Abstract
This review article discusses how social approaches to tuberculosis elimination might contribute to realizing the targets stipulated in the World Health Organization’s (WHO) End TB Strategy (2016–2035), with an emphasis on opportunities for progress in Asia and the Pacific. Many factors known to advance tuberculosis transmission and progression are pervasive in Asia and the Pacific, such as worsening drug resistance, unregulated private sector development, and high population density. This review article argues that historically successful social solutions must be revisited and improved upon if current worldwide tuberculosis rates are to be sustainably reduced in the long term. For the ambitious targets laid down in the WHO’s End TB Strategy to be met, biomedical innovations such as point-of-care diagnostics and new treatments for multidrug-resistant tuberculosis (MDR-TB) must be implemented alongside economic, social, and environmental interventions. Implementing social, environmental, and economic interventions alongside biomedical innovations and universal healthcare coverage will, however, only be possible if the health and other government sectors, civil society, and at-risk populations unite to work collaboratively in coming years.
Highlights
This review article discusses how social approaches to tuberculosis elimination might contribute to realizing the targets laid down in the World Health Organization’s (WHO) End TB Strategy (2016–2035), focusing on opportunities for progress in the Asia–Pacific region
Of the estimated 1.7 billion people asymptomatically infected with Mycobacterium tuberculosis worldwide, only 5–15% will progress to active tuberculosis disease during their lifetime
Of the approximately 10.4 million people who fell ill with tuberculosis in 2016, 56% were in five countries: India, Indonesia, China, the Philippines, and Pakistan, in descending order of the number of incident cases in each country [2]
Summary
This review article discusses how social approaches to tuberculosis elimination might contribute to realizing the targets laid down in the World Health Organization’s (WHO) End TB Strategy (2016–2035), focusing on opportunities for progress in the Asia–Pacific region. Of the estimated 1.7 billion people asymptomatically infected with Mycobacterium tuberculosis worldwide (said to have latent tuberculosis infection), only 5–15% will progress to active (symptomatic) tuberculosis disease during their lifetime. The World Health Organization’s End TB Strategy (2016–2035) aims to end the global tuberculosis epidemic by 2035 [4]. The strategy includes targets to reduce absolute mortality by 95% and incidence by 90% between 2015 and 2035, and to make sure that tuberculosis-affected families no longer have to bear catastrophic tuberculosis-related costs by 2030 [4,5]. While the strategy’s long-term vision is to eliminate tuberculosis globally, defined as less than one new tuberculosis case per million people per year, executing the time-bound pledge to “end the global tuberculosis epidemic” would mean reducing the global incidence rate from greater than 1000 new cases per million people in 2015 to less than 100 new cases per million people by 2035 [5]
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