End tb strategy
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WHO End TB Strategy 2025 2026 progress milestones
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https://www.ijidonline.com/article/S1201-9712(26)00206-7/ful…
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"End TB" strategy progress 2025
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Here is a comprehensive breakdown of the WHO End TB Strategy, drawn from Park's Textbook of Preventive and Social Medicine and supplemented with current progress data.
WHO End TB Strategy
Background
The End TB Strategy was adopted by the World Health Assembly in May 2014 and endorsed as part of SDG Target 3.3 by the UN in September 2015. It represents a paradigm shift from prior strategies:
| Era | Strategy | Focus |
|---|---|---|
| 1994-2005 | DOTS | Basic case detection + standardized treatment |
| 2006-2015 | Stop TB | HIV-TB, MDR-TB, private sector engagement |
| 2015-2035 | End TB | Holistic health + social interventions, zero deaths |
Between 2000-2014, DOTS and Stop TB together saved 43 million lives and met the MDG target of halting TB. However, incidence rates barely declined, because TB is deeply linked to poverty and social determinants.
Vision and Goal
- Vision: A world free of tuberculosis - zero deaths, disease, and suffering due to TB
- Goal: End the global TB epidemic
Milestones and Targets
| Indicator | 2020 Milestone | 2025 Milestone | 2030 (SDG) Target | 2035 (End TB) Target |
|---|---|---|---|---|
| Reduction in TB deaths (vs. 2015) | 35% | 75% | 90% | 95% |
| Reduction in TB incidence rate (vs. 2015) | 20% (<85/100,000) | 50% (<55/100,000) | 80% (<20/100,000) | 90% (<10/100,000) |
| TB families facing catastrophic costs | 0% | 0% | 0% | 0% |
Three Pillars and 10 Components
Pillar 1: Integrated, patient-centred care and prevention
- Early diagnosis of TB including universal drug-susceptibility testing; systematic screening of contacts and high-risk groups
- Treatment of all people with TB including drug-resistant TB, with patient support
- Collaborative TB/HIV activities and management of comorbidities
- Preventive treatment of persons at high risk, and vaccination against TB
Pillar 2: Bold policies and supportive systems
5. Political commitment with adequate resources for TB care and prevention
6. Engagement of communities, civil society organizations, and all public and private providers
7. Universal health coverage policy and regulatory frameworks for case notification, vital registration, quality and rational use of medicines, and infection control
8. Social protection, poverty alleviation, and action on other determinants of TB
Pillar 3: Intensified research and innovation
9. Discovery, development, and rapid uptake of new tools, interventions, and strategies
10. Research to optimize implementation and impact, and promote innovations
Four Principles
- Government stewardship and accountability, with monitoring and evaluation
- Strong coalition with civil society organizations and communities
- Protection and promotion of human rights, ethics and equity
- Adaptation of the strategy and targets at country level, with global collaboration
The 90-90-90 Global Plan Targets
- Reach 90% of all people with TB and place them on appropriate therapy
- Reach 90% of key/vulnerable populations
- Achieve 90% treatment success rate for all people diagnosed
Key Populations
Three categories of people at increased risk:
- Increased exposure - prisoners, miners, sex workers, healthcare workers, contacts of TB patients, people in overcrowded/poorly ventilated environments
- Limited access to services - migrants, women in gender-disparate settings, children, homeless people, indigenous groups, refugees
- Increased biological/behavioral risk - people living with HIV, diabetics, those on immunosuppressive therapy, malnourished, tobacco users, alcohol-use disorder, injecting drug users
Four Barriers Identified
- Weak health systems
- Underlying determinants (poverty, undernutrition, migration, ageing, risk factors like diabetes and silicosis)
- Lack of effective tools (point-of-care tests, shorter regimens, effective vaccine)
- Continuous unmet funding needs
Progress Status (as of 2025-2026)
The strategy is significantly off track. According to the World TB Day 2026 review:
- Between 2015-2024, global TB incidence declined by only ~12.3%, far short of the 50% target for 2025
- The COVID-19 pandemic severely disrupted TB services and set back progress
- The WHO South-East Asia Region (which accounts for >45% of global TB burden) is reviewing its gaps in this milestone year of 2025
- Funding remains well below the target of US$22 billion per year needed by 2027
- Psychosocial care and financial protection for TB-affected families remain largely unachieved
Source: Park's Textbook of Preventive and Social Medicine, pp. 237-239
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