Addressing TB comorbidities and risk factors is central to the World Health Organization (WHO) End TB Strategy. These guidelines consolidate the latest WHO recommendations on TB and key comorbidities. The guidelines are a living document and will include dedicated sections for each key TB comorbidit...y or health-related risk factor. The first edition focused on HIV-associated TB, updating the WHO policy on collaborative TB/HIV activities. This second edition expands on the previous edition and consolidates new and existing recommendations on interventions to address undernutrition in people with TB, to provide food assistance to households of people with TB in food-insecure settings, and to screen for TB among those who are undernourished or food insecure.
HIV and undernutrition are leading health-related drivers of TB globally, both negatively impacting on TB treatment outcomes. TB remains the top cause of death among people with HIV, and nearly half of people with TB are undernourished, which in turn increases their risk of early mortality.
These guidelines are intended for use by ministries of health, particularly TB programmes and departments addressing related health conditions and risk factors, by implementing partners, technical and funding agencies, civil society, affected communities, clinicians, and by public health practitioners.
The guidelines are complemented by an operational handbook, that provides practical advice on how to implement the recommendations at the scale needed to achieve national and global impact.
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PHSM are vital in reducing the risk and scale of infectious disease transmission and lowering hospitalization and deaths. Examples include contact tracing, quarantine and isolation, mask use, ventilation, school or workplace measures, mobility restrictions and travel requirements.
While these mea...sures are essential, decision-making on PHSM becomes particularly complex during rapidly evolving health emergencies, with incomplete information and under significant public and political pressure, especially when the pathogen is novel or poorly understood. In such contexts, guidance needs to be agile and responsive, developed and adapted based on emerging evidence and shifting epidemiological patterns. Decision-makers are frequently confronted with difficult trade-offs, having to balance measures that are:
─ effective but socially disruptive;
─ cost-effective but logistically burdensome;
─ beneficial for public health but economically disruptive; or
─ practical but inequitable or unethical
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The Best Buys for Disease Elimination is a practical, evidence-based guide to the most effective actions for countries to implement in order to eliminate communicable diseases. The guide highlights the efficient use of resources and prioritizing populations in vulnerable situations.
“The Region... of the Americas is advancing steadily towards the elimination of communicable diseases,” said Dr. Jarbas Barbosa, PAHO Director. “To achieve this, it is necessary to increase and sustain high vaccination coverage, engage communities to expand access to diagnosis and treatment, strengthen surveillance, and bring integrated services to marginalized communities, incarcerated populations, and those living in informal settlements,” he added.
For each disease and condition included in the Elimination Initiative, the Best Buys are presented as one-page documents with clear, accessible information. Each Best Buy summarizes expected impact goals, disease elimination targets, key operational indicators, and priority interventions that have proven to be cost-effective in different contexts.
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This plan, approved by the Organization’s 62nd Directing Council, was shaped by extensive consultations with countries and stakeholders, and commits to transformative health outcomes over the next six years, tackling noncommunicable diseases (NCDs), mental health, health security, fragmented healt...h systems and services, and the elimination of communicable diseases, amongst others.
“The COVID-19 pandemic taught us that the Region of the Americas is stronger when we work together,” said Dr. Jarbas Barbosa, PAHO Director. “This Strategic Plan harnesses our collective strength to build resilient health systems, reduce disease burden, and improve health and well-being for all across the Americas.”
The plan builds on lessons from the COVID-19 pandemic, which exposed gaps in health systems while highlighting the power of joint action. It targets measurable impacts in countries, such as reducing maternal mortality, reversing rising suicide rates, and eliminating diseases like leprosy and Chagas.
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The WHO handbook “Epidemiological Data Analysis for the Early Warning Alert and Response Network (EWARN) in Humanitarian Emergencies” explains how to collect, analyse, interpret, and share health data during crises such as conflicts or natural disasters. It is a practical guide for health and su...rveillance officers to detect disease outbreaks early and guide quick public health responses. The document outlines steps for managing data at different levels (local, regional, national), analysing disease trends by time, place, and person, and using indicators to monitor outbreak risks. It also provides methods for interpreting and communicating results clearly to decision-makers to support effective health interventions in emergencies.
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Les épidémies et les pandémies font partie des plus grandes menaces pesant sur un monde sûr et sain. Elles sont en augmentation et, dans le monde connecté d’aujourd’hui, elles se répandent plus loin et plus vite que jamais. Mais avec des mesures de préparation et d’intervention effica...ces, nous pouvons limiter leurs effets, voire les enrayer complètement.
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