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Review
. 2023 Oct 29:18:100301.
doi: 10.1016/j.lansea.2023.100301. eCollection 2023 Nov.

Ending TB in South-East Asia: flagship priority and response transformation

Vineet Bhatia  1 , Suman Rijal  1 , Mukta Sharma  2 , Akramul Islam  3 , Anna Vassall  4 , Anurag Bhargava  5 , Aye Thida  1 , Carmelia Basri  6 , Ikushi Onozaki  7 , Madhukar Pai  8 , Md Kamar Rezwan  1 , Nim Arinaminpathy  9 , Padmapriyadarsini Chandrashekhar  10 , Rohit Sarin  11 , Sandip Mandal  12 , Mario Raviglione  13
Affiliations
Review

Ending TB in South-East Asia: flagship priority and response transformation

Vineet Bhatia et al. Lancet Reg Health Southeast Asia. .

Abstract

Over the decades, the global tuberculosis (TB) response has evolved from sanatoria-based treatment to DOTS (Directly Observed Therapy Shortcourse) strategy and the more recent End TB Strategy. The WHO South-East Asia Region, which accounted for 45% of new TB patients and 50% of deaths globally in 2021, is pivotal to the global fight against TB. "Accelerate Efforts to End TB" by 2030 was adopted as a South-East Asia Regional Flagship Priority (RFP) in 2017. This article illustrates intensified and transformed approaches to address the disease burden following the adoption of RFP and new challenges that emerged during the COVID-19 pandemic. TB case notifications improved by 25% and treatment success rates improved by 6% between 2016 and 2019 due to interventions ranging from galvanising political commitments to empowering and engaging communities. Cumulative TB programme budget allocations in 2022 reached US$ 1.4 billion, about two and a half times the budget in 2016. An ambitious Regional Strategic Plan towards ending TB, 2021-2025, identifies priority interventions that will need investments of up to US$ 3 billion a year to fully implement them. Moving forward, countries in the Region need to leverage RFP and take up intensified, people-centred, holistic interventions for prevention, diagnosis, treatment and care of TB with commensurate investments and cross-ministerial and multi-sectoral coordination.

Keywords: Flagship; South-East Asia; Tuberculosis.

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Conflict of interest statement

VB, SR, MS, MKR and AT are WHO staff, while NA and SM were consultants for the modelling exercise. All other authors are members of the Southeast Asia Regional Strategic and Technical Advisory Group, and contributed in their advisory role without any associated honorarium. The authors declare no competing interest in production of this manuscript.

Figures

Fig. 1
Fig. 1
Impact of three packages of interventions on TB incidence and mortality in SEA Region.
Fig. 2
Fig. 2
a) Trends in case notification and estimated incidence in the South-East Asia Region. b) Trends in mortality in the South-East Asia Region.
Fig. 3
Fig. 3
Private provider notifications—number being treated, and percentage being notified. (Total of Bangladesh, India, Indonesia, and Myanmar).
See this image and copyright information in PMC

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