Promoting Universal and Equitable Access to Quality TB Diagnosis and Treatment for All
The first objective focuses on intensifying and improving case-finding to detect as many cases of TB as possible, as early as possible. This will require a comprehensive set of activities that begin with ensuring the availability of basic, quality TB services nationwide and then include the following:
- Conducting a detailed assessment of where the missing TB cases might be found, including reasons for diagnostic delay. The "onion model" framework can help to assess the fraction of TB cases unaccounted for in TB notification data. Fig. 6 shows a framework for analyzing and identifying potentially effective strategies to improve case detection.
- Initiatives for engaging all health care providers, namely public-public and public-private mix (PPM) approaches, should be further strengthened and institutionalized, together with the dissemination of the International Standards for Tuberculosis Care.
- Developing TB strategies for high-risk groups that are tailored to the specific characteristics of each risk group and the country’s unique environment.
- Developing approaches to minimizing access barriers, especially for the poor and vulnerable, including social and financial risk protection for vulnerable populations.
The focus on TB high-risk groups and vulnerable populations will be increasingly important in the Region because it has historically been shown that a decline in TB incidence leads to disease concentration among specific segments of the population. It is, therefore, critically important for national TB programmes to maintain the focus on TB high-risk groups, even if TB control successes among the general population lead to decreased attention and political commitment.