title: Shifting from tuberculosis control to elimination: Where are we? What are the variables and limitations? Is it achievable?
abstract: Tuberculosis (TB) is a priority in terms of incidence and mortality, with about 10.4 million new incident cases and 1.8 million deaths in 2015. The End-TB strategy recently launched by the World Health Organization in the context of the post-2015 agenda, aimed to achieve TB elimination, represents an evolution of the previous historical strategies originally aimed to achieve TB control. Globally, the current decline in TB incidence is rather slow at approximately 1,5% per year to reach the TB pre-elimination phase by 2035 (A more aggressive approach based on diagnosis and treatment of latently infected individuals has been proposed in the context of TB elimination to ensure future generations free of TB. We describes 4 scenarios which, combined, describe the TB epidemiology in a given setting: 1) in absence of interventions, 2) with early TB diagnosis and effective treatment, 3) with irregular TB treatment, 4) with TB co-infected by HIV not undergoing anti-retroviral treatment. To achieve TB Elimination, a more concerted action by funders and governments will be required for further investments into TB prevention, detection and treatment.
authors.affiliation: World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Maugeri Institute, IRCCS, Via Roncaccio 16, 21049, Tradate, Italy.
authors.forename: Rosella
authors.initials: R
authors.lastname: Centis
authors.affiliation: World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Maugeri Institute, IRCCS, Via Roncaccio 16, 21049, Tradate, Italy; Public Health Consulting Group, Lugano, Switzerland.
authors.forename: Lia
authors.initials: L
authors.lastname: D'Ambrosio
authors.affiliation: Centre for Clinical Microbiology, Division of Infection and Immunity, University College London and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, UK.
authors.forename: Alimuddin
authors.initials: A
authors.lastname: Zumla
authors.affiliation: World Health Organization Collaborating Centre for Tuberculosis and Lung Diseases, Maugeri Institute, IRCCS, Via Roncaccio 16, 21049, Tradate, Italy. Electronic address: giovannibattista.migliori@fsm.it.
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Migliori
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D035843:Biomedical Research; D060740:Disease Eradication; D014943:Global Health; D006801:Humans; D015994:Incidence; D012109:Research Support as Topic; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology / Q000517:prevention & control*; D014944:World Health Organization
chemical_list: D000995:Antitubercular Agents
keywords: Elimination; LTBI; MDR-TB; Strategy; Tuberculosis