Tuberculosis

TB is a disease of poverty and is associated with precarious living conditions, overcrowding, food and job insecurity, and weak health systems. Vulnerability to TB is increased by nutritional status, HIV status, housing conditions, working conditions, access to health services and lifestyle factors such as the use of alcohol, tobacco and other substances. TB claims more lives than any other infectious disease. It exists in all countries and age groups but disproportionally affects populations in low- and middle-income countries and people living in poverty. Key populations for TB response may include people in prison and other closed settings, people living with HIV, refugees, migrants and indigenous populations. They experience an increased impact from the disease and have higher risks of infection due to structural, environmental, biological and behavioural factors; they may also experience barriers to services stemming from criminalization, stigma and discrimination.

HIV

In 2016 the World Health Assembly endorsed the development of the updated Global Health Sector Strategy on HIV 2016–2021. This strategy established the role of the health sector in responding to HIV, including delivering for equity, by adapting HIV services for different populations and locations. The subsequent UNAIDS Global AIDS Strategy 2021–2026 specified high-level targets and commitments for 2025. These priorities focus on maximizing equitable and equal access to HIV services, eliminating barriers to achieving HIV outcomes and fully resourcing and sustaining HIV responses. Key populations in the HIV response include men who have sex with men, transgender people (especially transgender women), people who inject drugs, sex workers and people in prison and detention. Migrants and mobile populations are at a higher risk for HIV infection, especially women, who are more likely to be adversely affected by mobility issues than men.

Malaria

The WHO Global Technical Strategy for Malaria 2016–2030 provides guidance for the control and elimination of malaria, citing equity as a central principle. People who are socioeconomically disadvantaged (poor, low levels of education, poorly constructed homes, work in agriculture, etc.) have a higher risk of malaria infection. Underserved populations in the malaria response may include refugees, migrants, internally displaced people and indigenous populations. These populations are underserved because they have been traditionally excluded from disease control efforts and tend to have compromised access to health and malaria prevention efforts and control services. In some settings, for example, they may not be meaningfully considered by the laws, policies and legal frameworks that facilitate access to health and malaria services.

• prevention capacities cover national legislation, policy, financing, coordination, communication and advocacy as well as zoonotic disease, food safety, biosafety, biosecurity and immunization;
• detection capacities look at national laboratory systems, surveillance, reporting and human resources;
• response capacities assess emergency preparedness, emergency response operations, linking public health and security authorities, medical countermeasures and personnel deployment, and risk communication; and
• IHR-related hazards examine points of entry, chemical events and radiation emergencies.