Towards tuberculosis elimination: an action framework for low-incidence countries.

Area of Science:

• Public Health
• Epidemiology
• Global Health

Background:

• Countries with low tuberculosis (TB) incidence face unique epidemiological challenges, including low transmission, latent TB infection progression, vulnerable populations, and migration.
• Declining TB incidence often leads to reduced political commitment, funding, clinical expertise, and public awareness, hindering elimination efforts.

Purpose of the Study:

• To present an action framework for low TB incidence countries aiming for TB elimination.
• To guide countries in progressing from low incidence to pre-elimination and eventual elimination of TB as a public health problem.

Main Methods:

• Development of a tailored framework addressing challenges in low-incidence TB settings.
• Grouping priority interventions into eight key action areas.

Main Results:

• The framework includes eight priority action areas: political commitment, vulnerable groups, migrants, screening (active TB and latent TB infection - LTBI), drug-resistant TB, surveillance, research, and global support.
• Emphasizes a multisectorial approach, equitable access to diagnosis and care, addressing social determinants, and incorporating national and global dimensions.

Conclusions:

• The proposed framework provides a strategic roadmap for TB elimination in low-incidence settings.
• A comprehensive, multisectorial, and globally coordinated response is essential for achieving TB elimination.