WHO targets elimination of tuberculosis in over 30 countries

July 3, 2014
M. tuberculosis bacterial colonies. Credit: Centers for Disease Control and Prevention.

The World Health Organization (WHO) today, together with the European Respiratory Society (ERS), presented a new framework to eliminate tuberculosis (TB) in countries with low levels of the disease. Today there are 33* countries and territories where there are fewer than 100 TB cases per million population.

The framework outlines an initial "pre-elimination" phase, aiming to have fewer than 10 new TB cases per million people per year by 2035 in these . The goal is to then achieve full elimination of TB by 2050, defined as less than 1 case per million people per year.

Although TB is preventable and curable, in these 33 settings 155 000 people still fall ill each year and 10 000 die. Millions are infected and at risk of falling ill.

The proposed framework builds on approaches that are already proving successful. It was developed with experts from low-burden countries and adapted from the new WHO global TB strategy, 2016-35, approved by the World Health Assembly in May 2014. Country representatives gathered to discuss the framework and its implementation at a meeting co-hosted by WHO and the European Respiratory Society (ERS) in Rome in collaboration with the Italian Ministry of Health.

Italy is one of the 21 European countries addressed by the framework. The 33 countries, territories and areas also include seven from the Americas, three from WHO's Eastern Mediterranean Region, and two from WHO's Western Pacific Region.

The countries recognize the common need to reenergize the efforts to eliminate TB as a public health problem and prevent its resurgence. As TB rates have fallen in many of these countries, attention to this threat has waned and capacity to respond could be weakened.

"Low TB-burden countries already have the means to drive down TB cases dramatically by 2035," says Dr Hiroki Nakatani, WHO Assistant Director-General. "Universal health coverage, which ensures everyone has access to the health services they need without suffering financial hardship as a result, is the bedrock. The key is to target smart TB interventions towards the people who need them most."

The new WHO framework highlights the effectiveness of eight key interventions, in a coherent package for impact in the target countries:

1. Ensure funding and stewardship for planning and services of high quality;

2. Address most vulnerable and hard-to-reach groups;

3. Address special needs of migrants; cross-border issues;

4. Undertake screening for active TB and latent TB infection in high-risk groups and provide appropriate treatment; manage outbreaks;

5. Optimize MDR-TB prevention and care;

6. Ensure continued surveillance and programme monitoring and evaluation

7. Invest in research and new tools;

8. Support global TB control.

Among the most vulnerable groups are people who are poor or homeless, migrants, and members of ethnic minorities. In addition, people who use drugs or are incarcerated, and people with compromised immune systems (e.g. people living with HIV, malnutrition, diabetes, smokers and heavy drinkers) all have a much greater risk of falling ill with TB. Many of these vulnerable groups face barriers in accessing health services.

Addressing tuberculosis in the context of cross-border migration can also pose a significant challenge to health service providers. Many undergoing a course of TB treatment may have no option but to relocate for work, even if they have not completed their TB treatment. "Countries with a low incidence of TB are uniquely positioned to reach historically low levels of TB," adds Dr Mario Raviglione, Director of WHO's Global TB Programme. "They can serve as global trailblazers."

Globalization and increased population movements enable TB - an airborne infectious disease - to continue to spread across communities and countries. To eliminate the disease in low-burden countries it will be vital to dramatically scale up TB prevention and care in high-incidence countries. This interdependency calls for concerted action and tight collaboration between countries with high and low burden of TB.

"Powerful antibiotics and better living standards have almost pushed the disease out of many high-income countries. But we still have not succeeded. And if we do the wrong things now, TB could rebound, including with more drug-resistant forms," says Professor G.B. Migliori from ERS. "But if we get it right, and recommit to fighting the disease, both at home and abroad, TB will eventually no longer be a ."

Explore further: Scientists establish proof-of-concept for host-directed tuberculosis therapy

More information: *Australia, Austria, Bahamas, Belgium, Canada, Costa Rica, Cuba, Cyprus, Czech Republic, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Israel, Italy, Jamaica, Jordan, Luxembourg, Malta, Netherlands, New Zealand, Norway, Puerto Rico, Slovakia, Slovenia, Sweden, Switzerland, United Arab Emirates, United States of America, West Bank and Gaza Strip

Related Stories

Scientists establish proof-of-concept for host-directed tuberculosis therapy

June 27, 2014
In a new study published in Nature, scientists describe a new type of tuberculosis (TB) treatment that involves manipulating the body's response to TB bacteria rather than targeting the bacteria themselves, a concept called ...

Tuberculosis outbreak at Sacramento high school

July 2, 2014
Health officials in California say a high school is at the center of a tuberculosis outbreak in Sacramento County.

Research says TB infection may be underestimated among people taking corticosteroid pills

June 26, 2014
Tuberculosis infection among people taking corticosteroid pills may be underestimated, new research suggests. Current guidelines for what constitutes a positive TB skin test among corticosteroid pill users may not be capturing ...

New tuberculosis research movement needed

November 30, 2011
In this week's PLoS Medicine, Christian Lienhardt from the WHO in Geneva, Switzerland and colleagues announce that the Stop TB Partnership and the WHO Stop TB Department have launched the TB Research Movement.

Britain: Two people catch tuberculosis from pet cat

March 27, 2014
England's public health agency says two people have caught tuberculosis from a pet cat, the first time the bacterial disease has been documented to spread from cat to human.

New tuberculosis test more than skin deep

June 5, 2014
A new screening process for tuberculosis (TB) infections in Canadian prisons could mean that more than 50 per cent of those screened won't undergo unnecessary treatment due to false positives.

Recommended for you

Zika virus stifles pregnant women's weakened immune system to harm baby, study finds

August 21, 2017
The Zika virus, linked to congenital birth defects and miscarriages, suppresses a pregnant woman's immune system, enabling the virus to spread and increasing the chances an unborn baby will be harmed, a Keck School of Medicine ...

Novel approach to track HIV infection

August 18, 2017
Northwestern Medicine scientists have developed a novel method of tracking HIV infection, allowing the behavior of individual virions—infectious particles—to be connected to infectivity.

Faulty gene linked to obesity in adults

August 18, 2017
Groundbreaking new research linking obesity and metabolic dysfunction to a problem in the energy generators in cells has been published by researchers from the Harry Perkins Institute of Medical Research and The University ...

Two lung diseases killed 3.6 million in 2015: study

August 17, 2017
The two most common chronic lung diseases claimed 3.6 million lives worldwide in 2015, according to a tally published Thursday in The Lancet Respiratory Medicine.

New test differentiates between Lyme disease, similar illness

August 16, 2017
Lyme disease is the most commonly reported vector-borne illness in the United States. But it can be confused with similar conditions, including Southern Tick-Associated Rash Illness. A team of researchers led by Colorado ...

Addressing superbug resistance with phage therapy

August 16, 2017
International research involving a Monash biologist shows that bacteriophage therapy – a process whereby bacterial viruses attack and destroy specific strains of bacteria - can be used successfully to treat systemic, multidrug ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.