TABLE 4

Adaptation of the post-2015 global tuberculosis (TB) strategy to low-incidence countries

Priority action areaKey interventionsGlobal strategy pillars and components
1Ensure political commitment, funding and stewardship for planning and essential services of high qualityPolitical commitment and financing (plans, targets and leadership) Advocacy from civil society, communities and other stakeholders Central coordination, management and staffing for  TB elimination, including training, laboratory capacity,  TB test and drug forecasting and management, and  surveillance Partnerships among ministries, sectors and stakeholders1A−D 2A−D
2Address the most vulnerable and hard-to-reach groupsMapping of TB risk groups, including all groups with elevated  TB incidence and hard-to-reach groups Analysing and addressing barriers to access and adherence Social support and protection Addressing underlying social determinants1A−D 2B−D
3Address special needs of migrants and cross-border issuesUndertaking epidemiological assessment and proper surveillance Ensuring access to culturally sensitive health services Social support Establishment of cross-border collaboration Considering selective screening (pre- and/or post-entry) Addressing social determinants1A−D 2B−D
4Undertake screening for active TB and LTBI in TB contacts and selected high-risk groups, and provide appropriate treatmentContact investigation Outbreak management Consideration and prioritisation of other screening activities  on the basis of mapping of risk groups and assessing  benefits, risks and costs Monitoring for effectiveness of screening programmes  and policies1A+D
5Optimise the prevention and care of drug-resistant TBUniversal rapid drug susceptibility testing Optimised treatment, care, support and social protection Drug regulation and management1A−D 2A−D 3A−B
6Ensure continued surveillance, programme monitoring and evaluation and case-based data managementEnforcing compulsory notification Establishing an electronic case-based TB registry Implementing a core set of indicators for surveillance and  monitoring of evaluation Use of molecular epidemiology tools when needed Linkage and integration with other surveillance systems A monitoring and evaluation framework Regular monitoring of implementation, with periodic evaluation  and impact assessment2A−C
7Invest in research and new toolsMobilisation of financial resources for TB research Influencing the research agenda of main institutions Support for national and international capacity building for research3A−B
8Support global TB prevention, care and controlContribution and mobilisation of financial resources Promotion of global TB advocacy and visibility Contributions to global TB surveillance, monitoring and evaluation Support for bilateral and multilateral collaboration and technical  assistance1−3
  • LTBI: latent TB infection.