Professional Documents
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Kerri Viney Sidney Sax Research Fellow and Chair of the Executive
Committee of the TB Forum
Department of Public Health Sciences, Karolinska Institutet
Department of Global Health, Australian National University
Citizen News Service webinar
12 December, 2017
Happy UHC Day!
Vision:
A world free of TB
Zero TB deaths, Zero TB disease, and Zero TB
suffering
Goal:
End the global TB epidemic
Target 3.3: End the global TB epidemic
World Health Organization. Implementing the End TB Strategy: the essentials. 2015. Geneva, Switzerland. World Health Organization.
A. Early diagnosis of TB A. Political commitment with A. Discovery, development
including universal drug adequate resources for TB and rapid uptake of new
susceptibility testing and care and prevention tools, interventions and
systematic screening of B. Engagement of communities, strategies
contacts and high risk civil society organizations, B. Research to optimize
groups and public and private care implementation and
B. Treatment of all people with providers impact, and promote
TB including drug resistant C. Universal health coverage innovations
TB and patient support policy and regulatory
C. Collaborative TB-HIV frameworks for case
activities and management of notification, vital
co-morbidities registration, quality and
D. Preventive treatment of rational use of medicines
persons at high risk, and and infection control
vaccination against TB D. Social protection, poverty
alleviation and actions on
other determinants of TB
Pillar 2 of the End TB Strategy
World Health Organization. Implementing the End TB Strategy: the essentials. 2015. Geneva, Switzerland. World Health Organization.
Breaking the trajectory of the TB epidemic
Getting to the 2025 targets requires effective use of existing tools to combat TB,
complemented by universal health coverage and social protection to:
1. Push down global TB incidence rates from an annual decline of 2% in 2015 to 10% by
2025
2. Reduce the proportion of people with TB who die from TB from 15% in 2015 to 5% by
2025
Current global trend: -1.5%/year
-10%/year by 2025
(achieved in wealthy
Optimize use of current & new
tools emerging from pipeline, countries in 1950s and
pursue UHC and social 1960s)
protection, social determinants
-5%/year
Introduce new tools: a vaccine, new
drugs and shorter regimens for
treatment of active TB and latent
infection, a point-of-care test -17%/year
World Health Organization. Implementing the End TB Strategy: the essentials. 2015. Geneva, Switzerland.
World Health Organization.
Moving beyond UHC
Key indicator for UHC is out of pocket costs for health
services
However, out of pocket costs for health services are only one
part of the financial burden
Direct non-medical
Other expenditure
8%
Social protection should cover the special needs associated with TB through the
following policies:
Schemes for compensating the financial burden associated with illness such
as sickness insurance, disability pension, social welfare payments, other
cash transfers, travel or food vouchers or food packages
Siroka A, Lonnroth K and Ponce N. The impact of social protection on tuberculosis rates: a global analysis.
The Lancet Infectious Diseases. 2016 Apr; 16(4): 473-479
Framework to illustrate the inter-relationship between universal health
coverage, social protection, TB outcomes, and public health and social impact
Lonnroth K et al. Beyond UHC: Monitoring Health and Social Protection Coverage in the Context of Tuberculosis Care and
Prevention. PLoS Medicine. 2014; 11(9): e1001693
Summary