Publications

Antimicrobial resistance threatens the very core of modern medicine and the sustainability of an effective, global public health response to the enduring threat from infectious diseases. Systematic misuse and overuse of these drugs in human medicine and food production have put every nation at risk. Few replacement products are in the pipeline. Without harmonized and immediate action on a global scale, the world is heading towards a post-antibiotic era in which common infections could once again kill. This action plan underscores the need for an effective “one health” approach involving coordination among numerous international sectors and actors, including human and veterinary medicine, agriculture, finance, environment, and wellinformed consumers.

The SAARC Region continues to bear a significant burden of tuberculosis despite making significant progress in the global efforts to eliminate TB. Although notified TB cases have been steadily increasing, a decline in the prevalence is seen in all Member States, some reporting more than 50% decline since 1990. With good implementation of DOTS by Member States, the level of "multi-drug resistant" (MDR) TB among newly-detected cases is low. The year 2015 marks the deadline for global TB targets set in the context of the Millennium Development Goals (MDGs), and is a year of transitions: from the MDGs to a new era of Sustainable Development Goals (SDGs), and from the Stop TB Strategy to the End TB Strategy. This report is an excellent review of the current status and future plans for the control of TB in the SAARC Region. It includes information on burden of tuberculosis in the SAARC region, including incidence, prevalence, mortality along with the MDR-TB, TB/HIV confection etc. It also covers the information of the year 2014 and has been prepared on the basis of information collected from member countries during the year 2015 and by reviewing other related documents.

In 2011, the World Health Organization (WHO) issued "Guidelines for intensified tuberculosis case-finding and isoniazid preventive therapy for people living with HIV in resource constrained settings" and conditionally recommended the use of at least 36 months of isoniazid preventive therapy or IPT (as a proxy for lifelong or continuous treatment) for people living with HIV in high TB-prevalence and transmission settings, based on the results of unpublished studies. It was decided to update the evidence as the studies are now published, and explore whether the findings might require any change in the recommendation of lifelong IPT for people living with HIV. The main objective of this update is to reassess the recommendation to provide IPT for 36 months to children and adults living with HIV, including pregnant women, those receiving antiretroviral therapy (ART), and those who have successfully completed TB treatment and are living in settings with high TB and HIV prevalence and transmission, based on the requirements of the WHO Guidelines Review Committee.

The Framework for engagement of all health-care providers in the management of drug-resistant tuberculosis has been developed to support countries in the implementation of public–private mix (PPM) for drug-resistant tuberculosis (DR-TB). This document complements other guidance and practical tools on PPM for TB control and prevention. It serves as a guidance document for countries in engaging providers and partners from outside the national TB programmes (NTPs) to address the complexity of the programmatic management of DR-TB. The framework describes approaches for engaging different health-care providers and partners in diverse aspects of DR-TB care and management, including clinical care, public health tasks, patient-centred care, advocacy, funding mobilization, regulation and social protection. It describes the engagement of non-NTP providers and partners, which is not limited to diagnosis and treatment, but also includes other important aspects of DR-TB care, depending on the capacity and preference of the non-NTP providers and partners.

The World Health Organization (WHO), with contributions from many stakeholders, has developed a Global Action Framework for TB Research to foster high-quality national and global TB research over the next 10 years to 2025. The first part of the framework describes how to strengthen TB research in low- and middle-income countries most affected by TB by developing a national TB research plan. The second part of the framework describes how to enhance TB research globally by applying efforts to building strong research partnerships and networks and securing robust funding for research. The third part of the framework describes WHO’s activities in support of the framework.

This publication documents best practices in engagement of health-care providers in the management of drug-resistant tuberculosis (DR-TB). The aim is to share experiences and approaches that are being implemented in countries and by various health-care providers and partners. Some of the case studies in this document are also presented in the WHO’s Framework for engagement of all health-care providers in the management of drug-resistant tuberculosis. In the current document, case studies are presented by approach, for easier reference by readers who are interested in examples and experiences around the globe in implementation of public–private mix for DR-TB (PPM DR-TB). The WHO/Global TB Programme (GTB) team continues to document best practices for sharing in the public domain via the WHO/GTB website. National TB programmes and partners are encouraged to share their case studies with others via the website.

The World Health Organization (WHO), through the work of the Cluster for HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases, embraces the public health and research activities that make a difference to the lives of people at risk of, or suffering from, these diseases. This report looks back on the global progress made towards achieving MDG 6 between 2000 and 2015 in relation to all of the above diseases. It also summarizes global WHO recommendations and strategies for the SDG era, which are embedded in the sustainable development context, and sets out cross-cutting priorities. The report is designed to serve as a springboard for further discussion across the WHO network, with Member States and external partners. At this time of transition from the MDGs to the SDGs, WHO is committed to working with countries and partners to harness the power of global partnership, innovation and research to galvanize intensified action in countries and ensure that every last person benefits from our collective efforts to move towards the 2030 goals. We are confident that, together, we can put this fight on a sustainable footing, reduce the human suffering and deliver on our promise to the next generation.

The Stop TB Partnership is governed by a Coordinating Board, supported by two standing board committees: Executive Committee and Finance Committee. The Stop TB Partnership Coordinating Board has a responsibility towards the global TB community to build awareness, identify key strategic issues affecting TB and to set a strategic direction for the global effort to fight TB. The Coordinating Board is tasked with approving The Global Plan to Stop TB. Since its creation in 2001, the Stop TB Partnership has developed “The Global Plan to Stop TB” - a roadmap for the fight against TB for a five-year period. Each plan provides an estimate for the resources needed every five years to achieve the goals the world has set. The Partnership is now working on “The Global Plan to stop TB 2016-2020” to outline what it takes to set the world on the right track to reach the goals set in the post-2015 Global TB Strategy. The Plan will provide a large-scale, costed blue-print for how global TB efforts can become significantly more ambitious and effective over the next five years, proposing dramatic changes to the way TB programs are run.

Tuberculosis (TB) remains one of the world's most deadly diseases, killing three people every minute. Each year 9 million people develop TB and 1.5 million die from the disease. In 2014, the World Health Assembly unanimously approved a new End TB Strategy to end the global tuberculosis epidemic by 2035 – the first time governments have set a goal to end TB. This should start with acknowledging that the language commonly used to speak about TB must evolve. Language influences stigma, beliefs and behaviors, and may determine if a person feels comfortable with getting tested or treated. The authors describe how judgmental terms such as ‘TB suspect’ can powerfully influence attitudes and behaviour at every level – from inhibiting people to seek treatment to shaping the way policy-makers view the challenge of addressing the disease. The article also observes that the powerfully negative connotation of words such as ‘defaulter’ and ‘suspect’ place blame for the disease and responsibility for adverse treatment outcomes on one side — that of people with TB.

This agenda outlines the strategic direction that the Global TB Programme of the World Health Organization (WHO) is mapping out to promote the integration of digital health concepts into TB prevention and care activities. The document is primarily intended to inform TB decisionmakers at national and international levels. Its alignment to the principles and the three pillars underpinning WHO’s new End TB Strategy will help them coordinate their various efforts in one common direction in the coming years. The products and critical activities discussed in this agenda are premised upon the pressing needs and realities of TB programmes, of which three are particularly important:

• The current difficulties faced by managers and other decision-makers to match needs in TB prevention and care to the most appropriate digital health solutions. This is a result of the limited evidence base for the effectiveness of many digital health interventions for TB and the rapid advances in technologies of which potential users may be unaware.
• The need for an articulated and step-wise approach to develop comprehensive digital health solutions to support the End TB Strategy, in particular to limit fragmentation of efforts, leading for instance to multiple systems, redundancy and resource wastage.
• The opportunity to build upon, seek related synergies and align with promising ICT initiatives, both within health care and beyond, so as to increase the efficiency, scalability and sustainability of efforts.