Health system and environmental factors affecting global progress towards achieving End TB targets between 2015 and...

Area of Science:

• Global Health
• Epidemiology
• Environmental Health

Background:

• Health system and environmental factors significantly influence the achievement of World Health Organization (WHO) End Tuberculosis (TB) targets.
• Quantitative global data on progress and contributing factors remain scarce.

Purpose of the Study:

• To measure progress towards global End TB milestones between 2015 and 2020.
• To identify key health system and environmental factors associated with TB incidence and mortality reduction.

Main Methods:

• Utilized data from ten online repositories.
• Employed principal component analysis for health system performance measures.
• Applied radar charts, dumbbell plots, and linear regression to analyze progress and predictors.

Main Results:

• Significant variation in TB incidence and mortality reduction across countries and WHO regions.
• Only 39.3% of countries achieved >20% TB incidence reduction; 16.2% achieved >35% TB mortality reduction.
• Health system factors (financing, service delivery, access to medicine, governance) and environmental factors (temperature, air pollution) significantly impacted TB reduction.

Conclusions:

• Weak health systems are a major barrier in high-burden countries.
• Prioritizing health system strengthening, particularly in TB financing and access to medicine, is essential.
• Adherence to WHO air quality guidelines and reduction of greenhouse gas emissions are critical to mitigate environmental impacts.