Vaccines and Global Health: The Week in Review has expanded its coverage of new reports, books, research and analysis published independent of the journal channel covered in Journal Watch below. Our interests span immunization and vaccines, as well as global public health, health governance, and associated themes. If you would like to suggest content to be included in this service, please contact David Curry at: firstname.lastname@example.org
Out of Step 2017 – TB policies in 29 countries
A survey of prevention, testing and treatment policies and practices
MSF; Stop TB Partnership
July 2017 :: 101 pages
Executive Summary [Excerpt]
Although it can be prevented and successfully treated, tuberculosis (TB) is the world’s deadliest infectious disease: in 2015, 1.8 million people died from it.1 While there have been substantial and important innovations in the fight against TB, including faster, more accurate diagnostic tests and the first new medicines in nearly 50 years, deadly gaps remain in implementing and providing access to these advances. Outdated policies, practices and tools for diagnosing, as well as conservatism and inaction in registering and using new TB medicines, are key barriers to turning around the TB epidemic.
Adopting and implementing internationally recognised TB policies and guidelines from the World Health Organization (WHO) is fundamental to ending TB by 2030. But the Out of Step 2017 report reveals that many countries still lag behind in ensuring full implementation of the WHO guidelines and policies that are proven to reduce TB incidence and death.
Out of Step includes the results of a 29-country survey on national TB policies and practices. The report was created to identify gaps in implementation and monitor progress towards ending TB.
While countries have made progress since the 2015 Out of Step report, much more work needs to be done to make sure that these policies are fully implemented across all communities, so that they will make a real difference to people affected by TB.
Diagnosing TB quickly and accurately, so that people receive appropriate treatment, is an imperative first step. While many countries have adopted WHO guidelines and policies for diagnosis, the glacial pace of implementation is costing both lives and livelihoods. In 2015, more than 4 million people with TB went undiagnosed, and less than 25% of people estimated to have drug-resistant TB were diagnosed and treated.1
The first step to closing the deadly diagnostic gap is initial testing for all with Xpert MTB/RIF, a rapid molecular test that can diagnose TB and detect rifampicin resistance in 2 hours. For people with rifampicin-resistant (RR) TB, additional drug-sensitivity testing (DST) should be available so that they can be treated with medicines most likely to be effective. In the 29 countries surveyed, 52% (15) have adopted a policy of ‘Xpert for all’ and 47% (7/15) of them have widely implemented the test. Of all countries that provide initial testing with Xpert MTB/RIF only to high-risk groups (people living with HIV and people at risk for drug-resistant forms of TB), only 54% (15/28) have widely implemented it. Universal DST must be scaled up: 62% (18) of countries recommend it and 50% (9/18) of those have widely implemented it.
With such a low proportion of countries having fully implemented recommended tests, the diagnostic gap remains massive; this deadly gap must be closed…
New Report Reveals Governments are Failing to Prioritize Tuberculosis, the World’s Deadliest Infectious Disease
July 05, 2017
Two days ahead of the G20 summit in Germany, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) and the Stop TB Partnership released a report that shows countries are lagging behind in tackling tuberculosis (TB), introducing the best diagnostic devices, and implementing globally-recommended policies. The third edition of the “Out of Step” report reviews TB policies and practices in 29 countries–which account for 82 percent of the global TB burden–and shows that countries can do much more to prevent, diagnose, and treat people affected by TB.