Regional Framework for Action on Implementation of the End TB Strategy in the Western Pacific, 2016-2020
Progress in reducing the tuberculosis (TB) burden in the Western Pacific Region has been remarkable, with millions of lives saved and drastic reductions in prevalence and mortality in the past two decades. Throughout the Region, national tuberculosis programmes (NTPs) have expanded the basic TB services package and centred its focus on the most cost-effective, high-impact interventions at little or no cost to patients. Furthermore, accurate epidemiological information and programmatic evidence have provided a rich base for informed decision-making.
Despite unprecedented achievements, TB remains a leading killer in the Region, claiming more than 100 000 lives every year. Detecting TB cases in vulnerable populations such as migrants, prisoners, children, older people and the poor can be difficult, and many have limited capacity to cope with the burden of illness. Although basic TB services are available free of charge in almost all countries, TB patients continue to suffer from a heavy financial burden. Loss of income and direct expenses trigger a downward spiral, whereby patients are less able to complete treatment and may develop drug resistance. Annually, on average, there are an estimated 71 000 new cases of multidrug-resistant TB in the Region, with only 11 412 (16%) cases notified in 2013 and 6926 (10%) patients placed in treatment. Notably, the treatment success rate in the Region was only 52% for patients enrolled in treatment in 2011. Weaknesses in health systems and regulatory mechanisms result in limited services, inadequate treatment, irrational drug use and discrimination against people with TB.
In 2014, the Sixty-seventh World Health Assembly endorsed the Global strategy and targets for tuberculosis prevention, care and control after 2015, also known as The End TB Strategy. The strategy aims to “end the global TB epidemic” by 2035, bringing the level of disease burden in the whole world down to the level seen now in countries with the lowest TB burden. Within the scope of this 20-year time span, this regional framework focuses on the implementation of The End TB Strategy in the coming five years. The indicators and targets of The End TB Strategy are reinforced, especially ensuring no families face catastrophic costs due to TB. Based on extensive consultation, the regional framework aims to provide policy options for consideration in order to update national strategies and plans and strengthen national efforts to advance TB control.