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:: Box 2.1 The Sustainable Development Goals Goal 1. End poverty in all its forms everywhere Goal 2. End hunger, achieve food security and improved nutrition and promote sustainable agriculture Goal 3. Ensure healthy lives and promote well-being for all at all ages Goal 4. Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all Goal 5. Achieve gender equality and empower all women and girls Goal 6. Ensure availability and sustainable management of water and sanitation for all Goal 7. Ensure access to affordable, reliable, sustainable and modern energy for all Goal 8. Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all Goal 9. Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation Goal 10. Reduce inequality within and among countries Goal 11. Make cities and human settlements inclusive, safe, resilient and sustainable Goal 12. Ensure sustainable consumption and production patterns Goal 13. Take urgent action to combat climate change and its impacts a Goal 14. Conserve and sustainably use the oceans, seas and marine resources for sustainable development Goal 15. Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss Goal 16. Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels Goal 17. Strengthen the means of implementation and revitalize the Global Partnership for Sustainable Development a Acknowledging that the United Nations Framework Convention on Climate Change is the primary international, intergovernmental forum for negotiating the global response to climate change GLOBAL <strong>TUBERCULOSIS</strong> REPORT 2016 :: 7
:: Box 2.2 Sustainable Development Goal 3 and its 13 targets SDG3: Ensure healthy lives and promote well-being for all at all ages Targets 3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100 000 live births 3.2 By 2030, end preventable deaths of new-borns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1000 live births and under-5 mortality to at least as low as 25 per 1000 live births 3.3 By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases 3.4 By 2030, reduce by one third premature mortality from noncommunicable diseases through prevention and treatment and promote mental health and wellbeing 3.5 Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol 3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents 3.7 By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes 3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all 3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination 3.a Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate 3.b Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all 3.c Substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States 3.d Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks TRIPS, Trade-Related Aspects of Intellectual Property Rights raphy (e.g. urban versus rural), wealth (e.g. bottom 40%, or bottom versus top income quintiles) and employment status. Some indicators also give particular attention to specific subpopulations, such as pregnant women, people with disabilities, victims of work injuries and migrants. Disaggregation is intended to inform analysis of within-country inequalities and associated assessments of equity, as a basis for identifying particular areas or subpopulations where progress is lagging and greater attention is needed. This is an important consideration for the TB community, given the influence of socio-economic status and access to health care on TB epidemiology. Chapter 3 of this report includes examples of within-country analyses of TB data; it also illustrates across-country inequities in access to TB diagnosis and treatment using the case fatality ratio (CFR), one of the top 10 indicators for monitoring implementation of the End TB Strategy (see Section 2.2). 2.2 The End TB Strategy In 2012, in anticipation of the end of the eras of the MDGs and Stop TB Strategy, WHO’s Global TB Programme initiated the development of a post-2015 global TB strategy. Following 2 years of consultations, the proposed strategy was discussed at the 2014 World Health Assembly, where it was unanimously endorsed by all Member States. 1 That strategy is now known as the End TB Strategy. 2 The End TB Strategy “at a glance” is shown in Box 2.3. It covers the period 2016–2035 and the overall goal is to “End the global TB epidemic”, defined as around 10 new cases per 100 000 population per year. This is the level found in countries considered to have a low burden of TB in 2015 (Chapter 3). The End TB Strategy has three high-level, overarching indicators and related targets (for 2030, linked to the SDGs, and for 2035) and milestones (for 2020 and 2025). The three indicators are: 1 World Health Assembly. Global strategy and targets for tuberculosis prevention, care and control after 2015 (WHA67.1, Agenda item 12.1). Geneva: World Health Assembly; 2014 (http://apps.who.int/gb/ ebwha/pdf_files/WHA67/A67_R1-en.pdf, accessed 28 July 2016). 2 Uplekar M, Weil D, Lonnroth K, Jaramillo E, Lienhardt C, Dias HM, et al. WHO’s new End TB Strategy. Lancet. 2015;385(9979):1799–1801 (http://www.ncbi.nlm.nih.gov/pubmed/25814376, accessed 28 July 2016). 8 :: GLOBAL <strong>TUBERCULOSIS</strong> REPORT 2016
Page 1 and 2: GLOBAL REPORT TUBERCULOSIS 2016
Page 3 and 4: WHO Library Cataloguing-in-Publicat
Page 5 and 6: :: Abbreviations aDSM AE AIDS ART A
Page 7 and 8: The principal source of financial s
Page 9: Zhumagali Ismailov, Sarah Jackson,
Page 12 and 13: :: Executive Summary Background The
Page 14 and 15: TB prevention services South Africa
Page 16 and 17: Chapter 1 :: Introduction Tuberculo
Page 20 and 21: :: Box 2.3 The End TB Strategy at a
Page 22 and 23: :: TABLE 2.1 Top 10 indicators (not
Page 24 and 25: TABLE 2.2 :: The three TB high-burd
Page 26 and 27: Chapter 3 :: TB disease burden :: K
Page 28 and 29: :: Box 3.1 The WHO Global Task Forc
Page 30 and 31: :: Box 3.2 Updates to estimates of
Page 32 and 33: :: Box 3.3 Updated and interim esti
Page 34 and 35: :: FIG. 3.1 Strengthening national
Page 36 and 37: :: TABLE 3.2 Estimated epidemiologi
Page 38 and 39: :: FIG. 3.3 Estimated TB incidence
Page 40 and 41: :: FIG. 3.5 Global trends in the es
Page 42 and 43: :: FIG. 3.8 Trends in estimated TB
Page 44 and 45: :: FIG. 3.10a Top causes of death w
Page 46 and 47: :: FIG. 3.14 Trends in estimated TB
Page 48 and 49: :: FIG. 3.16 Data sources available
Page 50 and 51: :: TABLE 3.5 Estimated incidence of
Page 52 and 53: :: FIG. 3.20 Estimated incidence of
Page 54 and 55: :: FIG. 3.22 Global progress in imp
Page 56 and 57: :: TABLE 3.6 Number of TB cases fou
Page 58 and 59: :: TABLE 3.7 HIV-negative and HIV-p
Page 60 and 61: :: FIG. 3.29a The prevalence:notifi
Page 62 and 63: :: FIG. 3.31b The average CFR by st
Page 64 and 65: SIM and SINAN case-based databases,
Page 66 and 67: Prompt and accurate diagnosis of tu
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:: FIG. 4.2 New and relapse TB case
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:: FIG. 4.5 Percentage of new and r
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:: FIG. 4.8 Global numbers of notif
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:: TABLE 4.4 National guidance in p
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:: FIG. 4.9 Percentage of bacteriol
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:: FIG. 4.12 Number of MDR/RR-TB ca
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:: FIG. 4.14 Case notification rate
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:: FIG. 4.16a The ten countries wit
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:: Box 4.5 Community contributions
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:: FIG. 4.18 Estimated ART treatmen
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issued in March 2013 and updated in
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:: FIG. 4.22 Treatment outcomes for
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:: Box 4.6 Active TB drug-safety mo
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Prevention of new infections of Myc
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:: TABLE 5.2 TB preventive treatmen
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:: TABLE 5.3 Provision of TB preven
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:: FIG. 5.5 Coverage of BCG vaccina
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This chapter aims to provide a tube
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:: FIG. 6.2 Government spending on
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:: Box 6.1 Implications for TB of e
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:: Box 6.2 Innovations in engaging
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:: Box 6.4 Reforming systems to exp
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:: TABLE 6.1 TB patient social supp
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:: FIG. 6.5 Surveys of costs faced
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:: TABLE 6.3 Status of selected SDG
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Continue current trend (base case s
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can provide insights into progress
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lion, most (US$ 4.4 billion, 67%) i
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:: Box 3.2 Updates to estimates of
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:: FIG. 7.5 Funding for NTP budgets
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:: Box 7.2 International donor fund
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:: FIG. 7.6 Reported funding gaps f
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:: Box 7.3 Methods used to estimate
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:: Box 8.1 WHO’s Global Action Fr
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is critical to allow for the time-s
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:: FIG. 8.2 The global development
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:: FIG. 8.3 The development pipelin
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Annex 1 Access to the WHO global TB
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A data dictionary that defines each
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Annex 2 Country profiles :: FOR 30
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Bangladesh population 2015 :: 161 m
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China population 2015 :: 1 376 mill
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Democratic Republic of the Congo po
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India population 2015 :: 1 311 mill
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Kenya population 2015 :: 46 million
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Myanmar population 2015 :: 54 milli
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Pakistan population 2015 :: 189 mil
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Russian Federation population 2015
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Thailand population 2015 :: 68 mill
Page 168:
Viet Nam population 2015 :: 93 mill
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Central African Republic population
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Lesotho population 2015 :: 2.1 mill
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Namibia population 2015 :: 2.5 mill
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Sierra Leone population 2015 :: 6.5
Page 179 and 180:
Zimbabwe population 2015 :: 16 mill
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WHO African Region WHO MEMBER STATE
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WHO Eastern Mediterranean Region WH
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WHO South-East Asia Region WHO MEMB
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Annex 4 TB burden estimates, notifi
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:: TABLE A4.1 TB incidence estimate
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:: TABLE A4.1 Table TB incidence A4
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:: Table TABLE A4.2 A4.2 Estimates
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Table :: TABLE A4.2 A4.2 Estimates
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:: TABLE A4.3 Measured percentage o
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:: TABLE A4.3 Measured Table A4.3 p
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:: TABLE A4.4 TB case notifications
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:: TABLE A4.4 TB case notifications
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:: TABLE A4.5 Treatment outcomes by
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:: TABLE A4.5 Treatment outcomes by
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ISBN 9 789241 565394 Ending TB by 2
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