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

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Global Health Policy

Background:

• The World Health Organization (WHO) Western Pacific Region has implemented the End TB Strategy since 2015, aiming to eliminate tuberculosis (TB) by 2035.
• Despite progress, significant challenges persist, including an estimated 1.8 million new TB cases in 2016, with 20% missed by national programs.
• Gaps in diagnosis, enrollment, and treatment completion are more pronounced for drug-resistant TB, and affected families often incur catastrophic costs.

Purpose of the Study:

• To highlight persistent challenges in the End TB Strategy implementation within the WHO Western Pacific Region.
• To propose targeted interventions and strategies to address the gaps in TB diagnosis, treatment, and care.
• To emphasize the need for sustained financing and policy changes to mitigate the financial burden of TB.

Main Methods:

• Review of TB epidemic data and program implementation in the WHO Western Pacific Region.
• Emphasis on targeted interventions for high-risk populations, including systematic screening and patient-centered care.
• Discussion of strategies to improve TB diagnostic tools, algorithms, and engagement of all care providers.

Main Results:

• Significant progress in End TB Strategy implementation, but substantial gaps remain in case detection and treatment.
• Drug-resistant TB presents greater challenges in diagnosis, enrollment, and patient support, requiring additional resources.
• Many TB-affected families face severe financial hardship, underscoring the need for social protection linkages.

Conclusions:

• Targeted interventions, improved diagnostics, and comprehensive care are essential to find "missing" TB patients.
• Addressing drug-resistant TB necessitates dedicated resources for laboratories and patient support systems.
• Integrating TB care with social protection schemes and leveraging global health meetings are vital for sustained progress and universal health coverage.