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Ending TB in Australia: Organizational challenges for regional tuberculosis programs
Chris Degeling1, Jane Carroll2, Justin Denholm3
1Australian Centre for Health Engagement, Evidence and Values, Faculty of Social Science, University of Wollongong, NSW, Australia.
Health Policy (Amsterdam, Netherlands)
|December 11, 2019
Summary
Australia aims to eliminate tuberculosis (TB) by 2035. Local healthcare structures in New South Wales and Victoria present unique challenges and opportunities for achieving this goal through latent TB infection (LTBI) management.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Health Services Research
Background:
- The World Health Organization's End TB Strategy targets global tuberculosis (TB) elimination by 2050.
- Low-burden countries like Australia aim for earlier elimination by 2035, necessitating intensified efforts in case finding and latent TB infection (LTBI) treatment.
- Significant TB burden in Australia is concentrated in metropolitan Sydney (New South Wales) and Melbourne (Victoria), impacting regional TB programs.
Purpose of the Study:
- To compare and contrast key organizational attributes of healthcare systems in New South Wales and Victoria.
- To analyze how organizational structure, culture, and care systems influence TB prevention and LTBI treatment delivery.
- To identify organizational conditions and service models facilitating progress towards TB elimination in Australia.
Main Methods:
- Case study analysis comparing healthcare organizations in New South Wales and Victoria.
- Examination of organizational structure, culture, and systems of care.
- Assessment of potential barriers and facilitators to implementing TB elimination strategies.
Main Results:
- Differences in organizational structures, cultures, and care systems between NSW and Victoria were identified.
- These differences can create barriers or facilitate changes in organizational functions, particularly for TB prevention and LTBI treatment.
- Global health treaty ratification and national strategies alone are insufficient for TB elimination outcomes.
Conclusions:
- Local health system structures and funding significantly complicate the implementation of global health agendas like TB elimination, even in high-income countries.
- Tailored organizational conditions and service models are crucial for advancing TB elimination efforts.
- Further research is needed to identify optimal models for TB prevention and LTBI management to meet the 2035 elimination timeline.
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