Situational analysis of 10 countries with a high burden of drug-resistant tuberculosis 2 years post-UNHLM declaration: progress and setbacks in a changing landscape
Objectives: Globally, drug-resistant tuberculosis (DR-TB) is the leading cause of death globally related to antimicrobial resistance, affecting 500,000 emergent cases annually. In 2018, the first United Nations High-Level Meeting (UNHLM) on tuberculosis declared DR-TB a global public health priority...
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doaj-bb5ef6f4b50f4db4a1803f9d478bdab12021-07-23T04:47:39ZengElsevierInternational Journal of Infectious Diseases1201-97122021-07-01108557567Situational analysis of 10 countries with a high burden of drug-resistant tuberculosis 2 years post-UNHLM declaration: progress and setbacks in a changing landscapeIgnacio Monedero-Recuero0Medea Gegia1Douglas Fraser Wares2Sarabjit S. Chadha3Fuad Mirzayev4Unitat d'Atenció Territorial a la Cronicitat i Complexitat Garraf, Institut Català de la Salut, Departament de Salut, Generalitat de Catalunya, Barcelona, Spain; TB-HIV Department, International Union against Tuberculosis and Lung Disease, Paris, France; Corresponding author at: International Union against Tuberculosis and Lung Disease, 68, boulevard Saint-Michel, F-75006 Paris, France.Prevention, Diagnosis, Treatment, Care and Innovation Unit, Global TB Programme, World Health Organization, Geneva, SwitzerlandKNCV Tuberculosis Foundation, The Hague, The NetherlandsFoundation for Innovative New Diagnostics (FIND), New Dehli, IndiaPrevention, Diagnosis, Treatment, Care and Innovation Unit, Global TB Programme, World Health Organization, Geneva, SwitzerlandObjectives: Globally, drug-resistant tuberculosis (DR-TB) is the leading cause of death globally related to antimicrobial resistance, affecting 500,000 emergent cases annually. In 2018, the first United Nations High-Level Meeting (UNHLM) on tuberculosis declared DR-TB a global public health priority. Bold country targets were established for 2018–2022. This study reviews the DR-TB situation in 2018, and the UNHLM target accomplishments in 10 high-burden countries (HBCs). Methods: An ecological descriptive analysis of the top 10 DR-TB HBCs (Bangladesh, China, India, Indonesia, Myanmar, Nigeria, Pakistan, Philippines, Russian Federation, and South Africa), which share 70% of the global DR-TB burden, was undertaken, complemented by a cascade-of-care analysis and a survey gathering additional information on key advances and setbacks 2 years after the UNHLM declaration. Results: Most countries are showing historic advances and are on track for the 2018 and 2019 targets. However, according to the cascade-of-care, none of the countries are capable of providing effective care for 50% of the estimated patients. Increasing levels of fluoroquinolone resistance and access to timely susceptibility testing can jeopardize ongoing adoption of shorter, all-oral treatment regimens. The programmatic management of DR-TB in children remains minimal. Achievements for 2020 and beyond may be affected significantly by the coronavirus disease 2019 (COVID-19) pandemic. Conclusion: Triggered by the COVID-19 pandemic, there is a global risk of recoil in DR-TB care with long-term consequences in terms of deaths, suffering and wider transmission. Investment to support DR-TB services is more important now than ever to meet the aspirations of the UNHLM declaration.http://www.sciencedirect.com/science/article/pii/S1201971221005117TuberculosisUNHLMDR-TBMulti-drug-resistant tuberculosisHigh-burden countriesCOVID-19 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ignacio Monedero-Recuero Medea Gegia Douglas Fraser Wares Sarabjit S. Chadha Fuad Mirzayev |
spellingShingle |
Ignacio Monedero-Recuero Medea Gegia Douglas Fraser Wares Sarabjit S. Chadha Fuad Mirzayev Situational analysis of 10 countries with a high burden of drug-resistant tuberculosis 2 years post-UNHLM declaration: progress and setbacks in a changing landscape International Journal of Infectious Diseases Tuberculosis UNHLM DR-TB Multi-drug-resistant tuberculosis High-burden countries COVID-19 |
author_facet |
Ignacio Monedero-Recuero Medea Gegia Douglas Fraser Wares Sarabjit S. Chadha Fuad Mirzayev |
author_sort |
Ignacio Monedero-Recuero |
title |
Situational analysis of 10 countries with a high burden of drug-resistant tuberculosis 2 years post-UNHLM declaration: progress and setbacks in a changing landscape |
title_short |
Situational analysis of 10 countries with a high burden of drug-resistant tuberculosis 2 years post-UNHLM declaration: progress and setbacks in a changing landscape |
title_full |
Situational analysis of 10 countries with a high burden of drug-resistant tuberculosis 2 years post-UNHLM declaration: progress and setbacks in a changing landscape |
title_fullStr |
Situational analysis of 10 countries with a high burden of drug-resistant tuberculosis 2 years post-UNHLM declaration: progress and setbacks in a changing landscape |
title_full_unstemmed |
Situational analysis of 10 countries with a high burden of drug-resistant tuberculosis 2 years post-UNHLM declaration: progress and setbacks in a changing landscape |
title_sort |
situational analysis of 10 countries with a high burden of drug-resistant tuberculosis 2 years post-unhlm declaration: progress and setbacks in a changing landscape |
publisher |
Elsevier |
series |
International Journal of Infectious Diseases |
issn |
1201-9712 |
publishDate |
2021-07-01 |
description |
Objectives: Globally, drug-resistant tuberculosis (DR-TB) is the leading cause of death globally related to antimicrobial resistance, affecting 500,000 emergent cases annually. In 2018, the first United Nations High-Level Meeting (UNHLM) on tuberculosis declared DR-TB a global public health priority. Bold country targets were established for 2018–2022. This study reviews the DR-TB situation in 2018, and the UNHLM target accomplishments in 10 high-burden countries (HBCs). Methods: An ecological descriptive analysis of the top 10 DR-TB HBCs (Bangladesh, China, India, Indonesia, Myanmar, Nigeria, Pakistan, Philippines, Russian Federation, and South Africa), which share 70% of the global DR-TB burden, was undertaken, complemented by a cascade-of-care analysis and a survey gathering additional information on key advances and setbacks 2 years after the UNHLM declaration. Results: Most countries are showing historic advances and are on track for the 2018 and 2019 targets. However, according to the cascade-of-care, none of the countries are capable of providing effective care for 50% of the estimated patients. Increasing levels of fluoroquinolone resistance and access to timely susceptibility testing can jeopardize ongoing adoption of shorter, all-oral treatment regimens. The programmatic management of DR-TB in children remains minimal. Achievements for 2020 and beyond may be affected significantly by the coronavirus disease 2019 (COVID-19) pandemic. Conclusion: Triggered by the COVID-19 pandemic, there is a global risk of recoil in DR-TB care with long-term consequences in terms of deaths, suffering and wider transmission. Investment to support DR-TB services is more important now than ever to meet the aspirations of the UNHLM declaration. |
topic |
Tuberculosis UNHLM DR-TB Multi-drug-resistant tuberculosis High-burden countries COVID-19 |
url |
http://www.sciencedirect.com/science/article/pii/S1201971221005117 |
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