Implementing the End TB Strategy in the Western Pacific Region: Translating vision into reality

Abstract

The End TB Strategy aims to end the global tuberculosis (TB) epidemic by 2035 in line with the sustainable development goals targets and has been implemented in the World Health Organization (WHO) Western Pacific Region since 2015. Significant progress has been made in implementing this strategy. However, several challenges still remain. In 2016, an estimated 1.8 million people developed TB in the region, and of these about 20% were missed by national TB programmes. The gap in diagnosis and enrolment as well as treatment completion is greater with drug-resistant TB. Many TB-affected families face catastrophic costs due to the disease. Sustaining financing for TB care is a long-term challenge in many countries. This article emphasizes targeted interventions in highrisk populations, including systematic screening and patient-centred TB care. Several other approaches including improving TB diagnostic tools and algorithm, and engaging all care providers are suggested to find missing TB patients. Drug-resistant TB requires additional resourcing for laboratories, enrolment and patient support. Specific measures are required at different levels to mitigate financial burden due to TB including linking TB to overall social protection schemes. The Moscow Ministerial conference in 2017 and upcoming United Nations (UN) 2018 high-level meeting provide an opportunity to raise TB higher on the global agenda, forge partnerships and move towards universal health coverage.

Smoked Tobacco, Air Pollution, and Tuberculosis in Lao PDR: Findings from a National Sample

“…National TB Programs have attempted to implement some schemes for expanding social protection, including compensating the financial burden associated with illness; however, these have tended to be project-based and rely on external funding. There is a need for scalable integrated programs that link national authorities (e.g., Ministries of Energy, Environment, Finance, Welfare, Labor, and Health) with one another and communities [50].…”

“…Furthermore, there is a need to engage the agricultural ministry and the non-governmental organization sector to reexamine current farming and food production practices that represent a threat to respiratory health. As other authors have advocated, the time has come to view eradicating TB as a development imperative which prioritizes poverty alleviation and promotion of sustainable development along with enhanced biomedical approaches [5,50].…”

Contemporary Concise Review 2018: Respiratory infections and tuberculosis

“…The estimated TB incidence declined only by 2% from 2016 to 2017, barely higher than the 1.7% annual decline in TB mortality in the United Kingdom before the availability of effective treatment . Social inequities continue to hamper TB control in many parts of the world, and major gaps remain in reaching, diagnosing and effectively treating TB patients, especially in resource‐limited settings . On 26 September 2018, heads of state and government meeting at the United Nations General Assembly committed to mobilize US$ 13 billion to implement TB prevention and care, and US$ 2 billion for research on an annual basis by 2022 .…”

“…On 26 September 2018, heads of state and government meeting at the United Nations General Assembly committed to mobilize US$ 13 billion to implement TB prevention and care, and US$ 2 billion for research on an annual basis by 2022 . Hopefully, this important political commitment and additional funding support will promote universal health coverage and social protection, facilitate access to quality TB care and accelerate the development of better tools to meet the targets of the End TB Strategy by 2035 …”

Action towards Universal Health Coverage and Social Protection for Tuberculosis Care and Prevention: Workshop on the End TB Strategy Pillar 2 in the Western Pacific Region 2017

“…However, much remains to be done to reach UHC and social protection towards ending TB in LMICs. The Western Pacific Region, accounting for 17% of the global TB burden, also needs to move towards the full attainment of UHC and the expansion of social protection to end TB [4].…”