BrnYPi6IcAEuW1fOn 4 and 5 July 2014, Rome hosted a global consultation on the elimination of tuberculosis (TB) in low-incidence countries. The event, organised by the World Health Organisation (WHO) and the European Respiratory Society (ERS) in collaboration with the Italian Ministry of Health, aimed at adapting the recently adopted global strategy and targets for TB prevention, care and control after 2015 to the specific context and challenges of low-incidence countries.

More than 30 low-incidence countries were represented at the meeting, together with experts from WHO, ERS, the European Centre for Diseases Control, the Global Fund, the International Organisation for Migration, various research institutes, industry and civil society, including the TB Europe Coalition. Low-incidence countries are those ones with less than 10 TB cases per 100.000 population, including the majority of EU’s countries, the US, Canada, Australia, Cuba and various countries in the Middle East. The TB epidemiology in these countries is characterised by low rate of transmission in general population, occasional outbreaks, high-degree of concentration among vulnerable groups, especially migrants, and majority of cases are the result of latent TB infections become active.

During the two-day event, participants had the chance to input on a draft Action Framework that targets to achieve pre-elimination (10 TB cases per 1 million population) by 2035 and elimination (1 TB cases per 1 million population) by 2050 in low-incidence countries. The draft Framework also identifies priority action areas to achieve the aforementioned targets and showcases case studies based on countries experiences.

The plan will be finalised and approved by WHO in September 2014, after which strong political commitment from low-incidence countries will be needed to ensure its implementation via adapted national TB plans. Meaningful engagement of civil society and communities affected by TB will also be crucial to the process if we are to reach vulnerable groups and ensure full access to TB prevention and treatment.

Achieving TB eradication will require addressing TB as a social and not only medical issue and a truly global vision. Improving the living conditions of the most vulnerable populations is crucial in countries where the epidemic is concentrated among a limited number of high-risks groups and poor people.  Most importantly, in a globalised world, sustainable elimination in any country in spite of its incidence level, cannot be achieved without bold policies to fight TB in countries where most of the cases are concentrated. Only continuous technical and financial support to fight TB worldwide as well as the development of improved tools and technologies to prevent, diagnose and treat TB patients, will allow a dramatic reduction of the global burden of TB.