A Comparative Policy Review of Tuberculosis Infection Control Policies Across Six Countries: Insights on Screening,...

Tuberculosis (TB) infection remains one of the major global public health challenges, disproportionately affecting vulnerable and marginalized populations. This study aims to compare prevention, screening, and treatment policies for TB in selected countries to identify effective strategies and policy gaps that may inform national and international TB control programs.

This comparative review analyzed the prevention, screening, and treatment policies of TB in Iran, the United States, Ireland, Japan, the United Kingdom, and Türkiye in 2023. Comprehensive searches were conducted in electronic databases (PubMed, Scopus, Web of Science, and Embase), as well as on the official websites of ministries of health and national TB programs in these countries. The inclusion criteria were the availability of policy documents addressing prevention, screening, and treatment, detailed information on implementation processes, and publication between 1993 and 2023. Data were extracted and synthesized based on the scope and structure of national TB strategies and alignment with WHO recommendations.

Findings indicated that the UK and the US have successfully implemented effective TB control policies through structured strategies, surveillance systems, and intersectoral coordination. Iran, Japan, and Türkiye achieved notable reductions in TB mortality by adopting similar evidence-based policies. Although Ireland demonstrated a decline in incidence, its treatment success rate remained comparatively low. Challenges identified across countries included Multi-Drug-Resistant Tuberculosis (MDR-TB), inequitable distribution of health services, limited financial and human resources, structural deficiencies in health systems, inadequate coordination of care, social stigma, and barriers related to migrant populations, which have collectively hindered TB control, especially in treatment.

Effective TB control requires strengthening health system capacity, implementing integrated and active prevention programs, expanding screening among high-risk and migrant populations, improving surveillance systems, and preventing drug-resistant TB. Adequate financial investment, trained human resources, and coordinated policy implementation remain essential for sustainable TB control.