In a concerted effort to advance work towards achieving the long-term goal of eliminating tuberculosis (TB), the World Health Organization (WHO) has initiated efforts to support countries during the validation of TB elimination, alongside establishing necessary governance structures to monitor progress. This is in line with WHO’s existing mullti disease elimination frameworks and certification processes.
Commitments made by world leaders at the 2023 United Nations High-Level Meeting on TB have galvanized countries to accelerate the TB response on the road to TB elimination. This builds on WHO’s End TB Strategy, which delineates a comprehensive framework for Member States to intensify and accelerate efforts towards ending TB, underpinned by the overarching vision of a world free of TB. TB elimination is a continuation of the path for countries beyond the targets in the End TB Strategy. It entails further driving down incidence towards achieving an incidence rate of less than one case per million population. Although TB elimination efforts are often emphasized in low-TB-burden high-income countries, they are equally pertinent in settings approaching pre-elimination status and can also be explored in high-burden contexts aiming for elimination at the sub-national level or focusing on priority populations.
WHO has organized a series of consultations bringing together key experts from around the world, to shape the TB elimination agenda and develop a comprehensive TB Elimination Framework and Operational Guide. Insights from a first expert consultation in December 2023 in Istanbul scoped the preliminary work, particularly on identifying key metrics for monitoring TB elimination and their sustainability. Another consultation in June 2024 reviewed the progress on metrics, indicators, and governance processes to finalize the TB Elimination Framework and Operational Guide. This was followed by the meeting of WHO’s Strategic and Technical Advisory Group (STAG-TB) that also provided core inputs for the development of the guidance. Through the soon-to be released operational guidance on TB elimination, countries can apply for full validation of gold, silver, or bronze tiers on the path to elimination based on achieving relevant criteria and targets.
“WHO is expanding TB elimination efforts to cover all countries irrespective of their burden, with expanded criteria for national elimination focusing on priority populations, or on sub national elimination,” said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme. “This marks a crucial phase in the dialogue to drive accelerated action from Member States to scale up ongoing national and regional efforts to tackle and wipe out the TB epidemic”.
The comprehensive TB elimination framework and operational guide with key criteria and indicators, as well as a validation, governance, certification process, is scheduled to be released by the end of 2024.
