WHO CDS TB 2019.10 Eng

COMMITMENTS
ACT
IO N
S
REVIEW
NG
RT I
PO
D RE
M O N I TO R I N G A N
MULTISECTORAL
ACCOUNTABILITY FRAMEWORK
TO ACCELERATE PROGRESS
TO END TUBERCULOSIS
BY 2030
MULTISECTORAL
TO END TUBERCULOSIS
BY 2030
MULTISECTORAL ACCOUNTABILITY FRAMEWORK
TO ACCELERATE PROGRESS TO END TUBERCULOSIS BY 2030
© World Health Organization 2019
Some rights reserved. This work is available under the Creative

Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence
(CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-
nc-sa/3.0/igo).
Under the terms of this licence, you may copy, redistribute and
adapt the work for noncommercial purposes, provided the work
is appropriately cited, as indicated below. In any use of this work,
there should be no suggestion that WHO endorses any specific
organization, products or services. The use of the WHO logo is not
permitted. If you adapt the work, then you must license your work
under the same or equivalent Creative Commons licence. If you
create a translation of this work, you should add the following
disclaimer along with the suggested citation: “This translation was
not created by the World Health Organization (WHO). WHO is not
responsible for the content or accuracy of this translation. The
original English edition shall be the binding and authentic edition”.
Any mediation relating to disputes arising under the licence

shall be conducted in accordance with the mediation rules of the
World Intellectual Property Organization.
Cataloguing-in-Publication (CIP) data. CIP data are available at

http://apps.who.int/iris.
Sales, rights and licensing. To purchase WHO publications,

see http://apps.who.int/bookorders. To submit requests for
commercial use and queries on rights and licensing, see http://
www.who.int/about/licensing.
Third-party materials. If you wish to reuse material from this

work that is attributed to a third party, such as tables, figures or
images, it is your responsibility to determine whether permission
is needed for that reuse and to obtain permission from the
copyright holder. The risk of claims resulting from infringement
of any third-party-owned component in the work rests solely
with the user.
General disclaimers. The designations employed and the

presentation of the material in this publication do not imply the
expression of any opinion whatsoever on the part of WHO
concerning the legal status of any country, territory, city or area
or of its authorities, or concerning the delimitation of its frontiers
or boundaries. Dotted and dashed lines on maps represent
approximate border lines for which there may not yet be full
agreement.
The mention of specific companies or of certain manufacturers’

products does not imply that they are endorsed or nature that
are not mentioned. Errors and omissions excepted, the names of
proprietary products are distinguished by initial capital letters.
All reasonable precautions have been taken by WHO to verify

the information contained in this publication. However, the
published material is being distributed without warranty of any
kind, either expressed or implied. The responsibility for the
interpretation and use of the material lies with the reader. In no
event shall WHO be liable for damages arising from its use.
WHO/CDS/TB/2019.10
Contents
A. Background and rationale 1

B. Definitions and concepts 3
C. The Framework 5
1. Overview of major components, elements and underlying
principles 5
2. National (including local) level – individual countries,
with country adaptation 6
3. Global and regional levels – countries collectively 15
4. How the global/regional and national parts of the
framework are linked 21
D. Framework adaptation and use 23
References 25
Annex 1. The Sustainable Development Goals 27
Annex 2. The End TB Strategy at a glance 28
Annex 3. Top 10 indicators (not ranked) for monitoring
implementation of the End TB Strategy at global and
national levels, with recommended target levels that
apply to all countries. 29
Annex 4. The 14 indicators associated with tuberculosis incidence
included in the WHO tuberculosis-Sustainable
Development Goal monitoring framework 30
iii
COMMITMENTS
ACTIONS
REVIEW
MONITORING
AND REPORTING
A. Background and rationale
The first WHO Global Ministerial Conference on TB, entitled “Ending TB in

the Sustainable Development Era: a multisectoral response”, was held in Moscow
in November 2017. The aims were to accelerate the multisectoral response to the
tuberculosis epidemic at global, regional and country levels, in recognition of the fact
that investments and actions were falling short of those needed to reach the targets
and milestones of the WHO End TB Strategy and the target of ending the epidemic
by 2030 that is part of the United Nations Sustainable Development Goals; and to
inform the first United Nations General Assembly high-level meeting on tuberculosis
in September 2018. The conference was attended by 117 national delegations.
The Moscow Declaration to End TB (1), with both commitments by Member States and
calls to global agencies and other partners to accelerate efforts towards achieving the
Sustainable Development Goal target for tuberculosis and the targets and milestones
of the End TB Strategy, was adopted by all participating national delegations. It
addressed four key areas for action, one of which was multisectoral accountability.1
In the Moscow Declaration, Member States committed to “supporting the development
of a multisectoral accountability framework” in advance of the high-level meeting on
tuberculosis in 2018, and called on WHO to develop, working in close cooperation
with relevant partners, such a framework for consideration by WHO’s governing
bodies.2 The rationale for such a framework is that strengthened accountability
for the response to tuberculosis at national and global levels should contribute to
faster progress towards the targets and milestones of the End TB Strategy and the
Sustainable Development Goal target for tuberculosis.
The Secretariat submitted a report on preparations for the General Assembly high-
level meeting on tuberculosis to the Executive Board at its 142nd session in January
2018 (2, 3). Based on that report and the Moscow Declaration, the Board requested the
Director-General to develop, working with all relevant partners, a draft multisectoral
accountability framework for tuberculosis (hereafter MAF-TB) for consideration by
the Seventy-first World Health Assembly in May 2018 and presentation during the
high-level meeting in September 2018 (4).
Pursuant to the request in resolution EB142.R3, the Secretariat prepared a background
document (5). This covered definitions of accountability and an accountability
framework; existing examples of approaches to accountability for other top global
health priorities as well as topics beyond health;3 and an assessment of what elements
1
The others were: advancing the response within the 2030 Agenda for Sustainable Development; ensuring sufficient and
sustainable financing; and pursuing science, research and innovation.
2
Stakeholders specifically listed in the Moscow Declaration were (in the order they were listed therein): the United Nations
Special Envoy on TB; Member States; civil society representatives; United Nations organizations; the World Bank and other
multilateral development banks; Unitaid; the Stop TB Partnership; the Global Fund to Fight AIDS, TB and Malaria; and
research institutes.
3
The examples for health were HIV/AIDS, immunization, malaria, poliomyelitis, tobacco control, and women’s, children’s and
adolescents’ health. Other examples examined included climate change and national governance.
1
of a MAF-TB already exist and what might be missing. This background document
was used as the basis for discussions with stakeholders, in particular during a global
consultation held on 1 and 2 March 2018 in Geneva. Representatives of stakeholders
specifically listed in the Moscow Declaration were invited and the meeting was also
attended by WHO staff members from headquarters and all regional offices (6).
Based on the outcomes of the consultation and other discussions in 2018, including
an online public consultation, the WHO Secretariat prepared a draft version of a
MAF-TB, which was submitted for the consideration of the Seventy-first World Health
Assembly.
At the Seventy-first World Health Assembly in May 2018, Member States adopted
resolution WHA71.3 (7). This supported the Moscow Declaration and welcomed
the draft MAF-TB. It also requested the Director-General to continue to develop, in
consultation with Member States, the MAF-TB, “working in close collaboration with all
relevant international, regional and national partners as recommended in the Moscow
Declaration to End TB (2017), and to provide technical support to Member States
and partners, as appropriate, including for national adaptation and use of the draft
multisectoral accountability framework to accelerate progress to end tuberculosis,
MULTISECTORAL ACCOUNTABILITY FRAMEWORK TO ACCELERATE PROGRESS TO END TUBERCULOSIS BY 2030
taking into account national context, laws, regulations and circumstances, in order to
enable the monitoring, reporting, review and actions needed to accelerate progress
to end tuberculosis, both globally and nationally, leaving no one behind, through an
independent, constructive and positive approach, especially in the highest burden
countries, and the independent review of progress achieved by those countries”.
Member States also requested the Director-General to present the MAF-TB at the
General Assembly high-level meeting on tuberculosis in September 2018.
The General Assembly high-level meeting on tuberculosis was held on 26 September
2018, on the theme “United to end tuberculosis: An urgent global response to a global
epidemic”. The political declaration from the meeting, A/RES/73.3 (8), requested the
Director-General of WHO to continue to develop the MAF-TB in line with World Health
Assembly resolution WHA71.3, and to ensure its timely implementation no later than
2019.
The WHO Secretariat finalized the MAF-TB in April 2019, following further consulta-
tions and based on feedback received.
2
B. Definitions and concepts
Accountability means being responsible and answerable for commitments

made or actions taken.1
A framework provides an overview and structure of essential components and sub
components, and the relationships between them. A framework can be adapted, for
example by modifying, adding or deleting items, and by adding detail to subcomponents
to customize or give them greater specificity.
An accountability framework needs to define who is accountable (for example,
individuals, organizations, national governments), what commitments and actions
they are accountable for, and how they will be held to account. Mechanisms for
monitoring and reporting, as well as review, are critical in holding entities to account.
The essential components of an accountability framework (commitments, actions,
monitoring and reporting, review), and how they are related, are shown in Fig. 1.2
These components are underpinned and informed by constitutional, legal and
regulatory frameworks as well as political, social, professional, moral and ethical
codes of conduct and uncodified traditions and conventions.
Fig. 1. Essential components of an accountability framework
COMMITMENTS
ACTIONS
REVIEW
MAF-TB: DEFINITIONS AND CONCEPTS
MONITORING
AND REPORTING
1
Annex 1 of the background document prepared by the Secretariat provides a variety of definitions from dictionaries and other
sources
(http://www.who.int/tb/TBAccountabilityFramework_Consultation1_2March_BackgroundDocument_20180228.pdf?ua=1,
accessed 11 April 2019).
2
This figure is derived from the unified accountability framework for Women’s, Children’s and Adolescents’ health. That
framework depicts the action-monitoring-review cycle in a circle, as here, for the global and country levels separately. The
accountability framework for tuberculosis adds a component for “Commitments” and highlights “Monitoring and reporting” in
its third component.
3
Conceptually, commitments should be followed by the actions needed to keep or
achieve them. Monitoring and reporting are then used to track progress related to
commitments and actions. Review is used to assess the results from monitoring that
are documented in reports and associated products, and to make recommendations
for future actions. The cycle of action, monitoring and reporting, and review can
be repeated many times. The results from monitoring and reporting, and the
recommendations from reviews based on these results, should drive new and/or
improved actions. Periodically, new commitments or reinforcement of commitments
may be required based on reviews of progress.
Accountability can be strengthened by reinforcing one or more of the four components
of the framework. Examples include adding new actions, improving existing actions
or stopping ineffective actions; increasing the quality and coverage of data available
to monitor progress towards commitments made and actions taken; improving
reports to better inform reviews of progress; improving review processes, such as by
making them more high-level, more independent, more transparent and with wider
participation; and ensuring that the results of reviews have meaningful consequences
for action.
Multisectoral refers to the different sectors of an economy and/or related parts of

government, which can be defined in various ways (e.g. agriculture, fisheries, forestry,
mining, health, education, justice, housing, social services, manufacturing, retail
services, finance, the media, sports, entertainment, the environment, information
technology, telecommunications, energy, defence, public sector, private sector). In
the context of health, the term multisectoral is usually used to refer to sectors of
the economy (and related parts of government) that influence health and need to be
engaged by the health sector to address health issues. A multisectoral accountability
framework needs to include content related to multiple sectors.
4
C. The Framework
The multisectoral accountability framework for tuberculosis (MAF-TB) aims:

to support effective accountability of governments and all stakeholders, at global,
regional and country levels, in order to accelerate progress to end the tuberculosis
epidemic; and to be aligned fully with the End TB Strategy and the 2030 Agenda for
Sustainable Development. It is summarized in Fig. 2a and Fig. 2b.
1. Overview of major components, elements and underlying

principles
The framework has two major parts: (a) national (including local) level (Fig. 2a); and
(b) global and regional levels (Fig. 2b). The four components of accountability shown
in Fig. 1 (commitments, actions, monitoring and reporting, review) apply to both parts
of the framework.
The national part of the framework (Fig. 2a) defines commitments, actions, monitoring
and reporting processes, and review mechanisms that apply to individual countries.
The global and regional part of the framework (Fig. 2b) defines commitments,
actions, monitoring and reporting processes, and review mechanisms that apply to
all countries collectively, at global or regional levels.
MAF-TB: THE FRAMEWORK - MAJOR COMPONENTS, ELEMENTS AND PRINCIPLES

The elements listed under each of the four major components of the framework are
based on the End TB Strategy and associated World Health Assembly resolutions (7, 9);
the United Nations Sustainable Development Goals and General Assembly resolutions,
including political declarations of high-level meetings (8, 16); the established core
functions of actors operating at global and/or regional level; established systems
and best practices for monitoring and reporting; and existing review mechanisms.
It is not possible to be exhaustive in listing all elements that are relevant under each
of the four components of the framework and some elements require customization,
especially at national level. For this reason, major examples are provided, using
generic language.
The commitments listed first in both Fig. 2a and Fig. 2b are the Sustainable
Development Goals and End TB Strategy, and associated targets, milestones,
principles and pillars, since these have provided the foundation for subsequent
commitments. The Sustainable Development Goals were adopted by all Member
States of the United Nations in September 2015. The End TB Strategy was adopted
by all WHO Member States at the Sixty-seventh World Health Assembly in May 2014.
Civil society, tuberculosis-affected communities and patient groups have a
fundamental role to play in all components of accountability related to tuberculosis,
as acknowledged in the Sustainable Development Goals, the End TB Strategy, the
Moscow Declaration and the political declaration of the General Assembly high-level
meeting on tuberculosis in 2018.
5
It should be highlighted that many government institutions and other institutions (such
as United Nations organizations, including WHO) already have their own general
accountability mechanisms. The framework can inform these mechanisms, and they
can contribute to the aims of the MAF-TB. At the same time, the principal aim of the
MAF-TB is to support strengthened accountability of governments and stakeholders
at country level, and across countries collectively.
2. National (including local) level – individual countries, with country

adaptation
The national part of the framework is summarized in Fig. 2a. It applies to individual
countries, at national and local levels.
The four components of the framework and the elements listed under each
component should be adapted, adopted and agreed at country level within the
context of constitutional, legal and regulatory frameworks, as well as political,
social, professional, moral and ethical codes of conduct and uncodified traditions
and conventions.
Most of the elements have been defined in general terms only, because there is a need
for country adaptation. There will be differences among countries in the extent to
which different elements already exist, need strengthening or are relevant, and how
they are put into practice. This reflects differences in factors such as the tuberculosis
disease burden, existing political, administrative and legislative systems, the nature
of nongovernmental, civil society and private sector institutions and engagement,
and the status of social and economic development. In addition, the elements
shown are not intended to cover all possible elements of relevance; rather, they are
intended to show the main elements of relevance in many settings to ensure strong
accountability. There may be elements not listed that should be added.
For countries with indigenous peoples that have committed to implementing the
United Nations Declaration on the Rights of Indigenous Peoples, adaptation should
reflect the call in the Declaration to respect and promote the inherent rights of
indigenous peoples.
Elements that do not yet exist, or that do not yet exist in many countries including
most with a high burden of tuberculosis, are italicized. Other elements also need
strengthening in many countries.
Commitments
All countries that are Member States of the United Nations adopted the Sustainable
Development Goals in September 2015. The Sustainable Development Goals and
associated targets that are directly or indirectly relevant to the burden of tuberculosis
are shown in Table 1. The full list of goals is shown in Annex 1.
Sustainable Development Goal 17 (Strengthen the means of implementation and
revitalize the global partnership for sustainable development) includes three other
targets and indicators of specific relevance to the MAF-TB. Those which fall under the
heading of “data, monitoring and accountability” are shown in Table 2. They include
an indicator related to disaggregation of data and an indicator related to the coverage
of death registration (necessary to track causes of death reliably, including deaths
6
Fig. 2a. Multisectoral accountability framework for tuberculosis (MAF-TB):
national (including local) level – for individual countries, with adaptation according to national
constitutional, legal and regulatory frameworks and other relevant factors
Italicized text indicates elements that do not yet exist or are not yet in place in many countries, including
those with a high burden of tuberculosis. Other elements (especially those listed under actions) also need
strengthening in many countries.
COMMITMENTSa
Sustainable Development Goals for 2030 (adopted in 2015)
• Target 3.3 to end the tuberculosis epidemic, and other relevant targets
WHO’s End TB Strategy (adopted in 2014) and associated WHA resolutions

• Targets (2030, 2035) and milestones (2020, 2025), adapted to national level; pillars and principles
Political Declaration of the United Nations General Assembly high-level meeting on Ending AIDS (2016)
Moscow Declaration at WHO Global Ministerial Conference on ending tuberculosis (2017)
Political Declaration of the United Nations General Assembly high-level meeting on tuberculosis (2018)
Other national, regional, country group/bloc or global commitments relevant to tuberculosis.b
ACTIONS (examples)c
National (and local) strategic and operational plans to end (or eliminate)
tuberculosis, with a multisectoral perspective and covering government
REVIEW and partners, consistent with End TB Strategy and other WHO guidance:
Periodic (e.g. annual) review of the tuberculosis development, funding and implementation
response using a national-level review
Development and use of a national MAF-TB
mechanism (e.g. inter-ministerial commission),
with: Establishment, strengthening or maintenance of a national multisectoral
mechanism (e.g. inter-ministerial commission) tasked with providing
high-level leadership – preferably under the
oversight, coordination and periodic review of the national tuberculosis
direction of the head of government or head
response
of state, especially in countries with a high
tuberculosis burden Revisions to plans and policies, and associated activities, based on
monitoring, reporting and recommendations from reviews
a multisectoral perspective
Engagement with private sector, professional societies, civil society and
engagement of key stakeholders such as
tuberculosis-affected communities and patient groups
civil society and tuberculosis-affected
communities, parliamentarians, local Activities undertaken by civil society, tuberculosis-affected communities
governments, the private sector, universities, and patient groups, parliamentarians and the private sector
research institutes, professional associations Delivery of tuberculosis prevention, diagnosis, treatment and care
and other constituencies, as appropriate services
Periodic review of the national tuberculosis Development and enforcement of relevant legislation
programme (or equivalent) including
Universal health coverage policy – development and implementation
independent experts, either specific to
tuberculosis or as part of health sector reviews Multisectoral actions on social determinants of tuberculosis
Other reviews, such as those on specific topics Maintenance or strengthening of national health information and vital
registration systems
MAF-TB: THE FRAMEWORK – NATIONAL LEVEL
Media campaigns and social mobilization
MONITORING AND REPORTING

Routine recording and reporting of tuberculosis cases, treatment outcomes and other End TB Strategy indicators
via national information system consistent with WHO guidance and that meets WHO quality and coverage standards for
tuberculosis surveillance
Routine death registration, with coding of causes of death according to international standards, in national vital registration
system that meets WHO quality and coverage standards
National surveys and other special studies
National tuberculosis report (annual), and associated products customized for particular audiences
Annual reporting to WHO
Civil society and nongovernmental organization reports, and associated products
a
Targets, milestones, pillars and principles are explained in the main text.
b
Examples include political declarations of the United Nations General Assembly on antimicrobial resistance and noncommunicable diseases, and the
Delhi Call to Action (signed by Member States in the WHO South-East Asia Region).
c
It is not possible to list all relevant actions here, but major examples are provided.
7
caused by tuberculosis). Goal 17 also includes a target (17.17) intended to encourage
and promote effective public, public-private and civil society partnerships.
All countries that are Member States of WHO adopted the End TB Strategy, and its
associated targets, milestones, pillars and principles, in May 2014. The “End TB
Strategy at a glance” is shown in Annex 2.
The global targets and milestones of the End TB Strategy are shown in Table 3. When
the strategy was adopted, it was acknowledged that these targets and milestones
should be adapted at country level, in line with one of the underlying principles of the
Strategy.
The four underlying principles of the End TB Strategy are: government stewardship
and accountability, with monitoring and evaluation; a strong coalition with civil
society organizations and communities; protection and promotion of human rights,
ethics and equity; and adaptation of the strategy and targets at country level, with
global collaboration. The three pillars of the strategy are integrated, patient-centred
TB care and prevention; bold policies and supportive systems (including universal
health coverage, social protection, and action on TB determinants); and intensified
research and innovation.
Table 1. Sustainable Development Goals and targets relevant to the burden of

tuberculosis
GOAL AND NUMBER TARGETS EXPLANATORY NOTES
Directly related to tuberculosis
3. Ensure healthy lives 3.3 End the epidemics of AIDS, tuberculosis, malaria
and promote well-being and neglected tropical diseases and combat hepatitis,
for all at all ages waterborne diseases and other communicable diseases
Indirectly related to tuberculosis

3. Ensure healthy lives 3.4 By 2030, reduce by one third premature mortality Noncommunicable
and promote well-being from non-communicable diseases through prevention and diseases such
for all at all ages treatment and promote mental health and well-being as diabetes, and
3.5 Strengthen the prevention and treatment of substance smoking and alcohol
abuse, including narcotic drug abuse and harmful use of use, are risk factors
alcohol for tuberculosis.
3.8 Achieve universal health coverage, including financial Universal health
risk protection, access to quality essential health- coverage is part of
care services and access to safe, effective, quality and the End TB Strategy,
affordable essential medicines and vaccines for all and necessary to
3.a Strengthen the implementation of the World Health reach its targets and
Organization Framework Convention on Tobacco Control milestones. Research
in all countries, as appropriate and innovation for
3.b Support the research and development of vaccines tuberculosis is part of
and medicines for the communicable and non- the End TB Strategy
communicable diseases that primarily affect developing and its targets cannot
countries, provide access to affordable essential be achieved without it
medicines and vaccines and, in particular, provide access
to medicines for all
3.c Substantially increase health financing and the
recruitment, development, training and retention of the
health workforce in developing countries, especially in
least developed countries and small island developing
States
8
Indirectly related to tuberculosis (continued)
1. End poverty in all its 1.1 Eradicate extreme poverty for all people everywhere Levels of poverty,
forms everywhere 1.3 Nationally appropriate social protection systems and social protection,
measures for all, including floors undernutrition,
indoor air pollution,
2. End hunger, achieve 2.1 End hunger and ensure access by all people to safe, income levels and
food security and nutritious and sufficient food year-round distribution, and
improved nutrition and housing quality
promote sustainable are all associated
agriculture with tuberculosis
5. Achieve gender 5.1 End all forms of discrimination against all women and incidence.
equality and empower all girls everywhere Women and girls
women and girls 5.4 Recognize and value unpaid care and domestic work account for about one
through the provision of public services, infrastructure third of tuberculosis
and social protection policies cases globally.
5.A Undertake reforms to give women equal rights to
economic resources, as well as access to ownership
and control over land and other forms of property,
financial services, inheritance and natural resources, in
accordance with national laws
7. Ensure access to 7.1 Ensure universal access to affordable, reliable and
affordable, reliable, modern energy services
sustainable and modern
energy for all
8. Promote inclusive and 8.1.1 Annual growth rate of real GDP per capita
sustainable economic
growth, employment and
decent work for all
10. Reduce inequality 10.1 Achieve and sustain income growth of the bottom
within and among 40% of the population at a rate higher than the national
countries average
11. Make cities inclusive, 11.1 Ensure access for all to adequate, safe and affordable
safe, resilient and housing and basic services and upgrade slums
sustainable
Table 2. Sustainable Development Goal 17 and associated targets and indicators

relevant to monitoring of the tuberculosis epidemic
TARGETS RELEVANT TO MONITORING INDICATORS RELATED TO MONITORING
GOAL 17 OF THE TUBERCULOSIS EPIDEMIC OF THE TUBERCULOSIS EPIDEMIC
Strengthen the means 17.18 By 2020, enhance capacity- 17.18.1 Proportion of sustainable
of implementation building support to developing development indicators produced at the
and revitalize the countries, including for least developed national level with full disaggregation
global partnership for countries and small island developing when relevant to the target, in
sustainable development States, to increase significantly the accordance with the Fundamental
availability of high-quality, timely and Principles of Official Statistics
reliable data disaggregated by income,
gender, age, race, ethnicity, migratory
status, disability, geographic location
and other characteristics relevant in
national contexts
17.19 By 2030, build on existing 17.19.2 Proportion of countries that (a)

initiatives to develop measurements of have conducted at least one population
progress on sustainable development and housing census in the last 10 years;
that complement gross domestic and (b) have achieved 100 per cent
product, and support statistical birth registration and 80 per cent death
capacity-building in developing registration
countries
9
Table 3. Targets and milestones set in WHO’s End TB Strategy
MILESTONES TARGETS
INDICATORS
2020 2025 2030 2035
Percentage reduction in the absolute number of
tuberculosis deaths 35 75 90 95
(compared with 2015 baseline)
Percentage reduction in the tuberculosis
incidence rate 20 50 80 90
(new cases per 100 000 population per year)
Percentage of tuberculosis-affected households
experiencing catastrophic costs due to 0 0 0 0
tuberculosis disease
The Political Declaration of the General Assembly high-level meeting on ending AIDS
in June 2016 included targets of 90% treatment coverage and 90% treatment success
for tuberculosis by 2020.
The Moscow Declaration at the first WHO Global Ministerial Conference on Ending
Tuberculosis in the sustainable development era, held in 2017, included commitments
from national governments under four headings. These were: advancing the
response within the 2030 Agenda for Sustainable Development; ensuring sufficient
and sustainable financing; pursuing science, research and innovation; and developing
a multisectoral accountability framework.
The Political Declaration of the General Assembly high-level meeting on ending
tuberculosis, in September 2018, reinforced national commitments to the Sustainable
Development Goals and the End TB Strategy, and the commitments made in the
Moscow Declaration (8). Member States also made new commitments, including
commitments to four new global targets, as shown in Table 4, that are consistent
with the targets and milestones of the End TB Strategy. These targets need to be
adapted at the national level. Capacity to mobilize funding domestically varies among
countries, and national targets for the amount of funding to be mobilized from national
and international sources will vary accordingly.
Table 4. Global targets set in the political declaration of the United Nations
high-level meeting on tuberculosis
INDICATOR TARGET
Number of people with tuberculosis diagnosed and 40 million people, including 3.5 million children,
treated and 1.5 million people with drug-resistant
tuberculosis, including 115 000 children, over the
period 2018–2022
Number of people reached with treatment to prevent At least 30 million people, including 4 million
tuberculosis children under 5 years of age, 20 million other
household contacts of people affected by
tuberculosis, and 6 million people living with HIV
and AIDS, over the period 2018–2022
Mobilization globally of sufficient and sustainable At least US$ 13 billion annually by 2022
financing for universal access to quality prevention,
diagnosis, treatment and care of tuberculosis
Mobilization globally of sufficient and sustainable US$ 2 billion annually, over the period 2018–2022
financing for tuberculosis research
10
Relevant national commitments may also include those that are country-, region-
or countrybloc-specific.1 Examples of other global commitments relevant to
tuberculosis include United Nations General Assembly political declarations related
to antimicrobial drug resistance and noncommunicable diseases (10, 11).
Actions
The examples of actions listed for adaptation are based on the four principles, three
pillars and related 10 components of the End TB Strategy (Annex 2),2 as well as
recommended measures to accelerate progress included in the Moscow Declaration
of the WHO Global Ministerial Conference on ending tuberculosis that was held in
2017, WHA resolution WHA71.3 in 2018 and the political declaration of the General
Assembly high-level meeting on tuberculosis in 2018.
Examples of major actions needed include:
development, funding and implementation (including at the local level) of national
strategic and operational plans to end the tuberculosis epidemic (or eliminate
tuberculosis),3 which take a multisectoral perspective and comprise both
government and partners (via one unified national plan embedded within national
health strategies and plans), aligned with WHO’s End TB Strategy and WHO
guidance. These plans should include national targets and milestones aligned with
the global targets and milestones to which countries have committed. Resource
mobilization includes allocation of budgets and associated disbursement of funds
by governments and partners (at both national and subnational levels), so as to
provide sufficient financing for the tuberculosis response. As countries transition
from low to middle to high-income status, the share of funding from domestic
sources should increase. In middle-income countries, it is expected that most
funding can be mobilized from domestic sources and that all required funding can
be mobilized domestically in high-income countries;
development and use of a national MAF-TB;
establishment, strengthening or maintenance of a national multisectoral
mechanism (e.g. inter-ministerial commission) to provide oversight, coordination
and periodic high-level review of the national tuberculosis response;4
revisions to plans, policies and associated activities based on monitoring, reporting
and recommendations from reviews;
engagement with relevant stakeholders, including government ministries and

institutes, local governments, civil society, tuberculosis-affected communities,
patient groups, parliamentarians, the private sector, public-private partnerships
(including product development partnerships), philanthropic organizations, profes-
1
Examples of country blocs include the G20 and BRICS (Brazil, Russian Federation, India, China and South Africa).
2
There are four components under pillar 1, four under pillar 2, and two under pillar 3.
3
A tuberculosis pre-elimination or elimination plan is appropriate in countries that already have a low incidence of
tuberculosis, as per guidance provided in the WHO framework towards TB elimination in low-incidence countries.
https://www.who.int/tb/publications/elimination_framework/en/.
4
WHO will develop material that documents examples of existing national-level review mechanisms in countries with varying
levels of tuberculosis burden (ranging from low to high incidence of tuberculosis), to inform efforts to introduce such review
mechanisms in other countries.
11
sional associations, research institutes and universities (and associated research
networks), among others;1
activities undertaken by civil society, tuberculosisaffected communities and patient
groups, such as local and national education and advocacy, and participation in the
development and review of the tuberculosis response;
delivery of tuberculosis prevention, diagnostic, treatment and care services of high
quality and coverage;
drafting, enactment and enforcement of national legislation for tuberculosis, such
as a law to make case notification mandatory, and antidiscrimination laws, drawing
on existing guidance (for example, WHO’s guidance on ethics for the implementation
of the End TB Strategy (12), and other measures to reduce stigma, and increase
access to care for vulnerable and marginalized populations;
development and implementation of policy related to universal health coverage;
multisectoral action on the social determinants of tuberculosis infection and
disease, such as levels of poverty, social protection, nutrition and housing quality;
maintenance or strengthening of national health information and vital registration

systems to enable reliable tracking of the tuberculosis epidemic (in terms of
absolute numbers and trends in tuberculosis cases and deaths);
media campaigns, for example to raise public awareness about tuberculosis;
funding for and implementation of tuberculosis research and innovation, and
strengthening public-private partnerships to broaden access to new skills, sourc-
es of finance, specialized infrastructure and product pipelines.
Monitoring and reporting

The monitoring and reporting component defines the main elements that are needed
at national and local levels to reliably track the tuberculosis epidemic and the
national response. The elements listed are based on established systems at national
level, best practices for monitoring of tuberculosis incidence and mortality, WHO
guidance on case definitions and the recording and reporting of tuberculosis cases
and treatment outcomes (13), WHO operational guidance on implementing the End TB
Strategy, Sustainable Development Goal targets related to data, and the political
declaration of the General Assembly high-level meeting on tuberculosis in 2018.
For monitoring, there are three key elements. The first is routine surveillance of
tuberculosis cases and their treatment outcomes (13) through a national health
information system that meets quality and coverage standards (14). Ideally this
system should be case-based and electronic, in order to facilitate timely availability
and analysis of data,2 and the analyses should be disaggregated by variables such as
1
2
Until such systems can be put in place, well-established paper-based systems for aggregated recording and reporting of
cases and treatment outcomes, based on WHO guidance published in 2013, should continue.
12
age, sex and location.1 The second is routine monitoring of deaths due to tuberculosis
through a national vital registration system, with coding of causes of death according
to international standards.2 A large number of countries already have such systems
in place, but many others, including most with a high burden of tuberculosis, do not.
The third element is monitoring of other priority indicators related to the national
tuberculosis response, and associated targets, building on the ten priority operational
indicators recommended by WHO for monitoring the implementation of the End TB
Strategy (Annex 3) (15).
Routine systems for monitoring can be complemented by periodic studies on
priority topics, including nationally representative surveys (e.g. national surveys
of tuberculosis prevalence, anti-tuberculosis drug resistance and costs faced by
tuberculosis patients and their households).
For reporting, the main element is a national report. This should include (but not
necessarily be limited to) the key results at national and subnational levels from
routine monitoring (and special studies, if appropriate), with results disaggregated
by age, sex, location and other relevant variables; interpretation of results, including
assessment of progress towards national targets and the influence on such progress
of trends in Sustainable Development Goal indicators associated with tuberculosis
incidence in the country; assessment of trends in public and private funding for
research; and definition of future actions needed based on findings. It can also include
reporting on progress in adaptation and use of a national MAF-TB.
The national report can be accompanied by complementary outputs and products
that are customized for particular audiences, such as brochures, policy briefs,
presentations, press releases, fact sheets and dashboards showing progress against
indicators. Audiences include politicians, the general public, health professionals
and international donor agencies. Reports and associated products (e.g. scorecards)
produced by civil society and nongovernmental organizations may also be appropriate.
Although some countries do produce a national tuberculosis report every year
and in others there are reports produced by civil society and nongovernmental
organizations, these elements are not yet in place in many countries, including most
countries with a high burden of tuberculosis.
Countries report data for key indicators annually to WHO, using a global reporting
system managed by the WHO Global TB Programme. Following review, validation and
analysis, reported data are published in the annual WHO global tuberculosis report
and online (in the form of raw data and country profiles).
The indicators for which data should be collected routinely or through periodic studies,
as well as the methods and schedule for collection, validation, analysis and reporting
of data, should be discussed, agreed and approved at national level, informed by
global guidance and recommendations.
1
Sustainable Development Goal target 17.18 is “By 2020, enhance capacity-building support to developing countries, including
for least developed countries and small island developing States, to increase significantly the availability of highquality,
timely and reliable data disaggregated by income, gender, age, race, ethnicity, migratory status, disability, geographic
location and other characteristics relevant in national contexts”. See Table 2.
2
Indicator 17.19.2 for Sustainable Development Goal target 17.19 is: “Proportion of countries that (a) have conducted at least
one population and housing census in the last 10 years; and (b) have achieved 100 per cent birth registration and 80 per cent
death registration”. See Table 2.
13
Review
The elements listed under review are based on existing mechanisms as well as
new elements identified in the End TB Strategy, the Moscow Declaration of the WHO
Global Ministerial Conference on ending tuberculosis held in 2017, and the political
declaration of the General Assembly high-level meeting on tuberculosis held in 2018.
High-level reviews of the tuberculosis response at national level, and associated
declarations, resolutions and/or reports on recommendations for actions to be
taken, can play a key role in holding all those involved in the tuberculosis response
accountable for actions taken and progress made, in renewing or revising
commitments, and in driving the next cycle of “Actions – Monitoring and reporting
– Review”. These reviews need to be multisectoral with engagement of all key
stakeholders, including government ministries and institutes, local governments,
civil society, tuberculosis-affected communities, patient groups, parliamentarians,
the private sector, public-private partnerships (including product development
partnerships), philanthropic organizations, research institutes and universities
(and associated research networks) and professional associations, among others.
This broad involvement of stakeholders can offer an independent, constructive and
positive approach to review, as requested by the World Health Assembly in 2018 in

its resolution WHA71.3.
The review component of the framework includes periodic (e.g. annual) reviews
of the national tuberculosis response using a national-level review mechanism
(e.g. inter-ministerial commission), with three key features: high-level leadership,
preferably under the direction of the head of government or head of state, especially
in countries with a high burden of tuberculosis;1 a multisectoral perspective; and
engagement of key stakeholders, including government ministries and institutes,
local governments, civil society, tuberculosis-affected communities, patient
groups, parliamentarians, the private sector, public-private partnerships (including
product development partnerships), research institutes and universities (and
associated research networks), professional associations and other constituencies,
as appropriate.2 Sectors or ministries other than health that should be involved
include those responsible for finance, poverty alleviation, social protection, housing,
labour, justice, migration, education and science. Such reviews for tuberculosis, and
associated review mechanisms, are established in some countries but are not yet in
place in many others.3
An option is to expand existing intersectoral fora responsible for reviews related to
health to include tuberculosis.
1
The political declaration at the first United Nations high-level meeting on tuberculosis, held in September 2018, called for
national multisectoral mechanisms to review progress achieved towards ending the tuberculosis epidemic “with high-level
leadership, preferably under the direction of the head of state or government, and with the active involvement of civil society
and affected communities, as well as parliamentarians, local governments, academia, private sector and other stakeholders
within and beyond the health sector …” (para. 48).
2
The Moscow Declaration at the first WHO Global Ministerial Conference on ending tuberculosis in the Sustainable
Development era, held in November 2017, called for a multisectoral accountability framework that could include, according to
needs, “the convening of national inter-ministerial commissions on tuberculosis, or their equivalent, by Ministries of Health in
partnership with civil society and, where appropriate, with the direct engagement of the Heads of State, and the consideration
of expanding existing intersectoral fora to include actions against tuberculosis …”.
3
To support adaptation and use of the framework, WHO will develop material that documents examples of existing national-
level review mechanisms in countries with varying levels of tuberculosis burden (ranging from low to high tuberculosis
incidence), to inform efforts to introduce such review mechanisms in other countries.
14
A second review element is periodic reviews of the national tuberculosis programme
(or equivalent) that are commissioned by the national government. These reviews
include a wide range of stakeholders involved in the national tuberculosis response,
as well as independent experts.1 Such reviews are already well-established in many
countries, and are often coordinated by WHO in high tuberculosis burden countries.
They can either be specific to tuberculosis or part of a national health sector review.
National governments (or other levels of government in countries with federal or
devolved systems) could also choose to commission fully independent reviews, i.e.
reviews by individuals with no direct involvement or stake in the topic and outcomes
of the review.
The other element listed is reviews of specific topics, such as the programmatic
management of drug-resistant tuberculosis and research.
3. Global and regional levels – countries collectively

The global and regional part of the framework (summarized in Fig. 2b) applies to
countries collectively – either all countries (global) or all countries in a particular
region. The actors involved include WHO Member States, WHO and other relevant
United Nations and multilateral institutions, and all other actors operating at global or
regional level, including civil society, tuberculosis-affected communities and patient
groups.
Elements that do not yet exist or need significant strengthening are italicized.
Commitments
All countries that are Member States of the United Nations adopted the Sustainable
Development Goals in September 2015. The Sustainable Development Goals and
associated targets that are directly or indirectly relevant to the burden of tuberculosis
are shown in Table 1. The full list of goals is shown in Annex 1.
All countries that are Member States of WHO adopted the End TB Strategy, and its
associated targets, milestones, pillars and principles, in May 2014. The “End TB
Strategy at a glance” is shown in Annex 2.
MAF-TB: THE FRAMEWORK – GLOBAL AND REGIONAL LEVELS

The End TB Strategy includes commitments in the form of targets, milestones, pillars
and principles. The targets and milestones are shown in Table 3. The four underlying
principles are: government stewardship and accountability, with monitoring and
evaluation; a strong coalition with civil society organizations and communities;
protection and promotion of human rights, ethics and equity; and adaptation of the
strategy and targets at country level, with global collaboration. The three pillars are
integrated, patient-centred TB care and prevention; bold policies and supportive
systems (including universal health coverage, social protection, and action on TB
1
The latest guidance from WHO (published in 2013) on national reviews of tuberculosis programmes provides the following
definition: “Reviews of national tuberculosis programmes are external evaluations that are conducted periodically and that
aim at improving the managerial and technical performance of the programme in order to reduce morbidity and mortality
from TB. Reviews involve national and international experts and stakeholders”.
See https://www.who.int/tb/publications/framework-tb-programme-reviews/en/ (accessed 25 April 2019). Examples of
those involved in reviews of national tuberculosis programmes to date include national representatives from governments,
tuberculosis programmes, civil society, tuberculosis-affected communities, professional associations, the private sector,
universities and research institutes; and experts from other countries and international organizations. Recommendations are
usually presented to the minister of health and other senior officials at the end of the review.
15
Fig. 2b. Multisectoral accountability framework for tuberculosis (MAF-TB):
global and regional levels – countries collectively
Italicized text indicates elements that do not yet exist, or are not yet in place in all regions
COMMITMENTSa
Sustainable Development Goals for 2030 (adopted in 2015)
• Target 3.3 to end the tuberculosis epidemic, and other relevant targets
WHO’s End TB Strategy (adopted in 2014) and associated WHA resolutions

• Targets (2030, 2035), milestones (2020, 2025), pillars, principles
Political Declaration of the United Nations General Assembly high-level meeting on Ending AIDS (2016)
Moscow Declaration at WHO Global Ministerial Conference on ending tuberculosis (2017)
Political Declaration of the United Nations General Assembly high-level meeting on tuberculosis (2018)
Other global or regional commitments relevant to tuberculosisb
ACTIONS (examples)c
REVIEW Development, funding and implementation of the strategic
and operational plans of global agencies and regional
Periodic high-level reviews of the tuberculosis response at entities, including joint initiatives across agencies, strategic
global and/or regional level, with multisectoral perspective alliances across sectors,d linkages with other global health
and engagement of key stakeholders, including civil society priorities and initiatives, engagement of civil society and
and tuberculosis-affected communities, the private sector, tuberculosis-affected communities, and regional targets
and others. Existing examples are: and milestones as appropriate
United Nations General Assembly high-level meetings on
tuberculosis (2018, 2023) Resource mobilization and allocation of funding by global
financing agencies
United Nations General Assembly high-level political
forum for Sustainable Development Goal review WHO global tuberculosis strategy and associated
United Nations General Assembly reviews of Sustainable WHO guidance, norms and standards – development,
Development Goals (next in 2023) dissemination and implementation support
WHO Executive Board and World Health Assembly Global and regional advocacy and communication, including
review of progress reports on tuberculosis (including for financing, engagement of multiple sectors, civil society
2018, 2019, 2020) and WHO Regional Committee review and tuberculosis-affected communities, and human rights
of progress reports on tuberculosis
Strategic and technical support to countries by global and
High-level reviews by regional entities and country blocs (or regional agencies
equivalent)
Global strategy for tuberculosis research and innovation,
Other reviews requested and approved by countries
and related convening of international tuberculosis
collectively, at either global or regional level
research networks
MONITORING AND REPORTING

WHO framework for tuberculosis recording and reporting (cases, treatment outcomes)
WHO tuberculosis-Sustainable Development Goal monitoring framework
WHO global tuberculosis data collection (annual) and online database
WHO Global tuberculosis report (annual) and associated products
WHO progress reports on End TB Strategy and actions in follow-up to high-level meetings, to Executive Board and World
Health Assembly
Report in 2020 on global and national progress in the tuberculosis response, prepared by the
United Nations Secretary-General with WHO support
WHO Regional reports and associated products
United Nations data collection and reports on Sustainable Development Goals
Treatment Action Group/Stop TB Partnership and G-Finder annual reports on trends in funding for tuberculosis research
and product development, and periodic Médecins Sans Frontières/Stop TB Partnership reports on uptake of WHO policies
Other civil society and nongovernmental organization audits and reports, and associated products (e.g. scorecards)
a
Targets, milestones, pillars and principles are explained in the main text.
b
Examples include political declarations of the United Nations General Assembly high-level meetings on antimicrobial resistance and noncommunicable
diseases, and the Delhi Call to Action (signed by WHO Member States in the South-East Asia Region).
c
It is not possible to list all relevant actions, but major examples are provided.
16
d
For example, with agencies working on poverty alleviation, social protection, housing, labour, justice, and migration.
determinants); and intensified research and innovation. Annex 2 shows the “End TB
Strategy at a glance”.
The Political Declaration of the General Assembly high-level meeting on ending AIDS
in June 2016 included targets of 90% treatment coverage and 90% treatment success
for tuberculosis by 2020 (18).
The Moscow Declaration of the WHO Global Ministerial Conference on ending
tuberculosis (1), held in 2017, included commitments from national governments
and calls to partners to accelerate implementation of the End TB Strategy under
four headings. These were: advancing the response within the 2030 Agenda for
Sustainable Development; ensuring sufficient and sustainable financing; pursuing
science, research and innovation; and developing a multisectoral accountability
framework. The commitments were then supported by the World Health Assembly in
an associated resolution in 2018 (7).
The political declaration of the General Assembly high-level meeting on ending
tuberculosis, held in 2018, reinforced commitments in the Sustainable Development
Goals, the End TB Strategy and the Moscow Declaration. It also included four new
global targets as shown in Table 4. These targets are consistent with the targets and
milestones of the End TB Strategy.
Examples of other global commitments relevant to tuberculosis are United Nations
General Assembly political declarations related to antimicrobial drug resistance and
noncommunicable diseases (10, 11).
Actions
Actions are required at the global or regional level by global agencies on behalf of
their Member States collectively to support progress towards commitments.
The actions listed in Fig. 2b are based on the roles, responsibilities and related core
functions of actors operating at global and/or regional level.
Major examples of actions needed include:
development, funding and implementation of the strategic and operational plans

of global agencies, such as WHO (e.g. the Thirteenth General Programme of Work,
2019–2023 (17), and the biennial workplan and budgets), other bodies in the United
Nations system, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Stop
TB Partnership, Unitaid, the World Bank, and regional intergovernmental entities.1
These workplans include joint initiatives across agencies, such as: the WHO Director-
General’s flagship initiative, Find.Treat.All.#EndTB, which is a joint initiative with
the Stop TB Partnership and the Global Fund,2 and the interagency global action
plan for healthy lives and well-being for all, which addresses all the Sustainable
1
Such entities include, for example, the African Union and the European Union.
2
See https://www.who.int/tb/joint-initiative/en/, accessed 25 April 2019.
17
Development Goal 3 health targets, including tuberculosis.1,2 The workplans can
also include strategic alliances across sectors,3 linkages with other global health
priorities and initiatives,4 engagement of civil society and tuberculosis-affected
communities5 and regional plans with targets and milestones as appropriate;
resource mobilization and allocation of funding by global financing agencies, for
both implementation of available interventions at country level, and tuberculosis
research and development;
development and dissemination by WHO of global tuberculosis strategies and
associated guidance, norms and standards, including support for their adaptation
at country level;
global and regional advocacy and communication activities, for example for
increased financing for the tuberculosis response, multisectoral and civil society
engagement, and promotion and protection of human rights;
strategic and technical support to countries by global and regional agencies, dif-
ferentiated according to need;
development of a global strategy for tuberculosis research and innovation by WHO,
as requested by the World Health Assembly in WHA 71.3, and related convening of
international tuberculosis research networks;
Monitoring and reporting

The monitoring and reporting component defines the main elements of monitoring
and reporting for tuberculosis that are already undertaken at the global and regional
level, principally by WHO, and one new element that was requested in the political
declaration at the General Assembly high-level meeting on tuberculosis in 2018.
These elements include:
the WHO global framework that provides standardized case and treatment outcome
definitions for tuberculosis and a standardized approach to routine recording and
reporting of tuberculosis cases and treatment outcomes at national and subnational
levels (13); this framework includes reporting of cases disaggregated by age and
sex;
the WHO list of priority indicators for monitoring implementation of the End TB
Strategy, and associated targets (listed in Annex 3) (15);
the WHO global Tuberculosis-Sustainable Development Goal monitoring framework
of 14 indicators under seven Sustainable Development Goals for which there is
1
GAVI Alliance, Global Financing Facility, Global Fund, UNAIDS, United Nations Development Programme, United Nations
Population Fund, United Nations Children’s Fund, Unitaid, UN Women, World Bank Group, World Health Organization. Towards
a global action plan for healthy lives and well-being for all. Geneva: World Health Organization; 2018
(https://www.who.int/docs/default-source/global-action-plan/global-action-plan-phase-1-final.pdf, accessed 16 April 2019).
2
Another example is the Issue-based Coalition on Health in the WHO European Region. This was established in 2016. It is led
by the WHO Regional Office for Europe, and acts as a pan-European enabling mechanism to facilitate and promote the
implementation of Goal 3 targets and the health-related targets of the other Sustainable Development Goals by coordinating
the activities of the relevant United Nations funds, programmes and specialized agencies and other intergovernmental
organizations and partners (http://www.euro.who.int/__data/assets/pdf_file/0010/324784/1st-mtg-report-issue-based-
Coalition-Health-nov-2016.pdf?ua=1, accessed 16/04/2019).
3
One cross-sectoral example is a global roadmap for zoonotic tuberculosis which has been developed by WHO, the Food and
Agricultural Organization of the United Nations, the World Organisation for Animal Health and the International Union Against
Tuberculosis and Lung Disease. The roadmap defines 10 priority areas for action
(https://www.who.int/tb/publications/2017/zoonotic_TB/en/, accessed 25 April 2019).
4
One example is interagency and cross-sectoral work to overcome the global public health crisis of multidrug-resistant
tuberculosis, aligned with the global antimicrobial resistance agenda.
5
For example, WHO has established a Global Civil Society Task Force on Tuberculosis.
18
evidence of an association with trends in tuberculosis incidence.1 The indicators
are based on the seven goals and associated targets shown in Table 1, and are
listed in Annex 4. It is important to highlight that data for all indicators included in
the framework are already collected by global agencies (e.g. UNAIDS, WHO and the
World Bank) and stored in global databases that are publicly accessible. Therefore,
analysis of data for these indicators to inform the tuberculosis response does not
require additional efforts in data collection at either national or global level;
the WHO annual process of data collection from all Member States by the
Secretariat, and maintenance of all collected data in a WHO global TB database
managed according to best practice standards. In the European Region, data are
collected jointly by the Regional Office for Europe and the European Centre for
Disease Prevention and Control;
global reporting by WHO on an annual basis, in the form of a global tuberculosis
report and associated products. Examples of related products include regional
reports, fact sheets, scorecards, infographics, press releases, presentations, and
additional online material such as country profiles for all countries;2
periodic reports on progress in implementing the End TB Strategy to the World
Health Assembly, which the Director-General has been requested to submit under
Resolution WHA 67.1;
WHO Regional reports and associated products;
United Nations data collection and reports on the Sustainable Development Goals.
The United Nations has established a database to store data reported by Member
States on each of the indicators that have been approved for monitoring of progress
towards goals and targets. Reports are produced based on these data;
a report in 2020 on global and national progress in the tuberculosis response, to be
prepared by the Secretary-General with WHO support, as requested in the political
Global reports by civil society and nongovernmental organizations are also listed.
Current examples are annual reports by the Treatment Action Group/Stop TB
Partnership (18) and G-Finder (19) on trends in funding for tuberculosis research

and product development and periodic reports by Médecins Sans Frontières
and the Stop TB Partnership (20) on national adoption of WHO’s polices related to
tuberculosis diagnosis, treatment and care. Other reports and associated products
(e.g. scorecards) could be produced in future, to strengthen the role of non-state
actors in monitoring and reporting on tuberculosis, and to inform reviews.
Review
The elements listed under review are based on existing mechanisms as well as
new elements identified in the End TB Strategy, the Moscow Declaration of the WHO
Global Ministerial Conference on ending tuberculosis held in 2017, and the political
1
This Sustainable Development Goal monitoring framework was developed as part of the preparations for the WHO Global
Ministerial Conference on Tuberculosis, and was first published as part of WHO’s Global tuberculosis report, 2017 (see
pp. 12–16). The framework was also published as part of WHO’s Global tuberculosis report, 2018 (see pp. 20–21).
2
WHO’s global tuberculosis report contains two-page profiles for the 30 countries with the highest burden of tuberculosis;
profiles for all countries are available at https://www.who.int/tb/country/data/profiles/en/, accessed 11 April 2019.
19
High-level reviews of the tuberculosis response at global or regional level, and
associated declarations, resolutions and/or reports on recommendations for actions
to be taken, can play a key role in holding all those involved in the tuberculosis
response accountable for actions taken and progress made, in renewing or revising
commitments, and in driving the next cycle of “Actions – Monitoring and reporting
– Review”. These reviews need to be multisectoral with engagement of all key
stakeholders, including national governments, multilateral organizations, regional
entities, global development agencies, civil society, tuberculosis-affected communities,
parliamentarians, the private sector, public-private partnerships (including product
development partnerships), philanthropic organizations, professional associations,
research institutes and universities (and associated research networks), among
others.1
Four examples of high-level reviews that already exist are listed. Two of these are
specific to tuberculosis: General Assembly high-level meetings on tuberculosis (the
first in 2018, with a second planned for 2023);2 and WHO Executive Board and World
Health Assembly reviews of progress reports on tuberculosis (including in 2018, 2019,
2020). The other two are not specific to tuberculosis: the high-level political forum
for review of the Sustainable Development Goals (Goal 3 is reviewed periodically);

and reviews of progress towards all Sustainable Development Goals (the next review
is scheduled for 2023). General Assembly high-level meetings, the World Health
Assembly and the high-level political forum for Sustainable Development Goal review
are mechanisms that are also used for other global health priorities, such as HIV/
AIDS, noncommunicable diseases and women’s, children’s and adolescents’ health.
The General Assembly high-level meeting on tuberculosis in 2018 provides an
example of a review process that was high-level, multisectoral and multi-stakeholder
in nature. It included a wide range of stakeholders from a variety of sectors, from
within and beyond government. There were formal statements by heads of state and
government, ministers of foreign affairs, health and development and other eminent
persons, and from a range of other stakeholders. The scope and modalities of the
meeting were determined by the General Assembly, informed by consultations that
were enabled by the United Nations Secretariat and WHO. An intergovernmental
process was used to negotiate the political declaration, and this process was informed
by an interactive civil society stakeholder hearing at United Nations headquarters.
The political declaration of the high-level meeting committed Member States to
holding a “comprehensive review by Heads of State and Government at a high-level
meeting in 2023”.
Two elements that do not yet exist, or which do not yet exist in all regions, are also
listed. The first is high-level reviews of the tuberculosis response at the level of WHO
regions, other regional intergovernmental entities (e.g. European Union, African
Union) or other country blocs or country groupings (e.g. BRICS, Asia-Pacific Economic
Cooperation, high tuberculosis burden countries). Such reviews can have similar
representation to the General Assembly high-level meetings on tuberculosis, and
1
2
The political declaration of the General Assembly high-level meeting on tuberculosis of 2018 (A/RES/73/3) includes a
commitment to a second high-level meeting in 2023 (http://www.un.org/en/ga/search/view_doc.asp?symbol=A/RES/73/3).
20
may provide a particularly good opportunity for positive, constructive comments
and discussions regarding the status of progress and actions needed in the form of
independent peer review.1,2
The annual sessions of the World Health Assembly and the WHO regional committees
include Member State reviews of reports requested from the Director-General and
the Secretariat. These include reports on the state of the tuberculosis epidemic and
progress in the global and/or regional response, such as implementation of the Global
strategy and regional plan, and action on specific issues within the TB response. The
reports include data, analysis and conclusions on actions needed. For example, in
the resolution WHA 67.1 adopting the End TB Strategy in 2014, the Health Assembly
requested the Secretariat to report on progress in its implementation to the Health
Assembly in 2017, in 2020, and at regular intervals thereafter. These reviews by the
Health Assembly can be accompanied by resolutions, building on the reports and
Health Assembly deliberations, in which Member States commit to further action and
call for action by WHO and other partners and stakeholders.
The second element is defined in general terms as “Other reviews requested and
approved by countries collectively, at either global or regional level”. This is in
recognition of the fact that other types of reviews may be appropriate if they are
requested and agreed to by all countries collectively, at regional or global level. The
added value and resource implications of such additional reviews would need to be
carefully considered.3
4. How the global/regional and national parts of the framework
MAF-TB: THE FRAMEWORK – HOW GLOBAL/REGIONAL AND NATIONAL PARTS ARE LINKED
are linked
The global/regional and national parts are, by definition, part of the same framework.
This section explains the linkages between them.
The commitments shown in the global and regional part of the framework can be
adapted at national (and local) levels. Examples of adaptation include: defining
targets for reductions in incidence and mortality of tuberculosis in terms of absolute
numbers as well as relative (percentage) reductions; setting targets that are more
ambitious than ones set globally; and setting additional, complementary targets.
Actions taken at global and regional levels by global agencies should support
actions needed at country level to end the tuberculosis epidemic. This is the reason
for including in the global and regional part of the framework actions such as:
development and dissemination of global guidance, norms and standards related
to tuberculosis prevention, diagnosis, treatment and care, which in turn inform
national guidelines, norms and standards); global advocacy and communication
(for example, to raise global awareness and help to mobilize global resources for
ending tuberculosis); mobilization and allocation of funding by global financing
1
The political declaration (A/Res/73.3) of the General Assembly high-level meeting on tuberculosis held in 2018 includes a
commitment to establishing and promoting regional efforts and collaboration to set ambitious targets, generate resources,
and use existing regional intergovernmental institutions to review progress, share lessons and strengthen collective capacity
to end tuberculosis (http://www.un.org/en/ga/search/view_doc.asp?symbol=A/RES/73/3).
2
The Moscow Declaration called for a multisectoral accountability framework “that enables measuring progress both globally
and nationally through an independent, constructive and positive approach, especially in the highest burden countries, and an
independent review of progress by those countries.”
3
The WHO Global TB Programme is developing a background document on existing review mechanisms associated with other
top health priorities at the global or regional level.
21
agencies (which then support countries in need of external resources); provision of
strategic and technical support to countries (differentiated according to need); and
establishment and maintenance of international research networks.
Adoption of WHO guidance related to routine recording and reporting of tuberculosis
cases and treatment outcomes has ensured a standardized approach to recording and
reporting of tuberculosis cases and treatment outcomes at national levels since the
mid-1990s (13). National reporting of data according to this standardized approach by
Member States to the Secretariat since that time (around 200 countries and territories
report data each year, including almost all Member States) has enabled WHO to
conduct global analyses and to report on the tuberculosis epidemic and progress in
the response at global, regional and country levels on an annual basis since 1997.
The International Statistical Classification of Diseases and Related Health Problems,
as periodically revised,1 guides coding of causes of death at national level and in turn
reporting of deaths by cause to WHO. Global guidance from WHO (developed with
countries and partner agencies) has also helped to ensure a standardized approach to
special studies at national level, including national tuberculosis prevalence surveys,
national surveys of resistance to anti-tuberculosis medicines, inventory studies to
measure the underreporting of detected cases of tuberculosis, and surveys of costs

faced by tuberculosis patients and their households. WHO has also published a
handbook that provides guidance on analysis and use of data on tuberculosis derived
from routine monitoring and special studies.
Findings from reviews of the national tuberculosis responses should inform reviews
of the tuberculosis response at global and regional levels, and global or regional
reviews should help to drive actions needed to accelerate progress towards ending
tuberculosis at global, regional and national levels. All Member States have the
opportunity to participate in existing global reviews related to the Sustainable
Development Goals that are convened by the United Nations.
1
An update on the eleventh revision of the International Statistical Classification of Diseases and Related Health Problems will
be provided to the Executive Board at its 143rd session (see document EB143/13).
22
D. Framework adaptation and use
1. Member State actions

The process of adapting the framework at national level should include assessment
of all relevant components and elements according to the country context. There will
be differences among countries in the extent to which different elements already
exist, need strengthening or are relevant, and how they are put into practice. There
may also be elements not listed that should be added. Variation among countries
reflects factors such as the level and characteristics of the tuberculosis disease
burden, existing constitutional, legal, regulatory and administrative frameworks and
systems, the nature of nongovernmental, civil society and private sector institutions
and engagement, and the status of social and economic development.
The process of adapting the framework should involve officials across government
sectors, nongovernmental organizations, civil society and tuberculosis-affected
communities, United Nations and other multilateral and bilateral agencies operating
at country level, parliamentarians, professional associations, public-private partner
ships and the private sector. The result should be a framework providing an overview
of commit ments, actions, monitoring and reporting, and review mechanisms,
and steps being taken to better document and strengthen and/or sustain robust
accountability. Subsequent monitoring and reporting as well as review processes
should incorporate assessment of the framework itself.
2. WHO roles and actions

In the political declaration of the high-level meeting of the General Assembly on
tuberculosis, the Director-General of WHO was requested to ensure the “timely
implementation” of the MAF-TB “no later than 2019” (8). Furthermore, the General
Assembly requested the Secretary-General, in close collaboration with the Director-
General of WHO, to promote collaboration among all stakeholders to end the
tuberculosis epidemic and to implement the declaration with Member States and
MAF-TB: FRAMEWORK ADAPTATION AND USE
relevant entities. In World Health Assembly resolution WHA71.3, Member States

requested the Director-General to provide technical support for Member States and
partners, as appropriate, including for national adaptation and use of the framework.
In keeping with these requests, the Director-General and the WHO Secretariat will
guide and support, with urgency, the adaptation and use of the MAF-TB at country level,
and coordinate and support its adaptation and use at regional/global level, working
with Member States, partners, including civil society and affected communities, and
multisectoral stakeholders.
WHO’s unique status as a science- and evidence-based organization that sets
globally-applicable norms and standards, as well as WHO’s role in providing global
23
public goods that help to ensure health for all people (17) are fundamental to enable
the adaptation and use of the framework.
WHO’s ongoing efforts in fostering partnerships with global, regional and national
stakeholders in supporting Member States and promoting engagement of civil society
and other non-State actors will also be essential.
In 2018, WHO began to work with Member States, and partners, for the adaptation
and use of the MAF-TB, through country-based work and through consultations at
regional and global levels.
In 2019, WHO is providing guidance materials, including tools and documentation on
good practices related to the four components of the MAF-TB, drawing on experiences
in tuberculosis, other global health areas and other sectors.
WHO will provide global monitoring and reporting and review on use of the framework,
in keeping with the reporting on tuberculosis requested by the General Assembly
and the World Health Assembly. This will include reporting on adaptation and use
of the framework in the annual WHO global tuberculosis report, as well as in its
planned report on progress in implementing the End TB Strategy to the World Health
Assembly in 2020; and supporting the Secretary-General to prepare a report in 2020,

as requested by the General Assembly, on progress towards ending tuberculosis in
advance of a comprehensive review by heads of state and government at a high-level
meeting in 2023.
24
References
1. First WHO Global Ministerial Conference on Ending TB in the Sustainable Development

Era: A Multisectoral Response. Moscow Declaration on Ending Tuberculosis. (17
November 2017.
(https://www.who.int/tb/features_archive/Online_Consultation_
MinisterialConferenceDeclaration/en/, accessed 1 May 2019).
2. EB142/16. Preparation for a high-level meeting of the General Assembly on ending
tuberculosis: Report by the Director-General. In: 142nd session of the Executive Board,
Geneva, 22–27 January 2018:2. Geneva : World Health Organization, 2018.
(http://apps.who.int/gb/ebwha/pdf_files/EB142/B142_16-en.pdf, accessed 1 May
2019.
3. EB142/2018/REC/2. Summary records. In: 142nd session of the Executive Board,
Geneva, 22–27 January 2018. Summary records. Geneva : World Health Organization,
2018.
(https://apps.who.int/iris/bitstream/handle/10665/274365/B142_REC2-en.
pdf?sequence=1&isAllowed=y, accessed 1 May 2019).
4. Resolution EB142.R3. Preparation for a high-level meeting of the General Assembly on
ending tuberculosis. In: 142nd session of the Executive Board, Geneva, 22–27 January
2018. Resolutions, decisions and annexes. Geneva: World Health Organization,
2018:2–4.
(http://apps.who.int/gb/or/e/e_142r1.html, accessed 1 May 2019).
5. Developing a draft TB multisectoral accountability framework. Background
document. Stakeholder consultation convened by Global TB Programme, World
Health Organization, Chateau de Penthes, Geneva, 1–2 March 2018. Geneva : World
Health Organization, 2018.
6. Developing a draft TB multisectoral accountability framework. Stakeholder consultation
convened by the Global TB Programme, World Health Organization. Geneva, 1–2 March
2018. Geneva: World Health Organization, 2018.
7. Resolution WHA71.3. Resolution on preparation of a high-level meeting on ending
tuberculosis. In: Seventy-first World Health Assembly, Geneva, 21–26 May 2018.
Resolutions. World Health Organization, 2018
(http://apps.who.int/gb/ebwha/pdf_files/WHA71/A71_R3-en.pdf, accessed 1 May
2019).
8. General Assembly Resolution 73/3, Political declaration of the high-level meeting of
the General Assembly on the fight against tuberculosis, A/RES/73/3 (3 October 2018).
(https://digitallibrary.un.org/record/1645268?ln=en, accessed 1 May 2019).
9. Resolution WHA67.1. Global strategy for tuberculosis prevention, care and control after
MAF-TB: REFERENCES
2015. In: Sixty-seventh World Health Assembly, Geneva, 19–24 May 2014. Resolutions
and decisions, annexes. Geneva: World Health Organization, 2014:3–5.
(http://apps.who.int/gb/ebwha/pdf_files/WHA67/A67_R1-en.pdf, accessed 1 May
2019).
25
10. General Assembly Resolution 71/3, Political declaration of the high-level meeting of
the General Assembly on antimicrobial drug resistance, A/RES/71/3 (19 October 2016)
(https://www.un.org/en/ga/search/view_doc.asp?symbol=A/RES/71/3, accessed 1
May 2019).
11. General Assembly Resolution 73/2, Political declaration of the third high-level meeting
of the General Assembly on the prevention and control of non-communicable diseases,
A/RES/73/2 (10 October 2018).
(https://www.un.org/en/ga/search/view_doc.asp?symbol=A/RES/73/2, accessed 1
May 2019).
12. Ethics guidance for the implementation of the End TB Strategy. Geneva: World Health
Organization; 2017.
(https://www.who.int/tb/publications/2017/ethics-guidance/en/, accessed 1 May
2019).
13. Definitions and reporting framework for tuberculosis – 2013 revision (updated
December 2014) (WHO/HTM/TB/2013.2). Geneva : World Health Organization; 2014.
(https://www.who.int/tb/publications/definitions/en/, accessed 1 May 2019).
14. Standards and benchmarks for tuberculosis surveillance and vital registration
systems: checklist and user guide. Geneva : World Health Organization, 2014.
(https://www.who.int/tb/publications/standardsandbenchmarks/en/, accessed 1 May

2019).
15. Global tuberculosis report. Geneva: World Health Organization; 2018:15.
(https://www.who.int/tb/publications/global_report/en/, accessed 1 May 2019).
16. General Assembly 70/266. Political declaration on HIV and AIDS: on the fast track
to accelerating the fight against HIV and to ending the AIDS epidemic by 2030, A/
RES.70/266 (8 June 2016).
(https://undocs.org/A/RES/70/266, accessed 1 May 2019).
17. WHO Thirteenth General Programme of Work, 2019–2023. Geneva : World Health
Organization; 2018.
(https://www.who.int/about/what-we-do/thirteenth-general-programme-of-
work-2019-2023, accessed 1 May 2019).
18. Tuberculosis research funding trends 2005–2017. New York : Treatment Action Group;
2018.
(http://www.treatmentactiongroup.org/sites/default/files/tb_funding_2018_final.pdf,
accessed 1 May 2019).
19. Neglected disease research and development: reaching new heights. Geneva: G-
Finder, 2019.
(https://www.policycuresresearch.org/wp-content/uploads/Y11_G-FINDER_Full_
report_Reaching_new_heights.pdf, accessed 1 May 2019).
20. Out of step 2017: TB policies in 29 countries, 3rd ed. Geneva : Medecins Sans Frontieres
and Stop TB Partnership, 2017.
(http://www.stoptb.org/assets/documents/outofstep/UNOPS_out_of_step_2017_55_
online.pdf, accessed 1 May 2019).
26
Annex 1.
The Sustainable Development Goals
Goal 1. End poverty in all its forms everywhere

Goal 2. End hunger, achieve food security and improved nutrition and promote
sustainable agriculture
Goal 3. Ensure healthy lives and promote well-being for all at all ages
Goal 4. Ensure inclusive and equitable quality education and promote lifelong
learning opportunities for all
Goal 5. Achieve gender equality and empower all women and girls
Goal 6. Ensure availability and sustainable management of water and sanitation for
all
Goal 7. Ensure access to affordable, reliable, sustainable and modern energy for all
Goal 8. Promote sustained, inclusive and sustainable economic growth, full and
productive employment and decent work for all
Goal 9. Build resilient infrastructure, promote inclusive and sustainable industriali-
zation and foster innovation
Goal 10. Reduce inequality within and among countries
Goal 11. Make cities and human settlements inclusive, safe, resilient and sustainable
Goal 12. Ensure sustainable consumption and production patterns
Goal 13. Take urgent action to combat climate change and its impacts1
Goal 14. Conserve and sustainably use the oceans, seas and marine resources for
sustainable development
Goal 15. Protect, restore and promote sustainable use of terrestrial ecosystems,
sustainably manage forests, combat desertification, and halt and reverse
land degradation and halt biodiversity loss
Goal 16. Promote peaceful and inclusive societies for sustainable development, pro-
vide access to justice for all and build effective, accountable and inclusive
institutions at all levels
Goal 17. Strengthen the means of implementation and revitalize the Global
Partnership for Sustainable Development
MAF-TB: ANNEX 1
1
Acknowledging that the United Nations Framework Convention on Climate Change is the primary international,
intergovernmental forum for negotiating the global response to climate change.
27
Annex 2.
The End TB Strategy at a glance
A WORLD FREE OF TB
VISION
— zero deaths, disease and suffering due to TB
GOAL END THE GLOBAL TB EPIDEMIC
MILESTONES TARGETS
INDICATORS
2020 2025 SDG 2030 a END TB 2035
Percentage reduction in the absolute number of

35% 75% 90% 95%
TB deaths (compared with 2015 baseline)
Percentage reduction in the TB incidence rate
20% 50% 80% 90%
Percentage of TB-affected households
experiencing catastrophic costs due to TB (level 0% 0% 0% 0%
in 2015 unknown)
PRINCIPLES
1. Government stewardship and accountability, with monitoring and evaluation
2. Strong coalition with civil society organizations and communities
3. Protection and promotion of human rights, ethics and equity
4. Adaptation of the strategy and targets at country level, with global collaboration
PILLARS AND COMPONENTS
1. INTEGRATED, PATIENT-CENTRED CARE AND PREVENTION
A. Early diagnosis of TB including universal drug–susceptibility testing, and
systematic screening of contacts and high-risk groups
B. Treatment of all people with TB including drug-resistant TB, and patient
support
C. Collaborative TB/HIV activities, and management of comorbidities
D. Preventive treatment of persons at high risk, and vaccination against TB
2. BOLD POLICIES AND SUPPORTIVE SYSTEMS
A. Political commitment with adequate resources for TB care and prevention
B. Engagement of communities, civil society organizations, and public and
private care providers
C. Universal health coverage policy, and regulatory frameworks for case
notification, vital registration,
quality and rational use of medicines, and infection control
D. Social protection, poverty alleviation and actions on other determinants
of TB
3. INTENSIFIED RESEARCH AND INNOVATION
A. Discovery, development and rapid uptake of new tools, interventions and
strategies
B. Research to optimize implementation and impact, and promote innovations
a
Targets linked to the Sustainable Development Goals (SDGs).
28
Annex 3.
Top 10 indicators (not ranked) for monitoring implementation
of the End TB Strategy at global and national levels, with
recommended target levels that apply to all countries.
The target level is for 2025 at the latest.
RECOMMENDED
INDICATOR TARGET LEVEL
TB treatment coverage
Number of new and relapse cases that were notified and treated, divided by
1 ≥90%
the estimated number of incident TB cases in the same year, expressed as a
percentage.
TB treatment success rate
Percentage of notified TB patients who were successfully treated. The target
2 ≥90%
is for drug-susceptible and drug-resistant TB combined, although outcomes
should also be reported separately.
Percentage of TB-affected households that experience catastrophic costs
due to TBa
3 Number of people treated for TB (and their households) who incur 0%
catastrophic costs (direct and indirect combined), divided by the total number
of people treated for TB.
Percentage of new and relapse TB patients tested using a WHO-
recommended rapid diagnostic (WRD) at the time of diagnosis
4 Number of new and relapse TB patients tested using a WRD at the time ≥90%
of diagnosis, divided by the total number of new and relapse TB patients,
expressed as a percentage.
Latent TB infection (LTBI) treatment coverage
Number of people living with HIV newly enrolled in HIV care and the number
5 of children aged <5 years who are household contacts of cases started on ≥90%
LTBI treatment, divided by the number eligible for treatment, expressed as a
percentage (separately for each of the two groups).
Contact investigation coverage
6 Number of contacts of people with bacteriologically confirmed TB who were ≥90%
evaluated for TB, divided by the number eligible, expressed as a percentage.
Drug-susceptibility testing (DST) coverage for TB patients
Number of TB patients with DST results for at least rifampicin, divided by
100%
7 the total number of notified (new and retreatment) cases in the same year,
expressed as a percentage. DST coverage includes results from molecular
(e.g. Xpert MTB/RIF) as well as conventional phenotypic DST results.
Treatment coverage, new TB drugs
Number of TB patients treated with regimens that include new (endorsed
8 ≥90%
after 2010) TB drugs, divided by the number of notified patients eligible for
treatment with new TB drugs, expressed as a percentage.
Documentation of HIV status among TB patients
Number of new and relapse TB patients with documented HIV status, divided
9 100%
by the number of new and relapse TB patients notified in the same year,
expressed as a percentage.
Case fatality ratio (CFR)
10 Number of TB deaths divided by estimated number of incident cases in the ≤5%
same years, expressed as a percentage.
MAF-TB: ANNEX 3
CFR, case fatality ratio; DST, drug-susceptibility testing; HIV, human immunodeficiency virus; LTBI, latent TB infection; SDG,
Sustainable Development Goal; TB, tuberculosis; UHC, universal health coverage; WHO, World Health Organization; WRD,
WHO-recommended rapid diagnostic.
a
Catastrophic costs are provisionally defined as total costs that exceed 20% of annual household income.
29
Annex 4.
The 14 indicators associated with tuberculosis incidence
included in the WHO tuberculosis-Sustainable Development
Goal monitoring framework
SUSTAINABLE DEVELOPMENT INDICATOR INCLUDED IN TUBERCULOSIS-SUSTAINABLE DEVELOPMENT

GOAL GOAL MONITORING FRAMEWORK
1. End poverty in all its Proportion of population living below the international poverty line
forms everywhere Proportion of population covered by social protection floors/
systems
2. End hunger, achieve food Prevalence of undernourishment
security and improved
nutrition and promote
sustainable agriculture
3. Ensure healthy lives and Prevalence of HIV
promote well-being for all Prevalence of diabetes
at all ages Prevalence of alcohol use disorder
Percentage of the population aged ≥15 years who smoke

Coverage of essential health services, measured using the WHO
universal health coverage index
Health expenditure per capita
Percentage of health expenditures that are out-of-pocket
7. Ensure access to Proportion of population with primary reliance on clean fuels and
affordable, reliable, technology
sustainable and modern
energy for all
8. Promote inclusive and Gross domestic product /GDP) per capita
sustainable economic
growth, employment and
decent work for all
10. Reduce inequality within Gini index for income inequality
and among countries
11. Make cities inclusive, safe, Proportion of urban population living in slums, informal
resilient and sustainable settlements or inadequate housing
The latest status of each indicator and trends since 2000 (as collected by the United
Nations Statistical Division) are shown for all countries in the country profiles
published by WHO each year as part of the WHO global tuberculosis report (for the
30 high tuberculosis burden countries) and associated products (online profiles, for
all countries).1
1
For the 2019 country profile, see https://www.who.int/tb/country/data/profiles/en/ (accessed 14 April 2019).
30
MULTISECTORAL
TO END TUBERCULOSIS
BY 2030

WHO CDS TB 2019.10 Eng

Uploaded by

Copyright:

Available Formats

WHO CDS TB 2019.10 Eng

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

WHO CDS TB 2019.10 Eng

Uploaded by

Copyright:

Available Formats

COMMITMENTS

Some rights reserved. This work is available under the Creative

Any mediation relating to disputes arising under the licence

Cataloguing-in-Publication (CIP) data. CIP data are available at

Sales, rights and licensing. To purchase WHO publications,

Third-party materials. If you wish to reuse material from this

General disclaimers. The designations employed and the

The mention of specific companies or of certain manufacturers’

All reasonable precautions have been taken by WHO to verify

A. Background and rationale 1

The first WHO Global Ministerial Conference on TB, entitled “Ending TB in

Accountability means being responsible and answerable for commitments

Fig. 1. Essential components of an accountability framework

Multisectoral refers to the different sectors of an economy and/or related parts of

The multisectoral accountability framework for tuberculosis (MAF-TB) aims:

1. Overview of major components, elements and underlying

MAF-TB: THE FRAMEWORK - MAJOR COMPONENTS, ELEMENTS AND PRINCIPLES

2. National (including local) level – individual countries, with country

WHO’s End TB Strategy (adopted in 2014) and associated WHA resolutions

Media campaigns and social mobilization

MONITORING AND REPORTING

research and innovation.

Table 1. Sustainable Development Goals and targets relevant to the burden of

Indirectly related to tuberculosis

Table 2. Sustainable Development Goal 17 and associated targets and indicators

17.19 By 2030, build on existing 17.19.2 Proportion of countries that (a)

 engagement with relevant stakeholders, including government ministries and

 maintenance or strengthening of national health information and vital registration

Monitoring and reporting

positive approach to review, as requested by the World Health Assembly in 2018 in

3. Global and regional levels – countries collectively

MAF-TB: THE FRAMEWORK – GLOBAL AND REGIONAL LEVELS

WHO’s End TB Strategy (adopted in 2014) and associated WHA resolutions

MONITORING AND REPORTING

MAF-TB: THE FRAMEWORK – GLOBAL AND REGIONAL LEVELS

inter­national tuberculosis research networks;

Monitoring and reporting

MAF-TB: THE FRAMEWORK – GLOBAL AND REGIONAL LEVELS

for review of the Sustainable Development Goals (Goal 3 is reviewed periodically);

4. How the global/regional and national parts of the framework

measure the underreporting of detected cases of tuberculosis, and surveys of costs

1. Member State actions

2. WHO roles and actions

relevant entities. In World Health Assembly resolution WHA71.3, Member States

Assembly in 2020; and supporting the Secretary-General to prepare a report in 2020,

1. First WHO Global Ministerial Conference on Ending TB in the Sustainable Development

(https://www.who.int/tb/publications/standardsandbenchmarks/en/, accessed 1 May

Goal 1. End poverty in all its forms everywhere

Percentage reduction in the absolute number of

SUSTAINABLE DEVELOPMENT INDICATOR INCLUDED IN TUBERCULOSIS-SUSTAINABLE DEVELOPMENT

Percentage of the population aged ≥15 years who smoke

You might also like

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

engagement with relevant stakeholders, including government ministries and

maintenance or strengthening of national health information and vital registration

international tuberculosis research networks;