Introduction

Tuberculosis is a global problem for all mankind, with differences across countries and continents. The WHO End TB Strategy: Targets and Indicators has now been adopted.

The goal is to stop the global TB epidemic.

Target indicators

• Reduce TB mortality by 95% by 2035 compared to 2015.
• 90% reduction in TB incidence by 2035 compared to 2015.
• By 2035, no household with TB should face catastrophic costs.

Principles

1. Government leadership and responsibility, monitoring and evaluation.
2. Close cooperation between civil society organizations and the local population.
3. Protection and observance of human rights, ethical standards and the principle of justice.
4. Adaptation of the strategy and objectives at the country level with global cooperation.

Basic elements and components

1. Comprehensive treatment and prevention focused on the patient.
   • Early diagnosis of TB, including universal drug-susceptibility testing; and systematic screening of contacts and high-risk groups.
   • Treat all people with TB, including drug-resistant TB, and patient support.
   • Collaborative TB/HIV control and management of comorbidities.
   • Preventive treatment for those at higher risk and vaccination against tuberculosis.
2. Strong policies and supporting systems.
   • Political support with adequate resources for TB treatment and prevention.
   • Involvement of communities, civil society organizations, and all public and private aid providers.
   • Universal health coverage policy and legal framework for case notification, civil registration, quality assurance and rational use of medicines, and infection control.
   • Social protection, poverty alleviation and other determinants of TB.
3. Intensification of research and innovation.
   • Discovery, development and rapid deployment of new tools, practices and strategies.
   • Research to optimize implementation and impact, promoting innovation.

Stop the tuberculosis epidemic.

Stopping the global TB epidemic can be achieved by dramatically reducing mortality and morbidity, as well as eliminating the economic and social burden associated with this disease. If this target is not achieved, there will be serious individual and global public health consequences.

To achieve this goal by 2035, the following must be done.

1. Expand the scale and coverage of TB care and prevention, with a focus on high-impact, integrated, patient-centered approaches.
2. Realize the full benefits of health and development policies and systems by involving a much wider range of actors in government, communities and the private sector.
3. Strive for new scientific knowledge and innovations that can radically change the treatment and prevention of tuberculosis.

To ensure full impact, these interventions should be based on the principles of government leadership, civil society participation, human rights and equity, and adaptation to the unique conditions associated with different epidemiological situations and environments.

Achievement of goals

To achieve the targets set under the Stop TB strategy, it is necessary, first, to accelerate the annual decline in the incidence of tuberculosis in the world from 2% in 2015 to 10% per year by 2025.

Second, the proportion of people with TB who die from the disease (mortality rate) should be reduced from 15% projected in 2015 to 6.5% by 2025. Such a reduction in mortality and morbidity by 2025 can be achieved, despite the ambitious goal, if the available funds are complemented by universal health coverage and social protection measures.

To ensure sustainable progress beyond 2025 and achieve the 2030 Sustainable Development Goals (SDGs) and the Stop TB Strategy targets by 2035, additional available funds are needed by 2025.

In particular, to reduce the number of new TB cases among the estimated two billion people worldwide infected with Koch bacillus, a new vaccine is needed that provides effective pre-exposure and post-exposure prophylaxis, safer and more effective treatment regimens for latent TB infection, and better diagnostics; and safer and simpler treatment regimens, including shorter drug regimens for TB.

Another factor complicating the achievement of goals is HIV infection. The presence of HIV infection is the most powerful of the medical factors provoking the development of tuberculosis. The regularity of this phenomenon is explained by the predominant spread of these diseases among the same population groups according to the social risk factor and the characteristics of the immune mechanisms of the disease. Tuberculosis is the leading cause of death for people living with HIV. Today, any medical worker may encounter a case of pulmonary and extrapulmonary tuberculosis in a patient with HIV infection.