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Achieving the goals and targets of the WHO End TB Strategy requires innovative tools and strategies as well as rapid progress towards universal access. This document summarizes evidence gaps articulated in various WHO tuberculosis TB policy guidance to help steer innovation towards sustainable, desirable, acceptable, and feasible public health interventions required to end TB. It aims to serve as a reference for research policy-makers, funders, civil society and other relevant actors on the urgent TB research priorities for policy guidance.
Achieving the goals and targets of the WHO End TB Strategy requires innovative tools and strategies as well as rapid progress towards universal access. This document serves as an update to a previously released report with an identical title: It summarizes evidence gaps articulated in various WHO TB policy guidance to help steer innovation towards sustainable, desirable, acceptable, and feasible public health interventions required to end TB. It aims to serve as a reference for research policy-makers, funders, civil society and other relevant actors on the urgent TB research priorities for policy guidance.
This report provides the conclusions and recommendations of the 22nd meeting of WHO Strategic and Technical Advisory Group for Tuberculosis (STAG-TB), held in June 2022. In its work on TB, the World Health Organization (WHO) aims for a world free of TB and, as part of the Sustainable Development Goals, to end the global TB epidemic by 2030. It seeks to enable universal access to TB prevention and care, guide the global response to threats, and promote innovation. The WHO Secretariat, at all its levels, requires regular scientific, technical and strategic advice from the STAG-TB, the most recent of which is outlined in this report.
Regular review of evidence, and assessment of country needs for policy across the cascade of care is part of the core function of the Global Tuberculosis Programme of the World Health Organization (WHO/GTB). In this regard, GTB organized a consultation (2-4 March 2021) assembling scientists, public health experts, partners, civil society and countries to exchange views on emerging needs of Member States for policy guidance; to discuss critical evidence gaps related to emerging global TB policy development needs; and, to identify topical strategies best positioned to enhance the implementation and evaluation of global TB policy guidance. The present report summarizes the discussions from this meeting.
Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
BACKGROUND: Tuberculosis (TB) strains with drug resistance (DR-TB) are more difficult to treat than drug-susceptible ones, and threaten global progress towards the targets set by the End TB Strategy of the World Health Organization (WHO). WHO estimates that about half a million cases of multi-drug or rifampicin resistant (MDR/RR-TB) are estimated to occur each year. However, only one third were estimated to have accessed effective treatment and of those, just over half had a successful treatment outcome. Therefore, there is a pressing need for evidence-based policy recommendations on the treatment and care of patients with DR-TB, based on the most recent and comprehensive evidence available. In this regard, the WHO Consolidated Guidelines on Tuberculosis, Module 4: Treatment - Drug-Resistant Tuberculosis Treatment fulfills the mandate of WHO to inform health care professionals in Member States on how to improve treatment and care for patients with DR-TB. The 2020 recommendations on drug resistant TB treatment are contained in the second module to be released under the rubric of WHO Consolidated Guidelines on Tuberculosis (Module 4: Treatment). The WHO Consolidated Guidelines on Tuberculosis will group all TB recommendations in one document and will be complemented by matching modules of a consolidated operational handbook. The operational handbook will provide practical advice on how to put in place the recommendations at the scale needed to achieve national and global impact. OVERVIEW: Between 2011 and 2019, WHO has developed and issued evidence-based policy recommendations on the treatment and care of patients with DR-TB. These policy recommendations have been presented in several WHO documents and their associated annexes, including the WHO Consolidated Guidelines on Drug Resistant Tuberculosis Treatment, issued by WHO in March 2019. The policy recommendations in each of these guidelines have been developed by WHO-convened Guideline Development Groups, using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach to summarize the evidence, and formulate policy recommendations and accompanying remarks. The present WHO Consolidated Guidelines on Tuberculosis, Module 4: Treatment - Drug-Resistant Tuberculosis Treatment includes a comprehensive set of WHO recommendations for the treatment and care of DR-TB. The document includes two new recommendations, one on the composition of shorter regimens and one on the use of the BPaL regimen (i.e. bedaquiline, pretomanid and linezolid). In addition, the consolidated guidelines include existing recommendations on treatment regimens for isoniazid-resistant TB and MDR/RR-TB, including longer regimens, culture monitoring of patients on treatment, the timing of antiretroviral therapy (ART) in MDR/RR-TB patients infected with the human immunodeficiency virus (HIV), the use of surgery for patients receiving MDR-TB treatment, and optimal models of patient support and care. The guidelines are to be used primarily in national TB programmes, or their equivalents in Ministries of Health, and for other policy-makers and technical organizations working on TB and infectious diseases in public and private sectors and in the community.
The Global Tuberculosis Programme of the World Health Organization has the mandate to develop and disseminate evidence-based policy for tuberculosis prevention, diagnosis, treatment, and care. Regular review of evidence, and assessment of country needs for policy across the cascade of care is part of its core function. In this regard, GTB organized a fourth consultation assembling scientists, public health experts, partners, civil society, and countries to exchange views on emerging areas of need for evidence and for global TB policy guidance to achieve the goals and targets of the WHO End TB Strategy. The present report summarizes the outcome of this meeting.
The Global Tuberculosis Programme of the World Health Organization (WHO) convened a virtual technical consultation on “Innovative Clinical Trial Designs for Development of New TB Treatments” on 5 days between 20 August and 13 October 2021. The main objective of the meeting was to establish evidence-based approaches to trial designs and use of data to inform policy guidance of new regimens for the treatment of TB with the view to accelerate future regimen development. The consultation brought together researchers, academics, technical partners, TB drugs and regimens developers including pharmaceutical industry, trialists, regulators, guideline developers, programme managers, nongovernmental organizations and civil society.