Policy analysis on drug-resistant tuberculosis in ASEAN member countries using a governance framework approach: a...

Drug-resistant tuberculosis (DR-TB) heavily contributes to the global challenge of antimicrobial resistance (AMR), resulting in increased morbidity among tuberculosis cases. The Association of Southeast Asian Nations is home to approximately 10% of the world's population, accounting for almost 15% of the annual global TB incidence. Thus, this study aimed to evaluate the existing national policies on DR-TB in the region using the governance framework approach for AMR and the WHO Health System Building Blocks. A thorough search for DR-TB-related national policies was performed on the websites of official health ministries and international health organisations. A total of 118 policy documents were identified after the systematic searches, and 38 policy documents were included in the data analysis. Utilising the governance framework approach, we found that the least frequently addressed domains were antimicrobial research, equity and medicine regulation for monitoring and evaluation, policy design and implementation tools, respectively. While health workforce strategies were often detailed in these national policies, we found that financing schemes were the least frequently addressed health system building blocks. The findings of our study support the need to establish a comprehensive and consolidated policy development system following the governance framework approach and to strengthen the health system building blocks in order to achieve integrated care for patients with DR-TB as espoused by the principles of universal healthcare.