title: Planning to improve global health: the next decade of tuberculosis control.
abstract: The Global Plan to Stop TB 2006-2015 is a road map for policy-makers and managers of national programmes. It sets out the key actions needed to achieve the targets of the Millennium Development Goals relating to tuberculosis (TB): to halve the prevalence and deaths by 2015 relative to 1990 levels and to save 14 million lives. Developed by a broad coalition of partners, the plan presents a model approach combining interventions that can feasibly be supplied on the ground. The main areas of activity set out in the plan are: scaling up interventions to control tuberculosis; promoting the research and development of improved diagnostics, drugs and vaccines; and engaging in related activities for advocacy, communications and social mobilization. Scenarios for the planning process were developed; these looked at issues both globally and in seven epidemiological regions. The scenarios made ambitious but realistic assumptions about the pace of scale-up and implementation coverage of the activities. A mathematical model was used to estimate the impact of scaling up current interventions based on data from studies of tuberculosis biology and from experience with tuberculosis control in diverse settings. The estimated costs of the activities set out in the Global Plan were based on implementing interventions and researching and developing drugs, diagnostics and vaccines; these costs were US$ 56 billion over 10 years. When translated into cost per disability adjusted life year averted, these costs compare favourably with those of other public health interventions. This approach to planning for global tuberculosis control is a valuable example of developing plans to improve global health that has relevance for other health issues.
authors.affiliation: Stop TB Department, WHO, Geneva, Switzerland.
authors.forename: Dermot
authors.initials: D
authors.lastname: Maher
authors.forename: Chris
authors.initials: C
authors.lastname: Dye
authors.forename: Katherine
authors.initials: K
authors.lastname: Floyd
authors.forename: Andrea
authors.initials: A
authors.lastname: Pantoja
authors.forename: Knut
authors.initials: K
authors.lastname: Lonnroth
authors.forename: Alasdair
authors.initials: A
authors.lastname: Reid
authors.forename: Eva
authors.initials: E
authors.lastname: Nathanson
authors.forename: Thad
authors.initials: T
authors.lastname: Pennas
authors.forename: Uli
authors.initials: U
authors.lastname: Fruth
authors.forename: Jane
authors.initials: J
authors.lastname: Cunningham
authors.forename: Heather
authors.initials: H
authors.lastname: Ignatius
authors.forename: Mario C
authors.initials: MC
authors.lastname: Raviglione
authors.forename: Irene
authors.initials: I
authors.lastname: Koek
authors.forename: Marcos
authors.initials: M
authors.lastname: Espinal
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control; D003140:Communicable Disease Control / Q000191:economics / Q000639:trends*; D023801:Directly Observed Therapy; D005381:Financing, Organized; D014943:Global Health; D040361:Healthy People Programs; D006801:Humans; D007391:International Cooperation; D015995:Prevalence; D019057:Quality-Adjusted Life Years; D014376:Tuberculosis / Q000453:epidemiology; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*