In 2014, all Member States of the World Health Organization (WHO) and the United Nations (UN) committed to ending the TB epidemic by adopting WHO’s post-2015 End TB Strategy. The World Health Assembly passed a resolution in May 2014 approving with full support the new post-2015 End TB Strategy with its ambitious targets. The End TB Strategy aims to end the global TB epidemic as part of the newly adopted Sustainable Development Goals (SDGs, adopted by world leaders in September 2015).
| Vision | A world free of TB – zero deaths, disease and suffering due to TB |
| Goal | End the global tuberculosis epidemic |
Milestones and Targets
The End TB Strategy includes milestones (for 2020 and 2025) and targets (for 2030 and 2035) for considerable reductions in the TB incidence rate (new cases per 1 lakh population per year), the absolute number of TB deaths, and costs faced by TB patients and their households.
| Indicators | Milestones (2020) | Milestones (2025) | Targets (2030) | Targets (2035) |
|---|---|---|---|---|
| Percentage reduction in the absolute number of TB deaths (compared with the 2015 baseline) | 35% | 75% | 90% | 95% |
| Percentage reduction in the TB incidence rate (compared with the 2015 baseline) | 20% | 50% | 80% | 90% |
| Percentage of TB-affected households facing catastrophic costs due to TB (level in 2015 unknown) | 0% | 0% | 0% | % |
Principles
- Government stewardship and accountability, with monitoring and evaluation.
- Strong coalition with civil society organizations and communities.
- Protection and promotion of human rights, ethics and equity.
- Adaptation of the strategy and targets at the country level, with global collaboration.
Pillars and Components
The Key requirements to reach the milestones and targets are defined within the three pillars of the End TB strategy:
- Integrated, patient-centred care and prevention
- Early diagnosis of TB, including universal drug-susceptibility testing and systematic screening of contacts and high-risk groups.
- Treatment of all people with TB, including drug-resistant TB and patient support.
- Collaborative tuberculosis/HIV activities and management of co-morbidities.
- Preventive treatment of persons at high risk and vaccination against TB.
- Bold policies and supportive systems
- Political commitment with adequate resources for tuberculosis care and prevention.
- Engagement of communities, civil society organizations, and public and private care providers.
- Universal health coverage policy and regulatory frameworks for case notification, vital registration, quality and rational use of medicines, and infection control.
- Social protection, poverty alleviation and actions on other determinants of TB.
- Intensified research and innovation
- Discovery, development and rapid uptake of new tools, interventions and strategies.
- Research to optimize implementation & impact and promote innovations.
Reaching the Targets
Reaching the milestones and targets for reductions in TB incidence requires an annual decline in global TB incidence rates must first accelerate from 2% per year in 2015 to 10% per year by 2025 and then to an average of 17% per year from 2025 to 2035.
To reach the targets set out in the End TB Strategy, reaching the milestones and targets for reduction in TB deaths required not only these declines in TB incidence but also a reduction in the Case Fatality Ratio (CFR, the percentage of people with TB who die from the disease). The global CFR needs to decline from a projected 15% in 2015 to 6.5% by 2025.
Ending the Tuberculosis epidemic
Achievement of this goal by 2035 requires
- To expand the scope and reach of interventions for tuberculosis care and prevention with a focus on high-impact, integrated and patient-centred approaches.
- To pursue new scientific knowledge and innovations which can dramatically change TB prevention and care.
- To elicit full benefits of health and development policies and systems through engaging a much broader set of collaborators across government, communities and the private sector.
To ensure full impact, these actions must build on principles of government stewardship, engagement of civil society, human rights and equity, and adaptation to the unique context of various epidemics and settings.