New technologies for TB control : a framework for their adoption, introduction, and implementation

Overview

The past few years have seen remarkable successes in global TB control, resulting in an increase in the detection rate of smear-positive cases from 28% in 2000 to 60% in 2005 and a treatment success rate from 82% in 2000 to 84% in 2004. Nonetheless, 1.6 million people died from TB in 2005 and more than half of TB patients, including children, are not properly diagnosed or treated. Furthermore, the long duration of short-course chemotherapy limits treatment opportunities for many people living in poor and marginalized communities.

Significant challenges to TB control remain; these are compounded by the HIV epidemic and the emergence of multidrug-resistant TB and extensively drug-resistant TB. Improvements in existing approaches and new tools are urgently needed for several reasons: the most commonly used diagnostic tool is more than a century old, the current vaccine does not confer complete protection and may present an elevated risk of adverse events in children infected with HIV, and no new drugs have been available for over 40 years.

The ability to rapidly deploy and appropriately use new tools as they become available is critical to saving lives and will require concerted and well planned efforts by the entire Stop TB Partnership, including national TB control programmes, technical partners, community members and civil society representatives, product developers, donors and international organizations. It is now more urgent than ever for national programmes and health systems to improve management capacity to prepare to seize opportunities, and to use new tools optimally to assist millions of TB patients and their families and communities.

This document provides a framework for ensuring that new tools, once available, can be expediently and efficiently adopted at the global and country levels.