaquiline resistance during the treatment of drug-resistant tuberculosis: a systematic review. JAC Antimicrob. Resist. 4 , dlac029 (2022).

Jenkins, H. E. & Yuen, C. M. The burden of multidrug-resistant tuberculosis in children. Int. J. Tuberc. Lung Dis. 22 , 3–6 (2018).

WHO Consolidated Guidelines on Tuberculosis, Module 5: Management of Tuberculosis in children and Adolescents. World Health Organization https://www.who.int/publications/i/item/9789240046764 (2022).

Dodd, P. J., Mafirakureva, N., Seddon, J. A. & McQuaid, C. F. The global impact of household contact management for children on multidrug-resistant and rifampicin-resistant tuberculosis cases, deaths, and health-system costs in 2019: a modelling study. Lancet Glob. Health 10 , 1034–1044 (2022).

Dookie, N., Rambaran, S., Padayatchi, N., Mahomed, S. & Naidoo, K. Evolution of drug resistance in Mycobacterium tuberculosis : a review on the molecular determinants of resistance and implications for personalized care. J. Antimicrob. Chemother. 73 , 1138–1151 (2018).

Casali, N. et al. Evolution and transmission of drug-resistant tuberculosis in a Russian population. Nat. Genet. 46 , 279–286 (2014).

Cohen, K. A. et al. Evolution of extensively drug-resistant tuberculosis over four decades: whole genome sequencing and dating analysis of Mycobacterium tuberculosis isolates from KwaZulu-Natal. PLoS Med. 12 , e1001880 (2015).

Jiang, Q. et al. The evolution and transmission dynamics of multidrug-resistant tuberculosis in an isolated high-plateau population of Tibet, China. Microbiol. Spectr. 11 , e03991-22 (2023).

Ektefaie, Y., Dixit, A., Freschi, L. & Farhat, M. R. Globally diverse Mycobacterium tuberculosis resistance acquisition: a retrospective geographical and temporal analysis of whole genome sequences. Lancet Microbe 2 , e96–e104 (2021).

Auld, S. C. et al. Extensively drug-resistant tuberculosis in South Africa: genomic evidence supporting transmission in communities. Eur. Respir. J. 52 , 1800246 (2018).

Kendall, E. A., Fofana, M. O. & Dowdy, D. W. Burden of transmitted multidrug resistance in epidemics of tuberculosis: a transmission modelling analysis. Lancet Respir. Med. 3 , 963–972 (2015).

Yang, C. et al. Transmission of multidrug-resistant Mycobacterium tuberculosis in Shanghai, China: a retrospective observational study using whole-genome sequencing and epidemiological investigation. Lancet Infect. Dis. 17 , 275–284 (2017).

Becerra, M. C. et al. Transmissibility and potential for disease progression of drug resistant Mycobacterium tuberculosis : prospective cohort study. BMJ 367 , l5894 (2019).

Atre, S. R. et al. Tuberculosis pathways to care and transmission of multidrug resistance in India. Am. J. Respir. Crit. Care Med. 205 , 233–241 (2022).

El Halabi, J. et al. Measuring health-care delays among privately insured patients with tuberculosis in the USA: an observational cohort study. Lancet Infect. Dis. 21 , 1175–1183 (2021).

Odone, A. et al. Acquired and transmitted multidrug resistant tuberculosis: the role of social determinants. PLoS ONE   11 , e0146642 (2016).

Bayer, R. & Wilkinson, D. Directly observed therapy for tuberculosis: history of an idea. Lancet 345 , 1545–1548 (1995).

Pasipanodya, J. G., Srivastava, S. & Gumbo, T. Meta-analysis of clinical studies supports the pharmacokinetic variability hypothesis for acquired drug resistance and failure of antituberculosis therapy. Clin. Infect. Dis. 55 , 169–177 (2012).

Srivastava, S., Pasipanodya, J. G., Meek, C., Leff, R. & Gumbo, T. Multidrug-resistant tuberculosis not due to noncompliance but to between-patient pharmacokinetic variability. J. Infect. Dis. 204 , 1951–1959 (2011).

McKay, B., Castellanos, M., Ebell, M., Whalen, C. C. & Handel, A. An attempt to reproduce a previous meta-analysis and a new analysis regarding the impact of directly observed therapy on tuberculosis treatment outcomes. PLoS ONE   14 , e0217219 (2019).

Manson, A. L. et al. Genomic analysis of globally diverse Mycobacterium tuberculosis strains provides insights into the emergence and spread of multidrug resistance. Nat. Genet. 49 , 395–402 (2017).

Dreyer, V. et al. High fluoroquinolone resistance proportions among multidrug-resistant tuberculosis driven by dominant L2 Mycobacterium tuberculosis clones in the Mumbai Metropolitan Region. Genome Med. 14 , 95 (2022).

Cox, H. et al. Potential contribution of HIV during first-line tuberculosis treatment to subsequent rifampicin-monoresistant tuberculosis and acquired tuberculosis drug resistance in South Africa: a retrospective molecular epidemiology study. Lancet Microbe 2 , e584–e593 (2021).

Wang, Z. et al. Epidemiological characteristics and risk factors of multidrug-resistant tuberculosis in Luoyang, China. Front. Public Health 11 , 1117101 (2023).

Hang, N. T. L. et al. Primary drug-resistant tuberculosis in Hanoi, Viet Nam: present status and risk factors. PLoS ONE   8 , e71867 (2013).

Vashakidze, L. et al. Prevalence and risk factors for drug resistance among hospitalized tuberculosis patients in Georgia. Int. J. Tuberc. Lung Dis. 13 , 1148–1153 (2009).

CAS   PubMed   Google Scholar  

Andrews, J. R. et al. Predictors of multidrug-and extensively drug-resistant tuberculosis in a high HIV prevalence community. PLoS ONE   5 , e15735 (2010).

Mesfin, E. A. et al. Drug-resistance patterns of Mycobacterium tuberculosis strains and associated risk factors among multi drug-resistant tuberculosis suspected patients from Ethiopia. PLoS ONE   13 , e0197737 (2018).

Mbuh, T. P. et al. Predictors of drug-resistant tuberculosis among high-risk population diagnosed under national program conditions in the Littoral region, Cameroon. BioMed. Res. Int. 2021 , 8817442 (2021).

Skrahina, A. et al. Multidrug-resistant tuberculosis in Belarus: the size of the problem and associated risk factors. Bull. World Health Organ. 91 , 36–45 (2013).

Urrego, J. et al. The impact of ventilation and early diagnosis on tuberculosis transmission in Brazilian prisons. Am. J. Trop. Med. Hyg. 93 , 739–746 (2015).

Kerubo, G., Amukoye, E., Niemann, S. & Kariuki, S. Drug susceptibility profiles of pulmonary Mycobacterium tuberculosis isolates from patients in informal urban settlements in Nairobi, Kenya. BMC Infect. Dis. 16 , 583 (2016).

Oliveira, O. et al. Using Bayesian spatial models to map and to identify geographical hotspots of multidrug-resistant tuberculosis in Portugal between 2000 and 2016. Sci. Rep. 10 , 16646 (2020).

Jenkins, H. E. et al. Assessing spatial heterogeneity of multidrug-resistant tuberculosis in a high-burden country. Eur. Respir. J. 42 , 1291–1301 (2013).

Alene, K. A., Viney, K., McBryde, E. S. & Clements, A. C. A. Spatial patterns of multidrug resistant tuberculosis and relationships to socio-economic, demographic and household factors in northwest Ethiopia. PLoS ONE   12 , e0171800 (2017).

Paleckyte, A., Dissanayake, O., Mpagama, S., Lipman, M. C. & McHugh, T. D. Reducing the risk of tuberculosis transmission for HCWs in high incidence settings. Antimicrob. Resist. Infect. Control 10 , 106 (2021).

Escombe, A. R. et al. Tuberculosis transmission risk and infection control in a hospital emergency department in Lima, Peru. Int. J. Tuberc. Lung Dis. 14 , 1120–1126 (2010).

Telisinghe, L. et al. High tuberculosis prevalence in a South African prison: the need for routine tuberculosis screening. PLoS ONE   9 , e87262 (2014).

Dheda, K. et al. The epidemiology, pathogenesis, transmission, diagnosis, and management of multidrug-resistant, extensively drug-resistant, and incurable tuberculosis. Lancet Respir. Med. 5 , 291–360 (2017).

Houben, R. M. G. J. & Glynn, J. R. A systematic review and meta-analysis of molecular epidemiological studies of tuberculosis: development of a new tool to aid interpretation. Trop. Med. Int. Health 14 , 892–909 (2009).

Chen, S. et al. Risk factors for multidrug resistance among previously treated patients with tuberculosis in eastern China: a case-control study. Int. J. Infect. Dis. 17 , e1116-20 (2013).

Pradipta, I. S., Forsman, L. D., Bruchfeld, J., Hak, E. & Alffenaar, J. W. Risk factors of multidrug-resistant tuberculosis: a global systematic review and meta-analysis. J. Infect. 77 , 469–478 (2018).

Lomtadze, N. et al. Prevalence and risk factors for multidrug-resistant tuberculosis in the Republic of Georgia: a population-based study. Int. J. Tuberc. Lung Dis. 13 , 68–73 (2009).

Lee, E. G. et al. Age-stratified anti-tuberculosis drug resistance profiles in South Korea: a multicenter retrospective study. BMC Infect. Dis. 20 , 446 (2020).

Behr, M. A., Edelstein, P. H. & Ramakrishnan, L. Revisiting the timetable of tuberculosis. BMJ 362 , k2738 (2018).

Oladimeji, O. et al. Gender and drug-resistant tuberculosis in Nigeria. Trop. Med. Infect. Dis. 8 , 104 (2023).

McQuaid, C. F., Horton, K. C., Dean, A. S., Knight, G. M. & White, R. G. The risk of multidrug-or rifampicin-resistance in males versus females with tuberculosis. Eur. Respir. J. 56 , 2000626 (2020).

O’Donnell, M. R. et al. Extensively drug-resistant tuberculosis in women, KwaZulu-Natal, South Africa. Emerg. Infect. Dis. 17 , 1942–1945 (2011).

Gandhi, N. R. et al. Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa. Lancet 368 , 1575–1580 (2006).

Kolla, B. P., Oesterle, T., Gold, M., Southwick, F. & Rummans, T. Infectious diseases occurring in the context of substance use disorders: a concise review. J. Neurol. Sci. 411 , 116719 (2020).

Soboka, M. et al. Substance use disorders and adherence to antituberculosis medications in Southwest Ethiopia: a prospective cohort study. BMJ Open 11 , e043050 (2021).

Mekonnen, H. S. & Azagew, A. W. Non-adherence to anti-tuberculosis treatment, reasons and associated factors among TB patients attending at Gondar town health centers, Northwest Ethiopia. BMC Res. Notes 11 , 691 (2018).

Chaves Torres, N. M., Quijano Rodríguez, J. J., Porras Andrade, P. S., Arriaga, M. B. & Netto, E. M. Factors predictive of the success of tuberculosis treatment: a systematic review with meta-analysis. PLoS ONE   14 , e0226507 (2019).

Dixit, A. et al. Modern lineages of Mycobacterium tuberculosis were recently introduced in Western India and demonstrate increased transmissibility. Preprint at  medRxiv https://doi.org/10.1101/2022.01.04.22268645 (2022).

Casali, N. et al. Microevolution of extensively drug-resistant tuberculosis in Russia. Genome Res. 22 , 735–745 (2012).

Gygli, S. M. et al. Publisher Correction: prisons as ecological drivers of fitness-compensated multidrug-resistant Mycobacterium tuberculosis . Nat. Med. 27 , 1308–1308 (2021).

Loiseau, C. et al. The relative transmission fitness of multidrug-resistant Mycobacterium tuberculosis in a drug resistance hotspot. Nat. Commun. 14 , 1988 (2023).

Gygli, S. M., Borrell, S., Trauner, A. & Gagneux, S. Antimicrobial resistance in Mycobacterium tuberculosis : mechanistic and evolutionary perspectives. FEMS Microbiol. Rev. 41 , 354–373 (2017).

Li, S. et al. CRISPRi chemical genetics and comparative genomics identify genes mediating drug potency in Mycobacterium tuberculosis . Nat. Microbiol. 7 , 766–779 (2022).

Nguyen, L. & Pieters, J. Mycobacterial subversion of chemotherapeutic reagents and host defense tactics: challenges in tuberculosis drug development. Annu. Rev. Pharmacol. Toxicol. 49 , 427–453 (2009).

Morris, R. P. et al. Ancestral antibiotic resistance in Mycobacterium tuberculosis . Proc. Natl Acad. Sci. USA 102 , 12200–12205 (2005).

Mailaender, C. et al. The MspA porin promotes growth and increases antibiotic susceptibility of both Mycobacterium bovis BCG and Mycobacterium tuberculosis . Microbiology 150 , 853–864 (2004).

Rodriguez-Rivera, F. P., Zhou, X., Theriot, J. A. & Bertozzi, C. R. Visualization of mycobacterial membrane dynamics in live cells. J. Am. Chem. Soc. 139 , 3488–3495 (2017).

Madsen, C. T. et al. Methyltransferase Erm(37) slips on rRNA to confer atypical resistance in Mycobacterium tuberculosis . J. Biol. Chem. 280 , 38942–38947 (2005).

Wang, F., Cassidy, C. & Sacchettini, J. C. Crystal structure and activity studies of the Mycobacterium tuberculosis beta-lactamase reveal its critical role in resistance to β-lactam antibiotics. Antimicrob. Agents Chemother. 50 , 2762–2771 (2006).

Chambers, H. F., Kocagoz, T., Sipit, T., Turner, J. & Hopewell, P. C. Activity of amoxicillin/clavulanate in patients with tuberculosis. Clin. Infect. Dis. 26 , 874–877 (1998).

Donald, P. R. & Sirge, F. A. Early bactericidal activity of amoxicillin in combination with clavulanic acid in patients with sputum smear-positive pulmonary tuberculosis. Scand. J. Infect. Dis. 33 , 466–469 (2001).

Hugonnet, J.-E., Tremblay, L. W., Boshoff, H. I., Barry, C. E. & Blanchard, J. S. Meropenem-clavulanate is effective against extensively drug-desistant Mycobacterium tuberculosis . Science 323 , 1215–1218 (2009).

Vargas, R. Jr et al. Phase variation as a major mechanism of adaptation in Mycobacterium tuberculosis complex. Proc. Natl Acad. Sci. USA 120 , e2301394120 (2023).

Vargas, R. Jr Role of epistasis in amikacin, kanamycin, bedaquiline, and clofazimine resistance in Mycobacterium tuberculosis complex. Antimicrob. Agents Chemother. 65 , e0116421 (2021).

Farhat, M. R. et al. Genetic determinants of drug resistance in Mycobacterium tuberculosis and their diagnostic value. Am. J. Respir. Crit. Care Med. 194 , 621–630 (2016).

Nebenzahl-Guimaraes, H., Jacobson, K. R., Farhat, M. R. & Murray, M. B. Systematic review of allelic exchange experiments aimed at identifying mutations that confer drug resistance in Mycobacterium tuberculosis . J. Antimicrob. Chemother. 69 , 331–342 (2013).

Kadura, S. et al. Systematic review of mutations associated with resistance to the new and repurposed Mycobacterium tuberculosis drugs bedaquiline, clofazimine, linezolid, delamanid and pretomanid. J. Antimicrob. Chemother. 75 , 2031–2043 (2020).

Zhang, Y. & Yew, W. W. Mechanisms of drug resistance in Mycobacterium tuberculosis . Int. J. Tuberc. Lung Dis. 13 , 1320–1330 (2009).

Green, A. G. et al. Analysis of genome-wide mutational dependence in naturally evolving Mycobacterium tuberculosis populations. Mol. Biol. Evol. 40 , msad131 (2023).

Barilar, I. et al. Quantitative measurement of antibiotic resistance in Mycobacterium tuberculosis reveals genetic determinants of resistance and susceptibility in a target gene approach. Nat. Commun. 15 , 488 (2024).

Farhat, M. R. et al. GWAS for quantitative resistance phenotypes in Mycobacterium tuberculosis reveals resistance genes and regulatory regions. Nat. Commun. 10 , 2128 (2019).

Walker, T. M. et al. The 2021 WHO catalogue of Mycobacterium tuberculosis complex mutations associated with drug resistance: a genotypic analysis. Lancet Microbe 3 , e265–e273 (2022).

Ghodousi, A. et al. Isoniazid resistance in Mycobacterium tuberculosis is a heterogeneous phenotype composed of overlapping MIC distributions with different underlying resistance mechanisms. Antimicrob. Agents Chemother. 63 , e00092-19 (2019).

Spitaleri, A., Ghodousi, A., Miotto, P. & Cirillo, D. M. Whole genome sequencing in Mycobacterium tuberculosis . Ann. Transl. Med. 7 , S197 (2019).

Farhat, M. R. et al. Gyrase mutations are associated with variable levels of fluoroquinolone resistance in Mycobacterium tuberculosis . J. Clin. Microbiol. 54 , 727–733 (2016).

Chen, M. L. et al. Beyond multidrug resistance: leveraging rare variants with machine and statistical learning models in Mycobacterium tuberculosis resistance prediction. EBioMedicine 43 , 356–369 (2019).

Green, A. G. et al. A convolutional neural network highlights mutations relevant to antimicrobial resistance in Mycobacterium tuberculosis . Nat. Commun. 13 , 3817 (2022).

Yang, Y. et al. Machine learning for classifying tuberculosis drug-resistance from DNA sequencing data. Bioinformatics 34 , 1666–1671 (2018).

Gröeschel, M. I. et al. GenTB: a user-friendly genome-based predictor for tuberculosis resistance powered by machine learning. Genome Med. 13 , 138 (2021).

Safi, H. et al. Phase variation in Mycobacterium tuberculosis glpK produces transiently heritable drug tolerance. Proc. Natl Acad. Sci. USA 116 , 19665–19674 (2019).

Hicks, N. D. et al. Clinically prevalent mutations in Mycobacterium tuberculosis alter propionate metabolism and mediate multidrug tolerance. Nat. Microbiol. 3 , 1032–1042 (2018).

Liu, Q. et al. Tuberculosis treatment failure associated with evolution of antibiotic resilience. Science 378 , 1111–1118 (2022).

Kreutzfeldt, K. M. et al. CinA mediates multidrug tolerance in Mycobacterium tuberculosis . Nat. Commun. 13 , 2203 (2022).

Martini, M. C. et al. Loss of RNase J leads to multi-drug tolerance and accumulation of highly structured mRNA fragments in Mycobacterium tuberculosis . PLoS Pathog. 18 , e1010705 (2022).

Andersson, D. I., Nicoloff, H. & Hjort, K. Mechanisms and clinical relevance of bacterial heteroresistance. Nat. Rev. Microbiol. 17 , 479–496 (2019).

Vargas, R. et al. In-host population dynamics of Mycobacterium tuberculosis complex during active disease. eLife 10 , e61805 (2021).

Nimmo, C. et al. Dynamics of within-host Mycobacterium tuberculosis diversity and heteroresistance during treatment. EBioMedicine 55 , 102747 (2020).

Engelthaler, D. M. et al. Minority Mycobacterium tuberculosis genotypic populations as an indicator of subsequent phenotypic resistance. Am. J. Respir. Cell Mol. Biol. 61 , 789–791 (2019).

WHO Standard: Universal Access to Rapid Tuberculosis Diagnostics. World Health Organization https://www.who.int/publications/i/item/9789240071315 (2023).

Report of the 16th Meeting of the Strategic and Technical Advisory Group for Tuberculosis 2016. World Health Organization https://www.who.int/publications/m/item/report-of-the-16th-meeting-of-the-strategic-and-technical-advisory-group-for-tb (2016).

Jacobson, K. R. et al. Implications of failure to routinely diagnose resistance to second-line drugs in patients with rifampicin-resistant tuberculosis on Xpert MTB/RIF: a multisite observational study. Clin. Infect. Dis. 64 , 1502–1508 (2017).

Oga-Omenka, C. et al. Factors influencing diagnosis and treatment initiation for multidrug-resistant/rifampicin-resistant tuberculosis in six sub-Saharan African countries: a mixed-methods systematic review. BMJ Glob. Health 5 , e002280 (2020).

Svadzian, A., Sulis, G., Gore, G., Pai, M. & Denkinger, C. M. Differential yield of universal versus selective drug susceptibility testing of patients with tuberculosis in high-burden countries: a systematic review and meta-analysis. BMJ Glob. Health 5 , e003438 (2020).

Kim, S. J. Drug-susceptibility testing in tuberculosis: methods and reliability of results. Eur. Respir. J. 25 , 564–569 (2005).

Technical Manual for Drug Susceptibility Testing of Medicines Used in the Treatment of Tuberculosis. World Health Organization https://www.who.int/publications/i/item/9789241514842 (2018).

Yu, H.-J. et al. Performance evaluation of the BACTEC MGIT 960 system for rifampin drug-susceptibility testing of Mycobacterium tuberculosis using the current WHO critical concentration. J. Clin. Microbiol. 61 , e01086-22 (2023).

Shea, J. et al. Low-level rifampin resistance and rpoB mutations in Mycobacterium tuberculosis : an analysis of whole-genome sequencing and drug susceptibility test data in New York. J. Clin. Microbiol. 59 , e01885-20 (2021).

Torrea, G. et al. Variable ability of rapid tests to detect Mycobacterium tuberculosis rpoB mutations conferring phenotypically occult rifampicin resistance. Sci. Rep. 9 , 11826 (2019).

Automated Real-time Nucleic Acid Amplification Technology for Rapid and Simultaneous Detection of Tuberculosis and Rifampicin Resistance: Xpert MTB/RIF System: Policy Statement. World Health Organization https://www.who.int/publications/i/item/9789241501545 (2011).

Rapid Implementation of the Xpert MTB/RIF Diagnostic Test: Technical and Operational “How-to”; Practical Considerations. World Health Organization https://www.who.int/publications/i/item/9789241501569 (2011).

Dorman, S. E. et al. Xpert MTB/RIF Ultra for detection of Mycobacterium tuberculosis and rifampicin resistance: a prospective multicentre diagnostic accuracy study. Lancet Infect. Dis. 18 , 76–84 (2018).

Albert, H. et al. Development, roll-out and impact of Xpert MTB/RIF for tuberculosis: what lessons have we learnt and how can we do better? Eur. Respir. J. 48 , 516–525 (2016).

Zifodya, J. S. et al. Xpert Ultra versus Xpert MTB/RIF for pulmonary tuberculosis and rifampicin resistance in adults with presumptive pulmonary tuberculosis. Cochrane Database Syst. Rev. 2021 , CD009593 (2021).

Penn-Nicholson, A. et al. A prospective multicentre diagnostic accuracy study for the Truenat tuberculosis assays. Eur. Respir. J. 58 , 2100526 (2021).

Gomathi, N. S. et al. Validation of an indigenous assay for rapid molecular detection of rifampicin resistance in presumptive multidrug-resistant pulmonary tuberculosis patients. Indian J. Med. Res. 152 , 482–489 (2020).

Molbio Diagnostics: Molbio launches Truenat MTB-INH test for drug resistance in TB patients. Health News, ET HealthWorld https://health.economictimes.indiatimes.com/news/diagnostics/molbio-launches-truenat-mtb-inh-test-for-drug-resistance-in-tb-patients/96963161 (2023).

Theron, G. et al. Feasibility, accuracy, and clinical effect of point-of-care Xpert MTB/RIF testing for tuberculosis in primary-care settings in Africa: a multicentre, randomised, controlled trial. Lancet 383 , 424–435 (2014).

Yoon, C. et al. Impact of Xpert MTB/RIF testing on tuberculosis management and outcomes in hospitalized patients in Uganda. PLoS ONE   7 , e48599 (2012).

Di Tanna, G. L. et al. Effect of Xpert MTB/RIF on clinical outcomes in routine care settings: individual patient data meta-analysis. Lancet Glob. Health 7 , e191–e199 (2019).

Churchyard, G. J. et al. Xpert MTB/RIF versus sputum microscopy as the initial diagnostic test for tuberculosis: a cluster-randomised trial embedded in South African roll-out of Xpert MTB/RIF. Lancet Glob. Health 3 , 450–457 (2015).

Cattamanchi, A. et al. Multicomponent strategy with decentralized molecular testing for tuberculosis. N. Engl. J. Med. 385 , 2441–2450 (2021).

Penn-Nicholson, A. et al. Detection of isoniazid, fluoroquinolone, ethionamide, amikacin, kanamycin, and capreomycin resistance by the Xpert MTB/XDR assay: a cross-sectional multicentre diagnostic accuracy study. Lancet Infect. Dis. 22 , 242–249 (2022).

Cao, Y. et al. Xpert MTB/XDR: a 10-color reflex assay suitable for point-of-care settings to detect isoniazid, fluoroquinolone, and second-line-injectable-drug resistance directly from Mycobacterium tuberculosis-positive sputum. J. Clin. Microbiol. 59 , e02314-20 (2021).

De Vos, M. et al. Comparative analytical evaluation of four centralized platforms for the detection of Mycobacterium tuberculosis complex and resistance to rifampicin and isoniazid. J. Clin. Microbiol. 59 , e02168-20 (2021).

Meaza, A. et al. Evaluation of genotype MTBDRplus VER 2.0 line probe assay for the detection of MDR-TB in smear positive and negative sputum samples. BMC Infect. Dis. 17 , 280 (2017).

Nathavitharana, R. R. et al. Accuracy of line probe assays for the diagnosis of pulmonary and multidrug-resistant tuberculosis: a systematic review and meta-analysis. Eur. Respir. J. 49 , 1601075 (2017).

Driesen, M. et al. Evaluation of a novel line probe assay to detect resistance to pyrazinamide, a key drug used for tuberculosis treatment. Clin. Microbiol. Infect. 24 , 60–64 (2018).

Willby, M. J. et al. Detection of Mycobacterium tuberculosis pncA mutations by the Nipro Genoscholar PZA-TB II assay compared to conventional sequencing. Antimicrob. Agents Chemother. 62 , e01871-17 (2018).

Catalogue of Mutations in Mycobacterium tuberculosis Complex and their Association with Drug Resistance, 2nd edn. World Health Organization https://www.who.int/publications/i/item/9789240082410 (2023).

Ismail, N. et al. Genetic variants and their association with phenotypic resistance to bedaquiline in Mycobacterium tuberculosis : a systematic review and individual isolate data analysis. Lancet Microbe 2 , e604–e616 (2021).

An, Q., Lin, R., Yang, Q., Wang, C. & Wang, D. Evaluation of genetic mutations associated with phenotypic resistance to fluoroquinolones, bedaquiline, and linezolid in clinical Mycobacterium tuberculosis : a systematic review and meta-analysis. J. Glob. Antimicrob. Resist. 34 , 214–226 (2023).

Gan, W. C., Ng, H. F. & Ngeow, Y. F. Mechanisms of linezolid resistance in mycobacteria. Pharmaceuticals 16 , 784 (2023).

CRyPTIC Consortium & The 100,000 Genomes Project. Prediction of susceptibility to first-line tuberculosis drugs by DNA sequencing. N. Engl. J. Med. 379 , 1403–1415 (2018).

Pankhurst, L. J. Rapid, comprehensive, and affordable mycobacterial diagnosis with whole-genome sequencing: a prospective study. Lancet Respir. Med. 4 , 49–58 (2016).

Use of Targeted Next-generation Sequencing to Detect Drug-resistant Tuberculosis: Rapid Communication. World Health Organization https://www.who.int/publications/i/item/9789240076372 (2023).

The Use of Next-Generation Sequencing for the Surveillance of Drug-Resistant Tuberculosis: An Implementation Manual. World Health Organization https://www.who.int/publications/i/item/9789240078079 (2023).

Dippenaar, A. et al. Nanopore sequencing for Mycobacterium tuberculosis : a critical review of the literature, new developments, and future opportunities. J. Clin. Microbiol. 60 , e00646-21 (2022).

Sanchez-Padilla, E. et al. Detection of drug-resistant tuberculosis by Xpert MTB/RIF in Swaziland. N. Engl. J. Med. 372 , 1181–1182 (2015).

Ng, K. C. et al. Xpert Ultra can unambiguously identify specific rifampin resistance-conferring mutations. J. Clin. Microbiol. 56 , 10–1128 (2018).

Daum, L. T. et al. Next-generation sequencing for characterizing drug resistance-conferring Mycobacterium tuberculosis genes from clinical isolates in the Ukraine. J. Clin. Microbiol. 56 , e00009-18 (2018).

Tagliani, E. et al. Culture and next-generation sequencing-based drug susceptibility testing unveil high levels of drug-resistant-TB in Djibouti: results from the first national survey. Sci. Rep. 7 , 17672 (2017).

Walker, T. M. et al. Whole-genome sequencing to delineate Mycobacterium tuberculosis outbreaks: a retrospective observational study. Lancet Infect. Dis. 13 , 137–146 (2013).

Mahomed, S., Mlisana, K., Cele, L. & Naidoo, K. Discordant line probe genotypic testing vs culture-based drug susceptibility phenotypic testing in TB endemic KwaZulu-Natal: impact on bedside clinical decision making. J. Clin. Tuberc. Mycobact. Dis. 20 , 100176 (2020).

Milimo, D. et al. Diagnosis of rifampicin-resistant tuberculosis: discordant results by diagnostic methods. Afr. J. Lab. Med. 7 , 1–4 (2018).

Votintseva, A. A. et al. Same-day diagnostic and surveillance data for ttuberculosis via whole-genome sequencing of direct respiratory samples. J. Clin. Microbiol. 55 , 1285–1298 (2017).

Brown, A. C. et al. Rapid whole-genome sequencing of Mycobacterium tuberculosis isolates directly from clinical samples. J. Clin. Microbiol. 53 , 2230–2237 (2015).

Doyle, R. M. et al. Direct whole-genome sequencing of sputum accurately identifies drug-resistant Mycobacterium tuberculosis faster than MGIT culture sequencing. J. Clin. Microbiol. 56 , e00666–18 (2018).

Goig, G. A. et al. Whole-genome sequencing of Mycobacterium tuberculosis directly from clinical samples for high-resolution genomic epidemiology and drug resistance surveillance: an observational study. Lancet Microbe 1 , e175–e183 (2020).

Van Rie, A. et al. Sequencing mycobacteria and algorithm-determined resistant tuberculosis treatment (SMARTT): a study protocol for a phase-IV pragmatic randomized controlled patient management strategy trial. Trials 23 , 864 (2022).

Sibandze, D. B. et al. Rapid molecular diagnostics of tuberculosis resistance by targeted stool sequencing. Genome Med. 14 , 52 (2022).

Iyer, A. et al. Operationalising targeted next-generation sequencing for routine diagnosis of drug-resistant TB. Public Health Action. 13 , 43–49 (2023).

Cox, H. et al. Whole-genome sequencing has the potential to improve treatment for rifampicin-resistant tuberculosis in high-burden settings: a retrospective cohort study. J. Clin. Microbiol. 60 , e02362–21 (2022).

Kwong, J. C., McCallum, N., Sintchenko, V. & Howden, B. P. Whole genome sequencing in clinical and public health microbiology. Pathology 47 , 199–210 (2015).

Conradie, F. et al. Treatment of highly drug-resistant pulmonary tuberculosis. N. Engl. J. Med. 382 , 893–902 (2020).

Nyang’wa, B.-T. et al. A 24-week, all-oral regimen for rifampin-resistant tuberculosis. N. Engl. J. Med. 387 , 2331–2343 (2022).

Padmapriyadarsini, C. et al. Bedaquiline, delamanid, linezolid and clofazimine for treatment of pre-extensively drug-resistant tuberculosis. Clin. Infect. Dis. 76 , e938–e946 (2022).

Pym, A. S. et al. Bedaquiline in the treatment of multidrug- and extensively drug-resistant tuberculosis. Eur. Respir. J. 47 , 564–574 (2016).

Schnippel, K. et al. Effect of bedaquiline on mortality in South African patients with drug-resistant tuberculosis: a retrospective cohort study. Lancet Respir. Med. 6 , 699–706 (2018).

Ndjeka, N. et al. High treatment success rate for multidrug-resistant and extensively drug-resistant tuberculosis using a bedaquiline-containing treatment regimen. Eur. Respir. J. 52 , 1801528 (2018).

Ndjeka, N. et al. Treatment outcomes 24 months after initiating short bedaquiline-containing or injectable-containing rifampicin-resistant tuberculosis treatment regimens: a retrospective cohort study in South Africa. Lancet Infect. Dis. 22 , 1042–1051 (2022).

Zhao, Y. et al. Improved treatment outcomes with bedaquiline when substituted for second-line injectable agents in multidrug-resistant tuberculosis: a retrospective cohort study. Clin. Infect. Dis. 68 , 1522–1529 (2019).

Conradie, F. et al. Bedaquiline–pretomanid–linezolid regimens for drug-resistant tuberculosis. N. Engl. J. Med. 387 , 810–823 (2022).

Esmail, A. et al. An all-oral 6-month regimen for multidrug-resistant tuberculosis: a multicenter, randomized controlled clinical trial (the NExT study). Am. J. Respir. Crit. Care Med. 205 , 1214–1227 (2022).

Goodall, R. L. et al. Evaluation of two short standardised regimens for the treatment of rifampicin-resistant tuberculosis (STREAM stage 2): an open-label, multicentre, randomised, non-inferiority trial. Lancet 400 , 1858–1868 (2022).

WHO Operational Handbook on Tuberculosis. Module 4: Treatment of Drug-resistant Tuberculosis. World Health Organization https://www.who.int/publications/i/item/9789240006997 (2020).

US National Library of Medicine. ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT02589782 (2021).

Clinical Trial Results Offer Hope to DR-TB patients with short, effective treatment. Médecins Sans Frontières https://www.msf.org/clinical-trial-finds-short-effective-safe-DR-TB-treatment (2022).

US National Library of Medicine. ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT02333799 (2020).

US National Library of Medicine. ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT03086486 (2023).

Drug-resistant Tuberculosis Clinical Trials Progress Report. RESIST-TB https://www.resisttb.org/clinical-trials-progress-report (2023).

US National Library of Medicine. ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT02619994 (2019).

Mok, J. et al. 9 months of delamanid, linezolid, levofloxacin, and pyrazinamide versus conventional therapy for treatment of fluoroquinolone-sensitive multidrug-resistant tuberculosis (MDR-END): a multicentre, randomised, open-label phase 2/3 non-inferiority trial in South Korea. Lancet 400 , 1522–1530 (2022).

US National Library of Medicine. ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT04062201 (2022).

US National Library of Medicine. ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT02754765 (2023).

Guglielmetti, L. et al. Evaluating newly approved drugs for multidrug-resistant tuberculosis (endTB): study protocol for an adaptive, multi-country randomized controlled trial. Trials 22 , 651 (2021).

US National Library of Medicine. ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT03896685 (2022).

ShORRT Initiative. Tropical Disease Research https://tdr.who.int/activities/shorrt-research-package (2022).

Tuberculosis Treatment: 2023 Pipeline Report. Treatment Action Group https://www.treatmentactiongroup.org/resources/pipeline-report/2023-pipeline-report/ (2023).

WHO Operational Handbook on Tuberculosis. Module 4: Treatment — Drug-resistant Tuberculosis Treatment, 2022 Update. World Health Organization https://www.who.int/publications/i/item/9789240065116 (2022).

Maugans, C. et al. Best practices for the care of pregnant people living with TB. Int. J. Tuberc. Lung Dis. 27 , 357–366 (2023).

Patankar, S. et al. Making the case for all-oral, shorter regimens for children with drug-resistant tuberculosis. Am. J. Respir. Crit. Care Med. 208 , 130–131 (2023).

Turkova, A. et al. Shorter treatment for nonsevere tuberculosis in African and Indian children. N. Engl. J. Med. 386 , 911–922 (2022).

Management of Multidrug-resistant Tuberculosis in Children: A Field Guide. Sentinel Project on Pediatric Drug-Resistant Tuberculosis https://sentinel-project.org/wp-content/uploads/2022/03/DRTB-Field-Guide-2021_v5.pdf (2022).

Furin, J., Tommasi, M. & Garcia-Prats, A. J. Drug-resistant tuberculosis: will grand promises fail children and adolescents? Lancet Child. Adolesc. Health 2 , 237–238 (2018).

Karo, B. et al. Isoniazid (INH) mono-resistance and tuberculosis (TB) treatment success: analysis of European surveillance data, 2002 to 2014. Eur. Surveill. 24 , 1800392 (2019).

Gegia, M., Winters, N., Benedetti, A., Soolingen, D. & Menzies, D. Treatment of isoniazid-resistant tuberculosis with first-line drugs: a systematic review and meta-analysis. Lancet Infect. Dis. 17 , 223–234 (2017).

Furin, J., Cox, H. & Pai, M. Tuberculosis. Lancet 393 , 1642–1656 (2019).

WHO Consolidated Guidelines on Tuberculosis: Module 1: Prevention: Tuberculosis Preventive Treatment. World Health Organization https://www.who.int/publications/i/item/9789240001503 (2020).

Guidelines for Programmatic Management of Tuberculosis Preventive Treatment in India. National TB Elimination Programme https://tbcindia.gov.in/WriteReadData/l892s/Guidelines%20for%20Programmatic%20Management%20of%20Tuberculosis%20Preventive%20Treatment%20in%20India.pdf (2021).

Latent Tuberculosis Infection: Updated and Consolidated Guidelines for Programmatic Management. World Health Organization https://www.who.int/publications/i/item/9789241550239 (2018).

Kherabi, Y., Tunesi, S., Kay, A. & Guglielmetti, L. Preventive therapy for contacts of drug-resistant tuberculosis. Pathogens 11 , 1189 (2022).

Huang, C. C. et al. Isoniazid preventive therapy in contacts of multidrug-resistant tuberculosis. Am. J. Respir. Crit. Care Med. 202 , 1159–1168 (2020).

Seddon, J. A. et al. Levofloxacin versus placebo for the prevention of tuberculosis disease in child contacts of multidrug-resistant tuberculosis: study protocol for a phase-III cluster randomised controlled trial (TB-CHAMP). Trials 19 , 693 (2018).

Fox, G. J. et al. Levofloxacin versus placebo for the treatment of latent tuberculosis among contacts of patients with multidrug-resistant tuberculosis (the VQUIN MDR trial): a protocol for a randomised controlled trial. BMJ Open 10 , e033945 (2020).

First Effective Treatment to Prevent Multidrug-Resistant TB. UCL News https://www.ucl.ac.uk/news/2023/nov/first-effective-treatment-prevent-multidrug-resistant-tb (2023).

US National Library of Medicine. ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/NCT03568383 (2023).

WHO announces forthcoming updates on tuberculosis preventive treatment. World Health Organization https://www.who.int/news/item/13-02-2024-who-announces-forthcoming-updates-on-tuberculosis-preventive-treatment (2024).

Zimmerman, E., Smith, J., Banay, R., Kau, M. & Garfin, A. M. C. G. Behavioural barriers and perceived trade-offs to care-seeking for tuberculosis in the Philippines. Glob. Public Health 17 , 210–222 (2022).

Daftary, A., Frick, M., Venkatesan, N., & Pai, M. Fighting TB stigma: we need to apply lessons learnt from HIV activism. BMJ Glob. Health 2 , e000515 (2017).

Pradhan, A. et al. Internalized and perceived stigma and depression in pulmonary tuberculosis: do they explain the relationship between drug sensitivity status and adherence? Front. Psychiatry 13 , 869647 (2022).

Redwood, L. et al. Depression, stigma and quality of life in people with drug-susceptible TB and drug-resistant TB in Vietnam. Int. J. Tuberc. Lung Dis. 25 , 461–467 (2021).

Daftary, A., Padayatchi, N. & O’Donnell, M. Preferential adherence to antiretroviral therapy over tuberculosis treatment: a qualitative study of drug-resistant TB/HIV co-infected patients in South Africa. Glob. Public Health 9 , 1107–1116 (2014).

Susanto, T. D. et al. Anxiety and depression level of patients with multidrug-resistant tuberculosis (MDR-TB) in two hospitals in Banten province, Indonesia. Dialogues Health 2 , 100115 (2023).

Walker, I. et al. Depression and anxiety in patients with multidrug-resistant tuberculosis in Nepal: an observational study. Public Health Action 9 , 42–48 (2019).

Sommerland, N. et al. Evidence-based interventions to reduce tuberculosis stigma: a systematic review. Int. J. Tuberc. Lung Dis. 21 , S81–S86 (2017).

As’hab, P. P., Keliat, B. A. & Wardani, I. Y. The effects of acceptance and commitment therapy on psychosocial impact and adherence of multidrug-resistant tuberculosis patients. J. Public Health Res. 11 , 2737 (2022).

Thomas, B. E. et al. Psycho-socio-economic issues challenging multidrug resistant tuberculosis patients: a systematic review. PLoS ONE   11 , e0147397 (2016).

Udwadia, Z. & Furin, J. Quality of drug-resistant tuberculosis care: gaps and solutions. J. Clin. Tuberc. Mycobact. Dis. 16 , 100101 (2019).

Pai, M., Dewan, P. K. & Swaminathan, S. Transforming tuberculosis diagnosis. Nat. Microbiol. 8 , 756–759 (2023).

McKenna, L. et al. The 1/4/6x24 campaign to cure tuberculosis quickly. Nat. Med. 11 , 2337 (2023).

Zaunbrecher, M. A., Sikes, R. D. Jr, Metchock, B., Shinnick, T. M. & Posey, J. E. Overexpression of the chromosomally encoded aminoglycoside acetyltransferase eis confers kanamycin resistance in Mycobacterium tuberculosis . Proc. Natl Acad. Sci. USA 106 , 20004–20009 (2009).

Miotto, P. et al. A standardised method for interpreting the association between mutations and phenotypic drug resistance in Mycobacterium tuberculosis . Eur. Respir. J. 50 , 1701354 (2017).

Rifat, D. et al. Mutations in fbiD (Rv2983) as a novel determinant of resistance to pretomanid and delamanid in Mycobacterium tuberculosis . Antimicrob. Agents Chemother. 65 , e01948–20 (2020).

Plinke, C. et al. embCAB sequence variation among ethambutol-resistant Mycobacterium tuberculosis isolates without embB306 mutation. J. Antimicrob. Chemother. 65 , 1359–1367 (2010).

Safi, H. et al. Evolution of high-level ethambutol-resistant tuberculosis through interacting mutations in decaprenylphosphoryl-β-D-arabinose biosynthetic and utilization pathway genes. Nat. Genet. 45 , 1190–1197 (2013).

Srivastava, S., Ayyagari, A., Dhole, T. N., Nyati, K. K. & Dwivedi, S. K. emb nucleotide polymorphisms and the role of embB306 mutations in Mycobacterium tuberculosis resistance to ethambutol. Int. J. Med. Microbiol. 299 , 269–280 (2009).

Grant, S. S. et al. Baeyer-Villiger monooxygenases EthA and MymA are required for activation of replicating and non-replicating Mycobacterium tuberculosis inhibitors. Cell Chem. Biol. 23 , 666–677 (2016).

Dover, L. G. et al. EthA, a common activator of thiocarbamide-containing drugs acting on different mycobacterial targets. Antimicrob. Agents Chemother. 51 , 1055–1063 (2007).

Vilchèze, C. et al. Mycothiol biosynthesis is essential for ethionamide susceptibility in Mycobacterium tuberculosis . Mol. Microbiol. 69 , 1316–1329 (2008).

Zhang, Y., Dhandayuthapani, S. & Deretic, V. Molecular basis for the exquisite sensitivity of Mycobacterium tuberculosis to isoniazid. Proc. Natl Acad. Sci. USA 93 , 13212–13216 (1996).

Ando, H., Miyoshi-Akiyama, T., Watanabe, S. & Kirikae, T. A silent mutation in mabA confers isoniazid resistance on Mycobacterium tuberculosis . Mol. Microbiol. 91 , 538–547 (2014).

Vilchèze, C. et al. Altered NADH/NAD + ratio mediates coresistance to isoniazid and ethionamide in mycobacteria. Antimicrob. Agents Chemother. 49 , 708–720 (2005).

Reeves, A. Z. et al. Aminoglycoside cross-resistance in Mycobacterium tuberculosis due to mutations in the 5′ untranslated region of whiB7 . Antimicrob. Agents Chemother. 57 , 1857–1865 (2013).

Liu, J. et al. Mutations in efflux pump Rv1258c (tap) cause resistance to pyrazinamide, isoniazid, and streptomycin in Mycobacterium tuberculosis . Front. Microbiol. 10 , 216 (2019).

Gopal, P. et al. Pyrazinamide triggers degradation of its target aspartate decarboxylase. Nat. Commun. 11 , 1661 (2020).

Scorpio, A. & Zhang, Y. Mutations in pncA , a gene encoding pyrazinamidase/nicotinamidase, cause resistance to the antituberculous drug pyrazinamide in tubercle bacillus. Nat. Med. 2 , 662–667 (1996).

Wong, S. Y. et al. Functional role of methylation of G518 of the 16S rRNA 530 loop by GidB in Mycobacterium tuberculosis . Antimicrob. Agents Chemother. 57 , 6311–6318 (2013).

Catalogue of Mutations in Mycobacterium tuberculosis Complex and their Association with Drug Resistance. World Health Organization https://www.who.int/publications/i/item/9789240028173 (2021).

Farhat, M. R. et al. Rifampicin and rifabutin resistance in 1003 Mycobacterium tuberculosis clinical isolates. J. Antimicrob. Chemother. 74 , 1477–1483 (2019).

Nahid, P. et al. Treatment of drug-resistant tuberculosis. An Official ATS/CDC/ERS/IDSA clinical practice guideline. Am. J. Respir. Crit. Care Med. 200 , e93–e142 (2019).

Download references

Author information

These authors contributed equally: Helen Cox, Marwan Ghanem.

Authors and Affiliations

Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA

Maha Farhat & Marwan Ghanem

Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA

Maha Farhat

Institute of Infectious Disease and Molecular Medicine, Wellcome Centre for Infectious Disease Research and Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa

Division of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany

Claudia M. Denkinger & Mirna S. Abd El Aziz

German Center for Infection Research (DZIF), partner site Heidelberg University Hospital, Heidelberg, Germany

Claudia M. Denkinger

P.D. Hinduja Hospital and Medical Research Centre, Mumbai, India

Camilla Rodrigues

Ulaanbaatar, Mongolia

Handaa Enkh-Amgalan

National TB Control Programme, Manzini, Eswatini

Debrah Vambe

School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA

Cesar Ugarte-Gil

Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA

Jennifer Furin

McGill International TB Centre, McGill University, Montreal, Quebec, Canada

Madhukar Pai

You can also search for this author in PubMed   Google Scholar

Contributions

M.P., M.F., H.C., C.M.D., J.F. and M.G. wrote the article and, together with C.R. and M.S.A.E.A. researched data for the article. All authors contributed substantially to the discussion of the content and reviewed and/or edited the manuscript before submission.

Corresponding author

Correspondence to Madhukar Pai .

Ethics declarations

Competing interests.

The authors declare no competing interests.

Peer review

Peer review information.

Nature Reviews Microbiology thanks the anonymous reviewers for their contribution to the peer review of this work.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Related links

Clinicaltrials.gov: https://clinicaltrials.gov/

Supplementary information

Supplementary information.

Refers to the delivery of anti-tuberculosis drug treatment under direct observation of health workers, community workers or family members with the goal of improving adherence.

(XDR-TB). Defined as multidrug-resistant or rifampicin-resistant tuberculosis with further resistance to fluoroquinolones and to either bedaquiline or linezolid or both (key second-line drugs).

(Hr-TB). Defined as resistance to isoniazid and susceptibility to rifampicin.

(MDR-TB). Defined as resistance to rifampicin and isoniazid, the two most important first-line drugs used to treat tuberculosis (TB), regardless of resistance to other TB drugs.

Defined as multidrug-resistant or rifampicin-resistant tuberculosis with resistance to fluoroquinolones.

(RMR-TB). Defined as resistance to rifampicin (Rif), with susceptibility to isoniazid.

(RR-TB). Defined as resistance to rifampicin (Rif), regardless of resistance to other tuberculosis (TB) drugs. Individuals with RR-TB are treated with regimens similar to those for multidrug-resistant TB (MDR-TB) and are therefore grouped with MDR-TB as MDR/RR-TB.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Cite this article.

Farhat, M., Cox, H., Ghanem, M. et al. Drug-resistant tuberculosis: a persistent global health concern. Nat Rev Microbiol (2024). https://doi.org/10.1038/s41579-024-01025-1

Download citation

Accepted : 12 February 2024

Published : 22 March 2024

DOI : https://doi.org/10.1038/s41579-024-01025-1

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Quick links

  • Explore articles by subject
  • Guide to authors
  • Editorial policies

Sign up for the Nature Briefing: Microbiology newsletter — what matters in microbiology research, free to your inbox weekly.

global education future

COMMENTS

  1. Global Education Futures

    Global Education Futures. is a path breaking and paradigm forming initiative that takes on the challenge of exploring, experimenting, emerging, and engaging systemic innovation for lifelong and lifewide learning. By fostering the emergence of living learning communities, and bringing these communities into connection with each other to form ...

  2. Futures of Education

    Renewing education to transform the future, 2-4 December 2024. UNESCO International Forum on the Futures of Education 2024 Suwon, Gyeonggido, Republic of Korea. Find out more. ... H.E. President Sahle-Work Zewde, and develop a global report on the Futures of Education. The commission was charged with carefully considering inputs received ...

  3. What will education look like in 20 years?

    As we begin a new year, it is traditional to take stock of the past in order to look forward, to imagine and plan for a better future. But the truth is that the future likes to surprise us. Schools open for business, teachers using digital technologies to augment, not replace, traditional face-to face-teaching and, indeed, even students hanging ...

  4. Global education trends and research to follow in 2022

    The pandemic highlighted several trends in education that promise to be the focus of future policy and practice in 2022 and beyond: the importance of skills that supplement the learning of content ...

  5. The turning point: Why we must transform education now

    Financing of education ; While global education spending has grown overall, it has been thwarted by high population growth, the surmounting costs of managing education during the COVID-19 pandemic, and the diversion of aid to other emergencies, leaving a massive global education financial gap amounting to US$ 148 billion annually.

  6. UNESCO unveils new report on the Futures of Education

    1.30pm - Presentation of the Report on the Futures of Education. 2.30 - Global Education Meeting. An opportunity for a brief question and answer with representatives of UNESCO and of participating States will be offered at the end of the presentation of the report, around 2.20 pm, and at the end of the world meeting on education, around 6 pm.

  7. Global trends and the future of education

    This 2022 edition covers a rich array of topics related to economic growth, living and working, knowledge and power, identity and belonging and our physical world and human bodies and interactions. It includes a specific focus on the impact of COVID‑19 on global trends, and new futures thinking sections inviting readers to reflect on how the ...

  8. UNESCO's Futures of Education report

    UNESCO unveiled the much-awaited Futures of Education report entitled Reimagining our futures together: A new social contract for education. The new global report, prepared by an International Commission, explores how education can best shape the future of humanity and the planet as we look to 2050: What should we keep?

  9. Futures of Education: learning to become

    UNESCO's Futures of Education initiative aims to rethink education and shape the future. The initiative is catalyzing a global debate on how knowledge, education and learning need to be reimagined in a world of increasing complexity, uncertainty, and precarity. Thinking together so we can act together to make the futures we want THE VISION ...

  10. Global Education

    Key insights on Global Education. The world has made substantial progress in increasing basic levels of education. Despite being in school, many children learn very little. Children across the world receive very different amounts of quality learning. Hundreds of millions of children worldwide do not go to school.

  11. Future of education

    The Future of Education. Google for Education collaborated with research partner Canvas8 to conduct a study across 24 countries on the future of education. The result is a three-part global report highlighting insights from around the world. Global nonprofit American Institutes for Research (AIR) served as an advisor and consultant to this ...

  12. Global trends and the future of education

    Trends Shaping Education 2022 Global trends and the future of education. more info: https://doi.org/10.1787/bbdf63c5-en

  13. Exploring the future of education with experts around the world

    Today we launched Part 1: Preparing for a new future, which discusses the role education plays in equipping students with the skills and mindsets they'll need to navigate massive change. We discuss three key trends: There's a rising demand for global problem solvers. As the world faces a new set of global challenges, such as equitable ...

  14. Transforming education for the future

    Transform education now. The future of people and the planet depends on it.The Global Education 2030 Agenda UNESCO, as the United Nations' specialized agency for education, is entrusted to lead and coordinate the Education 2030 Agenda, which is part of a global movement to eradicate poverty through 17 Sustainable Development Goals by 2030.

  15. Education Overview: Development news, research, data

    Our Tertiary Education and Skills global program, launched with support from the Mastercard Foundation, aims to prepare youth and adults for the future of work and society by improving access to relevant, quality, equitable reskilling and post-secondary education opportunities. It is designed to reframe, reform, and rebuild tertiary education ...

  16. Driving a global movement to transform education: Key moments ...

    2022 was a year that witnessed major milestones in the global movement to transform education. Against a backdrop of an alarming learning, and budgetary crisis, UNESCO's call for a global mobilization to place education at the top of the political agenda resonated across the world with renewed national and global commitments. And three UNESCO World Conferences focusing on early childhood ...

  17. Reshaping Educational Models For Future Generations

    Global Shifts In Education Around the world, there are examples of educational institutions and systems that are redefining their focus to develop skills for the future.

  18. Empowering the next generation: Rethinking education and skills on

    International Youth Day is a moment to reflect on the dynamic role of education and skills in shaping the future of our youth. Read the perspectives of young individuals from around the globe on the urgency of educational reforms that foster creativity, inclusivity and practical learning, paving the way for generations of problem-solvers and ...

  19. Special Event on Transforming Education

    The event will highlight progress made since the Transforming Education Summit, 2022, and spur greater action between now and 2030. It will place a strong focus on investing in education and on skills development for the future, as we look ahead to the Summit of the Future in September 2024, as well as other major high-level meetings in 2025.

  20. The Promises and Pitfalls of a 'Global Humanities'

    O nce again, there are signs of deep trouble for the humanities in higher education — in the Western world, if not the world as a whole. News of closures trickles in relentlessly. At New Zealand ...

  21. In the face of global warming, students are dreaming up a better ...

    In the face of climate change, these students dream up a better future With heat waves and extreme weather becoming more and more common, one Indiana teacher wants to empower her students with ...

  22. Omsk Oblast

    Omsk Oblast (Russian: О́мская о́бласть, romanized: Omskaya oblast') is a federal subject of Russia (an oblast), located in southwestern Siberia.The oblast has an area of 139,700 square kilometers (53,900 sq mi). Its population is 1,977,665 (2010 Census) [9] with the majority, 1.12 million, living in Omsk, the administrative center.One of the Omsk streets

  23. What you need to know about UNESCO's Futures of Education report

    UNESCO is proposing answers to these three essential questions in its new global report on the Futures of Education entitled Reimagining our futures together: A new social contract for education. Over a million people have taken part in the global consultation process that informed this long-awaited flagship publication which calls for a major ...

  24. MCCCD Joins the National Applied Artificial Intelligence Consortium to

    In partnership with Miami Dade College (MDC) and Houston Community College, the Maricopa County Community College District (MCCCD), is proud to join the National Applied Artificial Intelligence Consortium (NAAIC), a groundbreaking initiative that aims to foster the growth of technician-level artificial intelligence (AI) professionals across the nation.

  25. Omsk Oblast, Russia guide

    In 1716, they founded a fortress at the mouth of the Om River - future Omsk. Russian peasants began to settle in the land around the fortress. To the south of Omsk, a line of outposts was constructed for protection from the nomads. In 1782, the fortress became a town. Omsk district was formed on the basis of the southern part of Tarsky district ...

  26. Omsk

    Omsk (/ ˈ ɒ m s k /; Russian: Омск, IPA:) is the administrative center and largest city of Omsk Oblast, Russia.It is situated in southwestern Siberia and has a population of over 1.1 million. Omsk is the third largest city in Siberia after Novosibirsk and Krasnoyarsk, and the twelfth-largest city in Russia. [12] It is an important transport node, serving as a train station for the Trans ...

  27. Transforming education for the future

    As the lead agency for education within the United Nations, UNESCO provides global and regional leadership to ensure every child, youth and adult has access to quality education throughout life while keeping two priorities, Africa and gender, in focus. Since its founding in 1945, UNESCO's education programme has evolved to match new global ...

  28. World Bank Advises Cameroon to Collect More Tax and Spend Better

    Cameroon, the second-biggest economy in Central Africa, needs to improve tax collection and the quality of its public spending to spur growth, according to the World Bank.

  29. Drug-resistant tuberculosis: a persistent global health concern

    In this Review, Pai and colleagues examine the global landscape of drug-resistant tuberculosis, exploring its epidemiology, causes, risk factors, stigma and associated mental health burden as well ...

  30. Launch of the 2024 Youth Report on technology in education

    The 2024 Youth Report is the result of an extensive consultation process in partnership with Restless Development involving +1500 youth and students across 8 regions. The consultations invited participants to reflect on the key challenges and opportunities for the use of technology in education in their regions through the lenses of two out of the four recommendations of the global Global ...