The path to tuberculosis elimination: a renewed vision.

Area of Science:

• Public Health
• Epidemiology
• Infectious Disease Control

Background:

• Tuberculosis (TB) elimination and pre-elimination goals were set in the 1990s for low-incidence countries.
• Current progress indicates a need for accelerated efforts to achieve pre-elimination even in well-resourced settings.

Purpose of the Study:

• To review the history and current status of TB elimination efforts.
• To propose a framework for accelerating progress towards TB pre-elimination.
• To guide stakeholders in actionable steps for TB control.

Main Methods:

• Review of historical TB elimination concepts and country experiences.
• Analysis of available interventions for TB control.
• Development of a five-stage framework for TB incidence reduction.

Main Results:

• A five-stage framework (high, moderate, low incidence, nearing pre-elimination, pre-elimination) is proposed, benchmarked by TB incidence levels.
• Countries can set 5-year targets for TB incidence reduction or stage progression.
• Prioritization of activities, tailored strategies, and consideration of ethical concerns are crucial.

Conclusions:

• The proposed framework provides actionable steps for countries to accelerate progress towards TB pre-elimination.
• Tailored strategies and accountability are key to achieving TB elimination goals.
• Addressing ethical and social concerns is important as pre-elimination is approached.