The World Health Organization (WHO) is launching a new Framework for collaborative action on TB and comorbidities to address the limited uptake of collaborative activities to reduce the burden of TB and comorbidities and to support countries in enabling access to people-centred care. The Framework is designed to stimulate action, recognising that addressing health-related risk factors and comorbidities among people with TB is essential to end the TB epidemic.

The Framework outlines the key steps to establish and strengthen collaboration across health programmes and across sectors for delivering people-centered services for TB and comorbidities, provides guidance on planning, implementation and evaluation of these services and is designed to facilitate scale-up of new WHO recommendations on TB, comorbidities and health-related risk factors.  

“The Framework for collaborative action on TB and comorbidities aims to alleviate the burden of those affected along their pathway of care, and increase access to high quality prevention and care for people with TB and comorbidities, at the same place,” said Dr Tereza Kasaeva, Director of WHO’s Global Tuberculosis Programme. “We urge countries to use the framework to support the roll out of people-centric approaches to end TB suffering and save lives.” 

Evidence tells us that five key risk factors drive the TB pandemic: alcohol use disorder, diabetes, HIV, tobacco smoking and undernutrition. In 2020, these risk factors accounted for an alarming 45% of all TB episodes. People with TB can also experience mental health disorders, drug use disorders and viral hepatitis, which can lead to poorer TB treatment outcomes and lowered quality of life. While there has been a focus for TB-HIV collaborative activities for decades – with tangible results that have reduced deaths and suffering due to TB – action on TB and other co-morbidities has languished. The Framework attempts to put the spotlight on TB and HIV as well as other comorbidities and multimorbidity – as a key concern for health programmes. 

“As we move towards universal health coverage, a shift is needed towards health systems designed for people, with people. The Framework for collaborative action on TB and comorbidities aims to do just this to ensure people-centred services for people living with TB” stressed WHO’s Assistant Director General for Universal Health Coverage/Communicable and Non-communicable diseases, Dr Ren Minghui. 

The development of the Framework for collaborative action on TB and comorbidities has been informed by interviews with survivors of TB and comorbidities, focus group discussions with staff from health programmes and clinicians, and through consultation with key stakeholders, including civil society.