WHO steps up the Director-General’s flagship initiative to combat tuberculosis

On the occasion on World TB Day, the World Health Organization (WHO) is announcing the expanded scope of the WHO Director-General’s (DG) Flagship Initiative on tuberculosis over the period from 2023 to 2027 to support fast-tracking progress towards ending TB and achieving Universal Health Coverage (UHC) by 2030.

Tuberculosis remains one of the world’s top infectious killers, causing 1.6 million deaths each year and affecting millions more, with enormous impacts on families and communities. The COVID-19 pandemic coupled with ongoing crises such as armed conflict, food insecurity, climate change, political and economic instability, has reversed years of progress made in the fight against TB. Last year, for the first time in nearly two decades, WHO reported an increase in the number of people falling ill with TB and drug resistant TB, alongside an increase in deaths.

“TB is preventable, treatable and curable, and yet this ancient scourge that has afflicted humanity for millennia continues to cause suffering and death for millions every year,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “WHO is committed to supporting countries to step up their response, by expanding access to services to prevent, detect and treat TB as part of their journey towards universal health coverage, and to strengthen their defences against epidemics and pandemics.”

The WHO DG flagship initiative on TB builds on the progress achieved and lessons learned from 2018-2022. It aims to scale up the delivery of quality care to people living with TB through equitable access to WHO-recommended rapid diagnostics, shorter all-oral treatment for infection and disease, increasing their access to social protection and other innovations including digital tools for health.

The initiative highlights the pressing need to increase both domestic and international investments in TB services, research, and innovation, particularly in new vaccine development. It calls for TB services and programmes, particularly in countries with a high TB burden, to be recognized as an essential component of health systems, bolstering primary healthcare and pandemic preparedness and response.

The DG’s flagship initiative aims to drive multisectoral action and accountability to tackle the key drivers of the TB epidemic - poverty, undernourishment, diabetes, HIV, tobacco and alcohol use, poor living and working conditions, among others. And its enhanced scope is much needed and timely as the international partners prepare for the upcoming UN High-Level Meeting on TB.

World Tuberculosis Day this year is being commemorated under the theme 'Yes! We can end TB!' with the goal of promoting optimism and fostering high-level leadership, increased investments, rapid adoption of new WHO recommendations, and strengthened multisectoral partnerships to combat the TB epidemic.

As part of the DG Flagship initiative, a special call to action is being issued by WHO and partners urging Member States to accelerate the rollout of new WHO-recommended shorter all-oral treatment regimens for drug-resistant TB.

Drug-resistant TB continues to be a pressing public health concern, taking a significant toll on individuals affected by TB, communities, and healthcare systems worldwide. In 2021, nearly half a million people fell ill with multidrug- or rifampicin-resistant TB (MDR/RR-TB), only one in three accessed treatment.

New WHO guidelines on drug-resistant TB treatment recommend rapid roll-out of the novel BPaLM/BPaL regimen that has the potential to significantly increase cure rates due to its high effectiveness, offer more extensive access because of its lower cost, and improve patients' quality of life, as it is an all-oral treatment that is considerably shorter than traditional regimens.

“2023 is our chance to push forward the agenda towards ending TB, ” said Dr Tereza Kasaeva, Director of WHO’s Global Tuberculosis Programme.  “On World TB Day, WHO is pressing for firm political commitment at the highest level, strong multisectoral collaboration including beyond health, and an effective accountability system. We need everyone--individuals, communities, societies, donors and governments--to do their part to end TB. Together, yes, we can end TB.”

In September 2023, the UN General Assembly will convene three High-Level Meetings focusing on UHC, pandemic preparedness and response and ending TB. There are clear linkages between these agendas and the Heads of State will deliberate to accelerate action, including on the goal to end TB.