The End TB Strategy

Ending the TB epidemic is a target under the Sustainable Development Goals that requires implementing a mix of biomedical, public health target and socioeconomic interventions along with research and innovation. The End TB Strategy encompasses a package of interventions that fall under three pillars. The first pillar – integrated, patient-centred care and prevention - puts patients at the heart of service delivery. The second pillar – bold policies and supportive systems – requires intense participation across government, communities and private stakeholders. The third pillar – intensified research and innovation – is critical to break the trajectory of the TB epidemic and reach the global targets.

The End TB Strategy builds on three strategic pillars underpinned by four key principles focusing on government stewardship, a strong coalition made up of civil society and communities, promoting human rights and equity, and adaptation of the Strategy at the country level. The success of the Strategy in driving down TB deaths and illness will depend on countries respecting the key principles as they implement the interventions outlined in each pillar.

To successfully roll-out the Strategy, countries and partners will need to focus on advocacy, baseline preparedness and collaboration. Implementing the End TB Strategy requires intensified action from and beyond the ministries of health, in close collaboration with all stakeholders including other ministries, communities, civil society and the private sector. It is essential for countries to “know their epidemic” by assessing the TB situation on the ground. The creation of a high-level multi-stakeholder coordinating mechanism led by the national government can also significantly enhance the implementation of the End TB Strategy.

Reliable measurement of progress in reducing TB incidence, TB deaths and catastrophic costs is essential. High-performance TB surveillance within national health information systems and national vital registration systems must be in place to monitor TB incidence and TB mortality, while special surveys are the most appropriate way to measure catastrophic costs. All countries should reach the ≥90% targets for treatment coverage, TB treatment success rate, preventive treatment coverage and uptake of new diagnostics and drugs by 2025 at the latest. In addition, 100% of TB-affected families should be protected from catastrophic costs.

Global elimination of TB as a public health problem, defined as <1 TB case per million population, is a long-term vision of WHO’s End TB Strategy, while the time-bound global target is to ‘end the global TB epidemic’, bringing down TB incidence, the number of TB deaths, and the percentage of TB patients and their households that face catastrophic costs by 2035.

In 2014, WHO released an action framework as part of the post-2015 global TB Strategy. This framework provided a structured approach for TB elimination, incorporating principles and recommended actions tailored to address specific challenges in settings with low TB incidence and regions approaching this threshold. Since then, a more ambitious vision has emerged, extending the concept of TB elimination beyond low-incidence settings. This expanded approach considers high-burden areas, targeting sub-national elimination and the elimination of TB among priority groups within high-burden settings. This expanded approach remains aligned with the End TB Strategy, aiming to accelerate and scale up efforts to address the epidemic more comprehensively.

To expedite progress towards TB elimination by 2050, WHO, in collaboration with key stakeholders, initiated the development of standardized guidance for validating TB elimination, identifying also the respective governance structures to monitor progress.

Learn more:

• An action framework towards TB elimination
• Stakeholder consultation report, 14–15 December 2023
• Stakeholder consultation report, 13–14 June 2024