Every year, among the estimated 9 million persons who develop tuberculosis (TB), 3 million are missed - not diagnosed, treated, or even tracked by national TB programs - according to a Guest Editorial in PLOS Medicine by Madhukar Pai of McGill University, Montreal, Canada and Puneet Dewan of the Bill & Melinda Gates Foundation, New Delhi, India.
Writing in observation of World Tuberculosis Day 2015, for which the Stop TB Partnership has established the theme "Reach, Treat, Cure Everyone," the authors call on national TB programs to retool in order to meet the ambitious goal of ending TB by 2035.
To address the challenge of ending TB, the authors advocate implementing new molecular diagnostic tests alongside "test and treat" strategies that include drug susceptibility testing to guide choice of treatment; streamlining regulatory and policy processes to facilitate adoption of new, shorter treatment regimens; implementing eHealth innovations to improve treatment adherence, and experimenting with innovative service delivery models that engage private-sector and informal providers in concert with public sector programs.
The authors assert that "none of the above strategies can be implemented at scale without adequate funding by donors, the private sector, and, most importantly, governments. In the long run, TB control will bring significant human, economic, and health benefits to any country."
Editorial: Testing and Treating the Missing Millions with Tuberculosis, Pai M, Dewan P, PLoS Med 12(3): e1001805. doi:10.1371/journal.pmed.1001805, published 24 March 2015.
The authors received no specific funding for this work.
The authors have read the journal's policy and have the following conflicts: MP has no financial or industry conflicts to disclose. He serves on the editorial boards of PLOS ONE and PLOS Medicine. He serves as a consultant to the Bill & Melinda Gates Foundation, and on the scientific advisory committee of the Foundation for Innovative New Diagnostics (FIND). PD has no financial or industry conflicts to disclose. He is a senior program officer at the Bill & Melinda Gates Foundation, and is responsible for the India TB program of the Foundation. He previously worked at the World Health Organization and the US Centers for Disease Control and Prevention.