WHO End TB Strategy
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| WHO End TB Strategy | |
|---|---|
| Name | WHO End TB Strategy |
| Formation | 2014 |
| Type | Global health strategy |
| Headquarters | Geneva |
| Parent organization | World Health Organization |
WHO End TB Strategy The WHO End TB Strategy is a global health policy framework launched by the World Health Organization and adopted by the World Health Assembly to accelerate the decline of tuberculosis through coordinated action across United Nations agencies, national health authorities, and civil society. It synthesizes guidance from prior initiatives including the Stop TB Partnership, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and frameworks from the Sustainable Development Goals process to align TB control with broader international targets. The strategy links technical guidance from the World Health Organization with financing mechanisms such as the Global Fund and partnerships with actors including Gavi, the Vaccine Alliance and national programs like India's Revised National TB Control Programme.
Background and Rationale
The strategy emerged from historical efforts including the Stop TB Partnership's earlier plans, lessons from the HIV/AIDS epidemic, and evaluations of programs supported by USAID, the European Union, and bilateral donors such as the United Kingdom's Department for International Development. It responds to epidemiological evidence compiled by the Global Burden of Disease Study, modelling from institutions like the Imperial College London TB unit, and policy reviews conducted by the World Bank and the United Nations Development Programme. The rationale references past public health milestones such as the Alma-Ata Declaration and integrates human rights guidance advanced by the Office of the United Nations High Commissioner for Human Rights.
Strategy Goals and Targets
The strategy sets numeric milestones tied to the Sustainable Development Goals and the End TB targets, including reductions in TB incidence and mortality by specific years, informed by modelling from Lancet-published studies and reports by the Global TB Programme of the World Health Organization. Targets mirror commitments made at global forums such as the United Nations General Assembly high-level meeting on TB and are synchronized with financing deadlines set by the Global Fund and multilateral lenders like the International Monetary Fund and the World Bank. National commitments by high-burden countries including India, South Africa, Indonesia, and China are benchmarked against these global targets and monitored alongside indicators used by the United Nations.
Pillars and Core Components
The strategy is structured around integrated pillars that reflect evidence-based interventions promoted by organisations such as the Stop TB Partnership, the World Health Organization, and research from Centers for Disease Control and Prevention collaborators. Components include patient-centered care drawing on protocols from Médecins Sans Frontières, infection control aligned with guidance from Occupational Safety and Health Administration-style frameworks, and research and development priorities coordinated with institutions like Bill & Melinda Gates Foundation-funded consortia and academic centres such as Johns Hopkins University, University of Oxford, and Harvard University. The approach emphasizes multisectoral action with participation from Ministry of Health (India), municipal authorities exemplified by New York City Health Department initiatives, and civil society networks like the Treatment Action Campaign.
Implementation and Financing
Implementation combines national strategic plans submitted to the Global Fund and technical support from the World Health Organization and regional bodies including the Pan American Health Organization and the European Centre for Disease Prevention and Control. Financing mixes domestic budgets from finance ministries, multilateral loans from the World Bank and grants from philanthropic organisations such as the Wellcome Trust and the Bill & Melinda Gates Foundation. Innovative mechanisms endorsed by the strategy draw on instruments trialled by the Global Financing Facility and results-based financing models tested in partnership with GAVI and bilateral partners like Norway and Japan.
Monitoring, Evaluation, and Accountability
Monitoring relies on surveillance systems coordinated by the World Health Organization and national programmes using data platforms compatible with DHIS2-style systems and analytic work by research groups at Imperial College London and Harvard T.H. Chan School of Public Health. Evaluation frameworks reference methodologies from the Global Fund's grant performance reviews and independent assessments by bodies such as the International Development Evaluation Association and academic audits published in journals like The Lancet and BMJ. Accountability includes reporting to the World Health Assembly, commitments tracked at the United Nations General Assembly high-level meetings, and civil society oversight by networks modeled after the Stop TB Partnership and Treatment Action Campaign.
Global and Country-Level Progress
Progress is reported annually in the Global Tuberculosis Report produced by the World Health Organization and is reflected in national scorecards from countries such as India, South Africa, Philippines, and Pakistan. Improvements in diagnostics and treatment uptake draw on innovations from manufacturers like Cepheid and trial results from institutions including London School of Hygiene & Tropical Medicine and Uniqure-affiliated research. Funding and programmatic expansion have been documented in analyses by the International Monetary Fund, the World Bank, and philanthropic evaluations from the Bill & Melinda Gates Foundation.
Challenges and Criticisms
Critics cite gaps identified by watchdogs such as Médecins Sans Frontières and policy analysts at Chatham House regarding financing shortfalls, delays in new vaccine development, and health-system constraints documented in country reviews for Democratic Republic of the Congo and Nigeria. Other concerns reference the interaction with the HIV/AIDS epidemic in southern Africa, antimicrobial resistance evaluated by the Wellcome Trust, and equity issues raised by the United Nations High Commissioner for Refugees in fragile settings. Debates in policy fora including the World Health Assembly and publications in The Lancet and Health Policy and Planning highlight the need for strengthened multisectoral governance, sustained investment, and accelerated research partnerships involving academic centres such as University of Cape Town and Makerere University.