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The National Strategic Plan (NSP) for Tuberculosis (TB) 2016-2020 builds on the past experiences for the National Tuberculosis Programme and its partners. This NSP provides a roadmap for delivering quality TB prevention and care service to the entire population, as an integral part of the country's move toward Universal Health Coverage. Between 1990 and 2015, Myanmar reduced the prevalence of TB by 50%, meeting the targets set by the Millennium Development Goals. Going forward, the country aims to further accelerate the rate decline.
The scope of the WHO treatment guidelines for drug-resistant tuberculosis, 2016 update thus differed from the one that guided the previous update of the WHO policy recommendations on the programmatic management of drug-resistant TB in 2011. It did not cover aspects of policy guidance on the programmatic management of drug-resistant TB that were of lesser priority or for which no new evidence has emerged since the 2011 revision. These included questions relating to the use of rapid diagnostics for RR-TB, the monitoring of response to treatment, the duration of longer (“conventional”) MDR-TB regimens, the delay in starting antiretroviral therapy in MDR-TB patients with human immunodeficiency virus (HIV) and models of care.
This Regional Strategic Plan towards Ending TB in the SEAR 2016–2020 describes the future directions and focus of the work towards TB elimination aiming to support Member States in reducing tuberculosis mortality and incidence in line with global targets as set in World Health Assembly (WHA) resolution WHA67.1. The resolution will guide countries in addressing persisting and emerging epidemiological and demographic challenges and advancing universal health coverage and robust health systems. The plan builds on and expands the existing updated Regional Strategic plan for TB Care and Control 2012–2015 and focuses on implementation of the End TB Strategy in the coming 5 years within the overall scope of the 20-year strategy covering 2015–2035.
Gender dynamics in TB enrolment, treatment and cure rates are not uniform. In some countries, men have better outcomes than women, while in other countries it is women who do. In most low and middle-income countries about two-thirds of reported TB cases are men and only one third women, and it is not well known whether this is due to a higher risk of developing TB among men or under-notification of TB among women with the evidence that women are less likely to be diagnosed with tuberculosis and successfully treated.
Childhood TB has been called a “sentinel event” because it indicates failure on two fronts. First, it signals an ongoing transmission, since the child likely contracted TB from someone close to him or her and who has likely remained untreated. Second, it indicates a wider failure in the system, since it points to the lack of preventative therapy that could have easily stopped the child from developing TB in the first place.
Keywords: TB, children, diagnostics, treatment, health system
The development of the Global Plan to End TB 2016-2020 was a more than 18-month effort, led by the Task Force of the Stop TB Partnership’s Coordinating Board. The development process was informed by the outcomes of four regional consultations as well as a two-month online consultation process. The regional consultation meetings in Addis Ababa (May), Bangkok (June), Istanbul (July) and Buenos Aires (August) brought together around 400 participants from government, TB programmes and other implementers, private providers, corporate sector, civil society and affected communities.
Despite numerous international treaties and commitments to protect the health rights of migrants, this population still faces significant barriers in their access to TB care. Migration, which is driven by a number of complex economic, social, political and environmental factors, is a determinant of ill health, and the health outcomes of migrants are impacted by the various dimensions of the migration process.
The World Health Organization (WHO) has released a consolidated summary of WHO recommendations on the use chest radiography (CXR) in TB detection and guidance on programmatic approaches to use CXR within primary care services. CXR is an essential tool for the early detection of TB, and therefore fundamental to achieve the targets set out in WHO’s End TB Strategy. The document also describes new technological developments in CXR, such as computer aided detection of TB (CAD) that holds promise for future use but needs to be further evaluated before WHO guidance is developed.
This document is prepared to provide information about good practices on Tuberculosis control in SAARC Member States. Good practices comprise examples of programmes, projects and activities that have been shown to contribute towards making interventions successful. Sharing good practices is important.
Globally, people who use drugs (PWUD) remain stigmatized and criminalized, which contributes to devastating health disparities, including extremely high rates of TB often combined with HIV and viral hepatitis. The range of these health issues and the prevailing lack of integrated health services capable of delivering TB, HIV, and harm reduction services in one place largely contribute to the scope of the TB crisis in communities of PWUD.