This document presents the findings of a modelling study that examined in detail the costs and benefits of tuberculosis (TB) screening plus TB preventive treatment (TPT) in four countries – Brazil, Georgia, Kenya and South Africa – which may serve as examples for other settings with a similar epidemiological context. The goal of the investment case is to support countries in advocating for and allocating increased resources to scale up TB screening and preventive treatment towards reaching new targets committed by Heads of State at the 2023 UN High-Level Meeting on TB. The results of the assessment show that relatively modest investments can achieve significant health and economic benefits in all four countries and provide a return of up to US$ 39 for each dollar invested.