The impact of social protection and poverty elimination on global tuberculosis incidence: a statistical modelling analysis of Sustainable Development Goal 1

Abstract

SummaryBackgroundThe End TB Strategy and the Sustainable Development Goals (SDGs) are intimately linked by their common targets and approaches. SDG 1 aims to end extreme poverty and expand social protection coverage by 2030. Achievement of SDG 1 is likely to affect the tuberculosis epidemic through a range of pathways. We estimate the reduction in global tuberculosis incidence that could be obtained by reaching SDG 1.MethodsWe developed a conceptual framework linking key indicators of SDG 1 progress to tuberculosis incidence via well described risk factor pathways and populated it with data from the SDG data repository and the WHO tuberculosis database for 192 countries. Correlations and mediation analyses informed the strength of the association between the SDG 1 subtargets and tuberculosis incidence, resulting in a simplified framework for modelling. The simplified framework linked key indicators for SDG 1 directly to tuberculosis incidence. We applied an exponential decay model based on linear associations between SDG 1 indicators and tuberculosis incidence to estimate tuberculosis incidence in 2035.FindingsEnding extreme poverty resulted in a reduction in global incidence of tuberculosis of 33·4% (95% credible interval 15·5–44·5) by 2035 and expanding social protection coverage resulted in a reduction in incidence of 76·1% (45·2–89·9) by 2035; both pathways together resulted in a reduction in incidence of 84·3% (54·7–94·9).InterpretationFull achievement of SDG 1 could have a substantial effect on the global burden of tuberculosis. Cross-sectoral approaches that promote poverty reduction and social protection expansion will be crucial complements to health interventions, accelerating progress towards the End TB targets.FundingWorld Health Organization.

Tuberculosis Elimination in Malaysia by 2035: Linkages and Implications to SDGs

“…A broadly and community based primary health care could deliver substantially better health objectives and greater SDG progress, by addressing the wider determinants of health, and by promoting equity, human dignity and social justice throughout society. Recent research has estimated that expanding social protection coverage could reduce the global incidence of tuberculosis by 76% by 2035 [25]. This level of achievement is possible for Malaysia, given the moderate TB burden.…”

Low Body Mass Index and Trends of Tuberculosis Infection: A Cohort Study of Orphan Children in Azad Jammu and Kashmir Pakistan

“…It is well known that environmental exposures, such as silica dust or cigarette smoke, can increase the risk of developing TB [8 -11]. TB is considered poverty and lifestyle associated disease [12,13]. According to the estimates, the risk of TB infection is 40% higher in poor developing countries as compared to the developed countries and it contributes as the second leading cause of death among infectious diseases in the poor countries [14].…”

“…Poor living standards, lack of basic health facilities may cause additional risk of tuberculosis by attracting the other risk factors like malnutrition, indoor living, air pollution etc. Orphan children represent a highly deprived and neglected group of the population worldwide [13]. They constitute a high-risk group for tuberculosis infection and malnutrition owing to their poor socio-economic status.…”

Os determinantes da mortalidade por Tuberculose e TB-HIV no Sul do Brasil: Da abordagem espacial à análise de sobrevida

“…Por essa característica, é requerido mais do que medidas isoladas, seu enfrentamento não pode ser pontual, centrado em procedimentos médicos individuais e ou na tecnologia dura (QUEIROGA et al, 2012;LONNROTH et al, 2009;CARTER et al, 2018), são necessárias ações alargadas, de um diagnóstico situacional criterioso com vistas a propostas mais finas e com acurácia, com perspectivas de mudanças de uma realidade (LONNROTH, 2009;WINGFIELD et al, 2016). (LONNROTH et al, 2009;CARTER et al, 2018). Carter et al (2018), em um estudo de predições, observou que a redução da pobreza provocou uma queda na incidência de tuberculose de 33,4% e que a ampliação da cobertura de proteção social resultou em redução na incidência de 76,1% até 2035.…”

“…(LONNROTH et al, 2009;CARTER et al, 2018). Carter et al (2018), em um estudo de predições, observou que a redução da pobreza provocou uma queda na incidência de tuberculose de 33,4% e que a ampliação da cobertura de proteção social resultou em redução na incidência de 76,1% até 2035. Desse modo, a compreensão dos determinantes sociais que favoreçam as mortes por TB poderá dar respostas relevantes para a meta de eliminação da TB.…”