Union article highlights how the SDG framework can act on determinants and risk factors of TB

The United Nations Sustainable Development Goals (SDGs) framework provides a means to act on the socio-economic determinants of tuberculosis (TB), enabling a much-needed acceleration towards the World Health Organization’s End TB goals in high TB burden countries in South-East Asia and Western Pacific regions.

A discussion of the opportunities to address these determinants of TB disease under the SDGs framework has been published this month in an open-access perspective article, led by the Union South-East Asia Office in the journal Tropical Medicine and Infectious Disease.

In 2014, the World Health Assembly adopted a resolution to make the world free of TB by the year 2035 through the End TB Strategy. However, progress towards ending TB by 2035 is less than expected. It is unlikely that any of the countries in the Asia Pacific (which comprises South-East Asia and the Western Pacific region) will be able to reach all the End TB Strategy’s 2020 milestones.

The article supports the need for improved and accessible diagnosis, treatment and prevention services. However, while recognising these medical interventions are necessary, the authors call attention to the need to mitigate the prevalence of health-related risk factors for TB; action against determinants which relate to exposure, infection, disease, and adverse treatment outcome.

The major socio-economic determinants of TB include factors such as: close contact with a person with infectious TB disease; age; gender; tobacco and alcohol use; malnutrition; HIV infection; diabetes mellitus; exposure to indoor air pollution; silicosis; intake of immunosuppressive drugs/medications; poverty; inequality; overcrowding; food and job insecurity; and weak health systems.

The article discusses how there are opportunities to address these determinants of TB disease under the SDGs framework - a list of 17 global goals, which outline the vision, principles, and commitments of United Nations member countries to a fairer and more sustainable world.

Dr Srinath Satyanarayana, Deputy Director of The Union’s Centre for Operational Research, and lead author of the article, points out that national TB programmes, ministries of health and governments in the 11 high TB burden countries in the Asia Pacific must realise that interventions beyond diagnosis and treatment of TB and TB infection are needed to reduce the risk factors and determinants of TB.

He says “Achieving End TB targets with the current pace of progress is highly challenging and unrealistic. The SDG framework provides an excellent opportunity for acting on several determinants and risk factors of TB. We therefore call upon stakeholders involved in achieving the SDGs and End TB targets to recognise that all goals are highly interlinked, and they need to combine and complement each other’s efforts to end TB and the determinants behind this disease.”

According to Professor Anthony Harries (Senior Advisor at The Union and the senior author on the manuscript) “ending the TB epidemic will require multi-sectoral action. As emphasised in the published manuscript, this can be done by addressing a large number of the non-health related Sustainable Development Goals. Progress towards ending TB should be considered as one of the important yardsticks to measure how well we are doing with achieving these goals and ensuring a fairer and more sustainable world."

The perspective piece ‘An Opportunity to END TB: Using the Sustainable Development Goals for Action on Socio-Economic Determinants of TB in High Burden Countries in WHO South-East Asia and the Western Pacific Regions’ was published in the journal Tropical Medicine and Infectious Disease.

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