Universal social protection is central to the 2030 Sustainable Development Goals and the WHO End TB Strategy, with the 2023 UN High-Level Meeting reaffirming its critical role in breaking the cycle of tuberculosis (TB) and poverty, especially amid crises like pandemics and climate change. The declaration calls for multisectoral action and ambitious targets, including that all people affected by TB receive comprehensive health and social benefits packages by 2027 to alleviate financial hardships. This guidance aims to help TB programmes and social protection stakeholders plan and implement inclusive, effective, and sustainable strategies to support those affected by TB, drawing on best practices and current WHO and ILO policies.