Guidance For National Strategic Planning For Tuberculosis

A national strategic plan (NSP) for TB is a key document that guides national authorities and stakeholders on how to comprehensively address the TB epidemic through interventions within the health and across other sectors. The NSP translates global, regional and national commitments into national and subnational targets and activities to be implemented to achieve these targets, and provides the basis for mobilizing domestic and external resources for the TB response. It outlines the overall goal(s), strategies and priority interventions, and provides guidance on how these are coordinated across sectors. This guidance is intended for use in developing standalone TB strategic plans, or TB interventions as part of multidisease or health sector plans. It describes key considerations and steps for strategic planning for TB in line with the World Health Organization’s End TB strategy, and the proposed structure of the NSP. The target audience of this publication are all stakeholders involved in national strategic planning for TB (e.g., ministry of health, other government ministries, private sector, civil society, affected communities, academic and research institutions, and technical and funding partners). The current document is an update to the 2015 Toolkit to develop a national strategic plan for TB prevention, care and control. It was developed to better align with global commitments and latest developments in TB and in public health, and builds on lessons learned from using the 2015 toolkit.

The importance of community and civil society engagement to end TB has been highlighted in various strategies of global commitments. The WHO End TB Strategy, aligned with the United Nations Sustainable Development Goals, emphasizes the role of communities and civil society in ending the TB epidemic by 2030. Furthermore, the political declaration of the 2081 United Nations High-level Meeting on TB Highlights the need to develop integrated, people-centred, community-based, gender-responsive health services. This guidance was developed in collaboration with civil society and other partners, in order to further strengthen engagement and leverage capacities of communities' and civil society in line with the End TB Strategy. The guidance emphasizes the complementarity of health systems and community systems; the key roles that people affected by TB should play in planning, decision-making, implementation and monitoring; and the role of ministries of health and their NTPs. It underlines the importance of fair, sustainable financing and of policy environment for community and civil society engagement. Its purpose is to provide guidance for communities and for all stakeholders in the health system for working together to end TB and strengthening people-centred care. Stakeholders in national TB responses include ministries of health, other government ministries, the private sector, civil society and affected communities, academic and research institutions, and technical and funding partners.

There have been calls to revisit the experiences of TB screening campaigns that were widely applied in Europe and North America in the mid-20th century, as well as more recent experiences with TB screening in countries with a high burden of the disease, and to assess their possible relevance for TB care and prevention in the 21st century. In response, WHO has developed guidelines on screening for active TB. An extensive review of the evidence has been undertaken. The review suggests that screening, if done in the right way and targeting the right people, may reduce suffering and death, but the review also highlights several reasons to be cautious. As discussed in detail in this book, there is a need to balance potential benefits against the risks and costs of screening; this conclusion is mirrored by the history of TB screening. This publication presents the first comprehensive assessment by WHO of the appropriateness of screening for active TB since the recommendations made in 1974 by the Expert Committee. However, the relative effectiveness and cost effectiveness of screening remain uncertain, a point that is underscored by the systematic reviews presented in this guideline. Evidence suggests that some risk groups should always be screened, whereas the prioritization of other risk groups as well as the choice of screening approach depend on the epidemiology, the health-system context, and the resources available. This book sets out basic principles for prioritizing risk groups and choosing a screening approach; it also emphasizes the importance of assessing the epidemiological situation, adapting approaches to local situations, integrating TB screening into other health-promotion activities, minimizing the risk of harm to individuals, and engaging in continual monitoring and evaluation. It calls for more and better research to assess the impact of screening and to develop and evaluate new screening tests and approaches.

The Operational guidance on adaptation and implementation of WHO’s Multisectoral Accountability Framework to end TB (MAF-TB) provides practical advice on key approaches and interventions needed to establish the MAF-TB at the national (and local) levels with concrete country examples, best practices and case studies under each suggested approach and interventions. It is intended for use by all stakeholders involved in their national TB response, including ministries of health and other relevant government ministries and bodies, national TB programmes (or their equivalents in ministries of health), other relevant national programmes, parliamentarians, the private sector, international organizations, nongovernmental and civil society organizations and TB-affected communities involved in planning, implementation, monitoring and evaluation and review of the TB response. The stakeholders involved may vary across countries depending on several factors, including the epidemiology and determinants of TB, the institutional arrangements for TB care and prevention and the degree of devolution of the political and health governance system.

The purpose of this document is to describe and explain how to apply the principles of good clinical practices (GCP) and good data management practices (GDMP) in the context of national tuberculosis (TB) surveys, namely national population-based surveys of TB prevalence, anti-TB drug resistance surveys, and surveys of costs faced by TB patients and their households. The primary target audience for this handbook includes national TB programmes (NTPs) and partners involved in the planning, design, conduct, oversight, analysis and reporting of a national TB survey. The in-country national survey coordination team is responsible for ensuring that all survey team members conform to this guidance document.

The purpose of this handbook is to bring together in summarized form the issues, recommended strategies and practical measures involved in addressing each of the components of the WHO Stop TB Strategy. This handbook has been prepared principally for use by national TB control programme managers and staff, as well as partner organizations and professionals involved in implementing TB control activities. Readers are provided with a concise account of the essential elements of a comprehensive TB control programme and an overview of the full range of activities that need to be implemented to achieve the TB control targets set for 2015. An adequate strategy for the control of tuberculosis (TB) globally calls for a comprehensive approach to address all of the main constraints facing TB control, including emerging challenges, as well as the main risk factors influencing the incidence of TB. Consequently, the scope of activities undertaken by national TB control programmes has greatly increased