Tuberculosis (TB)

The End TB Strategy

Graphic with slogan: We will end TB.

Ending TB is not just a public health problem, but a development challenge and opportunity. WHO’s post-2015 End TB Strategy, adopted by the World Health Assembly in 2014, aims to end the global TB epidemic as part of the newly adopted Sustainable Development Goals.

It serves as a blueprint for countries to reduce TB incidence by 80%, TB deaths by 90%, and to eliminate catastrophic costs for TB-affected households by 2030. The Strategy is not a “one size fits all” approach and its success depends on adaptation for diverse country settings.

Implementing the End TB Strategy: The Essentials

Cover image of
WHO

“Implementing the End TB Strategy: The Essentials” serves as an operational guide for countries on how to implement the Strategy and end the TB epidemic. It also provides some early examples of how countries are transitioning to the End TB Strategy. The Essentials emphasize that transitioning from “stopping TB” to “ending the TB epidemic” will call for major transformations in national TB control efforts. The End TB Strategy combines a holistic mix of health and social interventions. In order to end the TB epidemic, countries will need to strengthen their health and social sectors by achieving universal health coverage and social protection, which are also emphasized within the framework of the new SDG agenda.

fact buffet

New cases

80%drop in new TB cases by 2030

End TB Strategy
pdf, 1.95Mb

TB deaths

90%drop in people dying of TB by 2030

End TB fact sheet

Reducing poverty

100%of TB-affected families protected from catastrophic costs by 2030

End TB brochure

Key topics:

The End TB Strategy pillars and principals illustration.
WHO

Ending the TB epidemic is a target under the Sustainable Development Goals that requires implementing a mix of biomedical, public health target and socioeconomic interventions along with research and innovation. The End TB Strategy encompasses a package of interventions that fall under three pillars. The first pillar – integrated, patient-centred care and prevention - puts patients at the heart of service delivery. The second pillar – bold policies and supportive systems – requires intense participation across government, communities and private stakeholders. The third pillar – intensified research and innovation – is critical to break the trajectory of the TB epidemic and reach the global targets.

The End TB Strategy pillars and principals illustration.
WHO

The End TB Strategy builds on three strategic pillars underpinned by four key principles focusing on government stewardship, a strong coalition made up of civil society and communities, promoting human rights and equity, and adaptation of the Strategy at the country level. The success of the Strategy in driving down TB deaths and illness will depend on countries respecting the key principles as they implement the interventions outlined in each pillar.

Mother and daughter smiling to the camera.
UNICEF/Pirozzi

To successfully roll-out the Strategy, countries and partners will need to focus on advocacy, baseline preparedness and collaboration. Implementing the End TB Strategy requires intensified action from and beyond the ministries of health, in close collaboration with all stakeholders including other ministries, communities, civil society and the private sector. It is essential for countries to “know their epidemic” by assessing the TB situation on the ground. The creation of a high-level multi-stakeholder coordinating mechanism led by the national government can also significantly enhance the implementation of the End TB Strategy.

TB Frontline community volunteers Hirpessa Geleta (left) and Angasu Dhuguma (right) in Wolisso, Ethiopia.
WHO/N Tesfaye

Reliable measurement of progress in reducing TB incidence, TB deaths and catastrophic costs is essential. High-performance TB surveillance within national health information systems and national vital registration systems must be in place to monitor TB incidence and TB mortality, while special surveys are the most appropriate way to measure catastrophic costs. All countries should reach the ≥90% targets for treatment coverage, TB treatment success rate, preventive treatment coverage and uptake of new diagnostics and drugs by 2025 at the latest. In addition, 100% of TB-affected families should be protected from catastrophic costs.

Rural area in Lesotho
Samuel George Nuttall

Towards TB elimination in low-incidence countries

Global elimination of TB as a public health problem, defined as <1 TB case per million population, is a long-term vision of WHO’s End TB Strategy, while the time-bound global target is to “End the global TB epidemic”, defined as bringing down the global incidence from >1,000 per million population in 2015 to <100 per million by 2035.

Global TB strategy with ambitious targets accepted

The World Health Assembly passed a resolution in May 2014 approving with full support the new post-2015 End TB Strategy with its ambitious targets.

The resolution calls on governments to adapt and implement the strategy with high-level commitment and financing. It focuses on serving populations highly vulnerable to infection and poor health care access, such as migrants. The strategy and resolution both highlight the need to engage partners within the health sector and beyond, such as in the fields of social protection, labour, immigration and justice.

WHO will monitor the implementation of the strategy and evaluate progress towards the milestones and the 2035 targets.

Resources

“Tuberculosis kills five thousand people every day. The social and economic impacts are devastating, including poverty, stigma and discrimination. While the world has committed to ending the TB epidemic by 2030, actions and investments don’t match the political rhetoric. We need a dynamic, global, multisectoral approach. The good news is that we finally have two great opportunities to move forward: the first WHO Global Ministerial Conference to End TB in Moscow in 2017, followed by the first UN General Assembly High-Level Meeting on TB in 2018. These will build momentum, get different sectors engaged, and accelerate our efforts to make TB history."

Dr Tedros Adhanom Ghebreyesus, WHO Director-General