As national and state health agencies continue to tighten their belts in the wake of federal funding cuts, El Paso physicians have remained focused on testing for and containing tuberculosis (TB), aided by the city’s ongoing support.
The El Paso health department reported a reduction of $3.2 million in federal funding and the elimination of 21 grant-funded positions for the 2025 fiscal year, according to city documents. Another 5% cut was proposed last year but was ultimately rescinded, a city spokeswoman said. Still, the department continues to put almost $1 million of federal and state funding to work in TB testing and resources.
“Tuberculosis is one of those diseases of public health importance, and we cannot put ... people at risk,” said Hector Ocaranza, MD, an El Paso pediatric specialist and member of the Texas Medical Association’s Council on Science and Public Health.
TB is a notifiable condition in Texas. The Texas Department of State Health Services (DSHS) has details on when and how to notify a local or regional health department.
DSHS determined that 21.2% of TB cases in Texas in 2022 were in border counties even though only 9.5% of the state’s population lives there.
Dr. Ocaranza and Gilbert Handal, MD, both see patients that live in Texas and those who cross the border from Juarez, Mexico. Patients are receptive to care, but both physicians say they face challenges with completing the high-commitment treatment, sometimes because patients relocate during the six- to 12-month regimen.
But El Paso doctors are prepared for that complication, as Dr. Ocaranza praises their collaboration with DSHS and the Centers for Disease Control and Prevention, which facilitates a program with Mexican health officials for those who cross the border regularly. DSHS also runs the Binational Tuberculosis Program, with four sites along the border providing prevention and care.
El Paso officials tracked 327 cases of TB in 2022, 339 in 2023, and 470 in 2024. That number fell to 112 in 2025, according to preliminary data compiled by Dr. Ocaranza.
Patients with a positive screening may have active TB or latent tuberculosis infection (LTBI), which Dr. Handal notes can be asymptomatic. The differentiation is determined by a chest X-ray.
“Many people have no idea that LTBI is the main thing, and then they do not test for LTBI and do not treat those patients. It’s a big error,” he said.
Also of concern is the rise of drug-resistant TB. Per DSHS:
- In 2022, Texas reported 157 people diagnosed with TB to have drug resistance to at least one TB medication.
- Among those, 12 cases (1.1%) were resistant to at least rifampin and isoniazid, two of the most important medications used to kill TB bacteria. This is known as multidrug-resistant TB (MDR-TB).
- 146 people were exposed to MDR-TB in 2021.
- While MDR-TB can be treated, the cost is much higher than the cost to treat drug-susceptible TB.
- DSHS works with TB clinics across the state to make sure patients with drug resistant TB have access to life-saving treatments.
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