Accelerating Action to End TB€¦ · improve the clinical diagnosis of pediatric TB. Because of...
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8ACCELERATING ACTION TO END TBTUBERCULOSIS REPORT TO CONGRESSJANUARY 2020
U.S. AGENCY FOR INTERNATIONAL DEVELOPMENT REPORT TO CONGRESSON FISCAL YEAR (FY) 2018 TUBERCULOSIS PROGRAMMING
ACCELERATING ACTION TO END TB
The U.S. Agency for International Development (USAID) submits this report to Congress pursuant to P.L. 110-293, the Tom Lantos and Henry J. Hyde U.S. Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Authorization Act of 2008, Section 302(d), which amended P.L. 87-195, the Foreign Assistance Act of 1961, to add Section 104B(g).
On the Cover: A mother and son complete MDR-TB treatment in Kenya. Photo credit: Alex Kamweru, USAID.
1FY2018 | TUBERCULOSIS REPORT TO CONGRESS
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GLOBAL CONTEXT
1 World Health Organization Global Tuberculosis Report, 20192 Ibid.3 Ibid.4 Ibid.5 Ibid.6 Ibid.7 Ibid.8 National TB Patient Cost Survey to monitor progress toward the target to eliminate catastrophic costs and help design social protection and universal health coverage, accessed at http://www.who.int/tb/areas-of-work/tb-hiv/garciai_patient_cost_survey_rationale_and_method.pdf9 Stop TB Partnership http://www.stoptb.org/assets/documents/global/advocacy/unhlm/UNHLM_Targets&Commitments.pdf
Tuberculosis (TB) remains the world’s deadliest infectious disease: it takes the lives of an estimated 4,000 people each day.1 Delayed diagnosis, weak laboratory services and health care, high-risk co-morbidities, and the challenges of drug-resistant TB (DR-TB) cause millions of people to suffer and die from the disease each year. To reach the ambitious global goal of ending TB by 2030, governments of the highest-burden countries, donors, faith-based organizations, other non-governmental organizations, the private sector, and other global TB stakeholders must take accelerated action to fight the epidemic.
In Calendar Year 2018, ten million (estimate range, 9.0–11.1 million) people became ill with TB, and 1.5 million (estimate range, 1.3–1.6 million) people died from the disease.2 Identifying individuals with TB and immediately linking them to effective treatment to prevent further transmission continues to be a major challenge. Of those people who were ill with TB, health providers only reported 69 percent of them to National TB Programs (NTPs), and only 45 percent received diagnostic testing.3
In addition, almost a half million people developed a deadlier form of TB that is resistant to the most effective treatment.4 Drug-resistant TB (DR-TB), which includes multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB), is more difficult and expensive to diagnose and treat and has become a major challenge for Ministries of Health the world over. Furthermore, DR-TB takes a tremendous physical, social, and economic toll on patients and families, many of whom already struggle in poverty. For these and other reasons, only one in five people with DR-TB starts treatment, and just over half of these individuals are cured.5
Many people with TB have other health problems that further exacerbate their condition. Unfortunately, high-risk co-morbidities are strongly associated with TB. More than two million people with TB are undernourished, the highest risk factor for the disease and an added
difficulty for patients to complete treatment successfully.6 Other major risk factors for TB are smoking, abuse of alcohol, infection with HIV, and diabetes.7
TB has a devastating impact on development and exacerbates poverty, which places economic and social strains on individuals, families, and communities. According to the World Health Organization (WHO), TB patients and their households lose, on average, 50 percent of their annual incomes from missed work and the cost of seeking treatment, even where TB care is available free of charge.8
In September 2018, the High-Level Meeting (UNHLM) on TB of the United Nations General Assembly set the stage for urgent attention to, and action on, TB. This included establishing the ambitious targets of diagnosing and enrolling an additional 40 million people on treatment for TB by 2022 (commonly referred to as “40x22”), with a focus on countries with the highest burden of the disease, and enrolling 30 million on preventive therapy for TB (commonly referred to as “30x22”).9
With funding from U.S. taxpayers through Congress, USAID is working with governments, civil society, and the private sector in our partner countries to accelerate their responses to end TB while ensuring they are progressing on the Journey to Self-Reliance.
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USAID’S GLOBAL TB PROGRAM
10 World Health Organization Global Tuberculosis Report, 2019
USAID leads the U.S. Government’s global TB-control efforts, by working with agencies and partners around the world to reach every person with the disease, cure those in need of treatment, and prevent the spread of new infections. To achieve this, USAID works through the U.S. Government’s Global TB Strategy, the National Action Plan for Combating Multidrug-Resistant Tuberculosis (National Action Plan), the Stop TB Partnership’s Global Plan to End TB, and the WHO’s End TB Strategy. To meet the targets set at the UNHLM and avoid duplication, the U.S. Government collaborates closely with the WHO; the Global
Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund); and other public and private partners.
In cooperation with Ministries of Health, USAID provides bilateral assistance in 23 countries with high burdens of TB. USAID expanded its funding for TB in the Socialist Republic of Vietnam this year because of a more than 50 percent increase in the estimated burden of the disease in the country.10 Leveraging the U.S. Government’s investment in the Global Fund, USAID also provides targeted technical assistance in an additional 32 countries. This technical assistance is usually short-term, to remove barriers to the implementation of National Strategic Plans (NSPs), including support to prevent, find and treat people with TB, build national capacity to use existing resources and turn evidence into policy, and expand the introduction of new tools.
USAID plays a critical coordination role in each country by working closely with a wide range of multi-sectoral TB stakeholders, including Ministries of Health, the Secretariat and Principal Recipients of the Global Fund, other U.S. Government Departments and Agencies, the WHO, the Stop TB Partnership, civil society, local non-governmental organizations, faith-based groups, communities, and the private sector.
USAID’S FOCUS ON RESULTSTo improve measurable TB outcomes, USAID supports Ministries of Health to develop and implement patient-centered approaches to increase the detection of infections and improve access to high-quality care for the disease. These efforts include promoting prevention strategies, expanding community- and facility-based screening, developing diagnostic networks, identifying appropriate treatment regimens, and leveraging financial commitments from governments and other stakeholders. USAID’s goal is to ensure that people with TB, especially those who are living in poverty, are at the forefront
of interventions at all levels of health care.
2018 ACHIEVEMENTS IN USAID TB PRIORITY COUNTRIES
23 Countries with bilateral programs funded by USAID
55Countries in which organizations received technical assistance from USAID and our partners
4,600,000 Cases of TB detected
14 percent Increase in case-notifications
89 percent Treatment-success rate
98,435 Individuals with DR-TB started on appropriate treatment
37,000,000GeneXpert cartridges procured under concessional pricing (cumulative)
78 Countries in which partners used the Bedaquiline Donation Program (cumulative)
40,000 Health workers trained1
23Countries in which partners completed drug-resistance surveys (cumulative)
22 Countries completed TB-prevalence surveys (cumulative)
7 Research studies funded that focused on new treatment regimens2
1 While health workforce shortages and capacity issues remain, there has been significant progress. Some of the constraints include limited number of qualified health care workers at the primary health care level with often large workloads.2 A detailed description of USAID’s research studies and clinical trials are outlined in the recently published Combating Multidrug-Resistant Tuberculosis, Year Three of the National Action Plan Report.
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In FY 2018, USAID made significant progress toward reaching the targets set forth in the U.S. Government’s Global TB Strategy and National Action Plan. On average, in the 23 countries where the United States funds governments directly, since 2000 the incidence of TB decreased by 27 percent, mortality from the disease decreased by 44 percent, and notifications of cases of infection increased by 114 percent.11
11 World Health Organization Global Tuberculosis Report, 2019
FINDING PEDIATRIC CASES OF TBIN THE REPUBLIC OF UGANDA After Uganda’s 2016 national prevalence survey revealed that
the burden of TB was higher than previously thought, the
National Leprosy and Tuberculosis Program (NLTP) within
the Ministry of Health and other stakeholders directed their
focus to improving the detection of TB cases. With funding
from the Global Fund, USAID worked with the NLTP to
spearhead interventions at the national level, including setting
targets for case finding, weekly surge reporting, and rolling
out the Active Case-Finding (ACF) toolkit to nine Districts
through trainings, workshops, and mentorships.
The Mukono Health Center IV in Central Uganda was
finding only an average of five pediatric cases of TB per
month, even though, based on population projections, the
expected number of new cases per month should have been
13. Since February 2018, a USAID partner has helped the
health facility improve its pediatric screening for TB, build
the capacity of its health workers for clinical diagnosis, and
document the cascade of care. This support has consisted
of bi-weekly quality improvement coaching sessions and
on-the-job mentorship visits to the facility’s teams to
improve the clinical diagnosis of pediatric TB. Because of
this intervention, screening for pediatric TB at the clinic has
increased from 18 to 58 percent, which has meant the facility now finds 15 cases of the disease in children each month.
Mukono HC IV Health worker screening children for TB. Photo credit: Godfrey Kirunda, Defeat TB.
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In year four of the five-year U.S. Government Global TB Strategy, USAID is on track to meet three of the document’s four targets. USAID’s partners have treated 12.2 million people with TB successfully (achieving 94 percent of the five-year target in year four); started 330,000 individuals with DR-TB on second-line drug therapy (achieving 92 percent of the five-year target in year four); and accomplished a treatment-success rate of almost 90 percent. Despite the tremendous progress made in these areas, the incidence rate of TB around the world has decreased by only 13 percent since 2014.
In FY 2018, USAID invested a total of $265 million in activities to control TB, appropriated through the Global Health Programs
(GHP) and Economic Support Fund (ESF) accounts. This funding includes bilateral assistance in high-burden countries and
resources spent through USAID’s regional platforms and centrally managed contracts, grants, and cooperative agreements.
0
100000
200000
300000
400000
2014 2015 2016 2017 2018
Cumulative Number Started on DR Treatment
Target: Global TB Strategy (2015-2019)
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Cumulative Number of Patients Successfully Treated
Target: Global TB Strategy (2015-2019)
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Incidence Rate
Target: Global TB Strategy (2015-2019)
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20%
40%
60%
80%
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2014 2015 2016 2017
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Target: Global TB Strategy (2015-2019)
41%
9% 3% 19%
14%
7% 5%
Person-centered Care
Procurement Supply Management
TB/HIV
MDR-TB
Research
Health System Strengthening
Strategic Information
USAID Global TB Program Distribution
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USAID’S GLOBAL ACCELERATOR TO END TUBERCULOSISAt the September 2018 UNHLM, USAID Administrator Mark Green announced the Agency’s new business model for TB—the Global Accelerator to End Tuberculosis. The Accelerator is designed to increase investments from the public and private sectors to end the TB epidemic while simultaneously building local commitment and capacity to achieve the goals set forth at the UNHLM in a way that builds self-reliance. It focuses on countries with high burdens of TB where the Agency can align with local communities and partners to deliver performance-based results toward the global targets.
The Accelerator aims to help our partners meet the targets
set at the UNHLM by deploying more-focused technical
expertise to increase the diagnosis and treatment of TB and
MDR-TB, especially to Ministries of Health; strengthening the
involvement of, and response to, TB by local organizations,
including community and faith-based groups; accelerating the
sustainable transition of the funding and management of TB
programs to national governments and their partners; and
improving coordination with other health programs.
The Accelerator ensures that USAID is fighting to end TB
efficiently and effectively while focusing on locally generated
solutions and combating stigma and discrimination. Since
the launch of the Accelerator, USAID has shifted its business
model to develop programs and strategies to achieve a
more accountable, responsible, and inclusive response to
TB in our priority countries to meet the commitments
and targets set at the UNHLM. USAID is improving
our partnerships by mutually agreeing on priority areas
of collaboration with all stakeholders at all levels. The
approach has focused on three key areas, including joint
TB Partnership Statements with national governments;
enhanced and focused technical support; and increased
ownership, financing, and engagement by local partners.
TB PARTNERSHIP STATEMENTS WITH NATIONAL GOVERNMENTSUSAID’s investments are most successful when partner
governments match them with their own strong
commitments. To align our investments better with national
priorities to meet the targets of the UNHLM, USAID has
signed 17 Partnership Statements with the Governments of
the People’s Republic of Bangladesh; the Democratic Republic
of Congo; the Federal Democratic Republic of Ethiopia; the
Kyrgyz Republic; the Republics of India, Kazakhstan, Malawi,
Mozambique, Nigeria, the Philippines, South Africa, Tajikistan,
Uganda, Uzbekistan, and Zambia; the United Republic of
Tanzania; and the Socialist Republic of Vietnam.
ENGAGING PRIVATE HOSPITALSIN THE REPUBLIC OF INDONESIAIndonesia has the third-highest incidence of TB, after India and
China. In 2018, Indonesia detected and notified 565,466 TB
patients (67 percent of the estimated cases), a 74-percent
increase from the number of TB patients notified in 2014.1
Approximately 20 percent of this national increase took place
in USAID-supported Districts, even though they include only
11 percent of Indonesia’s total population.
To drive this increase, USAID’s partners engaged intensively
with hospitals in Indonesia, especially private ones. As a result,
the notification of TB cases in the 16 USAID-supported
Districts grew from almost 58,000 in 2014 to more than
105,000 in 2018. Specifically, notifications from private-
sector hospitals in USAID-supported Districts increased
from almost 12,000 patients in 2014 to almost 34,000 in
2018, a number four to six times higher than in Districts not
supported by USAID.
1 World Health Organization Global Tuberculosis Report, 2019
6FY2018 | TUBERCULOSIS REPORT TO CONGRESS
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FOCUSED TECHNICAL SUPPORT FOR TBTo support more sustainable and focused TB programming,
USAID has expanded our network of senior-level TB
technical advisors embedded in NTPs within Ministries
of Health. As of October 2019, USAID has placed more
than 40 advisors in 20 countries who provide mentorship
and guidance to NTP staff and coordinate efforts among
all relevant stakeholders to control TB. In particular,
the advisors help remove barriers to achieving national
goals under NSPs and grants from the Global Fund.
LOCALLY GENERATED TB SOLUTIONS As a key component of the Accelerator, the TB Local
Organizations Network (LON) enables USAID
to partner directly with local organizations in TB
priority countries to implement locally generated
diagnosis, treatment, and prevention services.
LON builds on the capacity and available resources
of local institutions — including civil society, faith-
based, and private sector service delivery provider
organizations, as well as academic institutions — to
maximize the potential impact of USAID resources
and accelerate the transition to local accountability and
ownership. USAID has made eight initial LON awards.
LOOKING FORWARDWhile notable progress took place in FY 2018, too many
people continue to suffer and die from TB. In FY 2019 and
2020, USAID will continue to accelerate programmatic shifts
that have measurable results and that develop and encourage
accountability and coordination in priority countries to reach
the targets set by the UNHLM by 2022.
LOCAL ORGANIZATION NETWORKS (LON) AWARDEES ■ Kingdom of Cambodia: Khmer HIV/AIDS Non-Governmental
Organization Alliance (KHANA)
■ Republic of India: Resource Group for Education and Advocacy for
Community Health (REACH)
■ Republic of Indonesia: Yayasan KNCV
■ Republic of Kenya: Conference of Catholic Bishops
■ Republic of Mozambique: Ajuda de Desenvolvimento de Povo para Povo
■ Republic of South Africa: Interactive Research and Development (IRD)
■ Republic of South Africa: TB and HIV Investigative Network (THINK)
■ Republic of Zimbabwe: Union Trust
GOVERNMENT COMMITMENT TO A “TB-FREE” INDIA Indian Prime Minister Narendra Modi has made an ambitious
commitment to achieve a “TB-Free” India by 2025, five
years ahead of the global target set at the UNHLM. The
Government of India has quadrupled its funding for the
National TB Program to extend access to high-quality care and
treatment for TB through multi-sectoral and community-led
approaches. Through the Accelerator, USAID is strengthening
its partnership with the Government of India to advance
the country’s efforts to eliminate TB even further.
A new USAID-India End TB Alliance is part of this partnership.
Composed of leading experts in the public and private sectors,
including industry and civil society leaders, academics, scientists,
and donors, the Alliance offers innovative approaches that have
guided USAID’s investments in engaging communities to help
meet the needs of TB patients and address stigma and gender
discrimination around the disease. In addition, the
Alliance facilitates private-sector involvement at all levels
to contribute to the common goal of a TB-free India.
A health worker monitoring a woman’s TB treatment. Photo credit: Challenge TB.
7FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
APPENDIX This appendix provides a snapshot into achievements during Fiscal Year (FY) 2018 in each of the 23 countries in which the U.S.
Agency for International Development (USAID) provides bilateral assistance to end tuberculosis (TB).
NOTES ■ Unless otherwise noted, notification data is used as a proxy for diagnosed and started on treatment.
■ The charts use 2018 data for the estimated burden.
■ The Stop TB Partnership calculated the targets for “40x22” (diagnosing and enrolling an additional 40 million people on treatment
for TB by 2022, with a focus on countries with the highest burden of the disease) and “30x22” (enrolling 30 million on preventive
therapy for TB) by using the latest estimates generated by the World Health Organization (WHO) for the incidence of TB and
the number of notifications available publicly. With the exception of the Republics of India and The Philippines, USAID calculated
all projections by using the Tuberculosis Impact Model and Estimates (TIME) model implemented by Avenir Health. To reflect
country ambition, USAID adjusted upward the targets for TB treatment in India and the Philippines based on their governments’
announcements at the United Nations General Assembly High-Level Meeting on TB (UNHLM) in September 2018.
■ For the purpose of this appendix, “drug-resistant TB” (DR-TB) means a strain of the disease resistant to at least isoniazid and rifampicin.
■ Complete data for preventative treatment for TB in 2018 were either partially available or unavailable for the
Islamic Republic of Afghanistan; the People’s Republic of Bangladesh; the Republics of Kenya, Malawi, Uganda,
Uzbekistan, and Zambia; and the United Republic of Tanzania. USAID obtained data for the Kingdom of
Cambodia from the National Tuberculosis Program (NTP) within the Cambodian Ministry of Health.
■ Data on the number of TB cases attributable to top risk factors were not available for certain risk factors
in some countries. Missing data related to these graphs are noted directly on the graphs.
■ The WHO has revised significantly the estimates of the burden of DR-TB for Calendar Year 2018.
Accordingly, the WHO is updating the targets for DR-TB treatment enrollments based on these new global
estimates, and they were not available at the time USAID prepared this report for FY 2018.
■ The WHO has revised downward the estimate for the overall burden of TB in the Kyrgyz Republic for Calendar Year
2018. However, USAID calculated the target for the number of Kyrgyz patients started on treatment for TB based on the
estimates of the burden of the disease for 2017. Therefore, the targets appear higher than the estimated burden.
■ In our previous Report to Congress (FY 2017), the targets for the number of patients on preventive treatment for TB
included only the targets for under-five child household contacts of bacteriologically confirmed TB cases and persons who
were living with HIV (PLHIV). This year (FY 2018), the target for preventive treatment for TB includes an additional third
category: household contacts more than five years of age and adults. This is in alignment with the goals set at the UNHLM.
■ Data on childhood TB from previous years have been inconsistent because of a mixture of programmatic
challenges with diagnosing and treating the disease in children, as well as data-reporting problems.
■ The charts present the distribution of USAID’s Program funding in broad categories.
■ The charts present the distribution of USAID’s Program funding according to the Agency’s internal budgeting and
finance system, which includes two cross-cutting categories: training and support costs. Training is approximately
ten percent across all categories. “Support costs” are defined as system costs to support TB diagnosis and
care, including the categories of Health-Systems Strengthening (HSS) and Strategic Information (SI).
DATA SOURCES:USAID sourced the data for all of the following pages from internal systems, the WHO, the Stop TB Partnership’s Global Drug
Facility, and NTPs.
8FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
AFGHANISTAN
ETHIOPIA
DEMOCRATIC REPUBLIC OF THE CONGO
NIGERIA
BANGLADESH
INDIA
CAMBODIA INDONESIAKENYA
KYRGYZ REPUBLIC
MALAWI
MOZAMBIQUE
BURMA
PHILIPPINES
VIETNAM
SOUTH AFRICA
TAJIKISTAN
UGANDA
UKRAINE
TANZANIA
UZBEKISTAN
ZAMBIA
ZIMBABWE
USAID TB PRIORITY COUNTRIES
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ACCELERATING ACTION TO END TB
AFGHANISTAN
ETHIOPIA
DEMOCRATIC REPUBLIC OF THE CONGO
NIGERIA
BANGLADESH
INDIA
CAMBODIA INDONESIAKENYA
KYRGYZ REPUBLIC
MALAWI
MOZAMBIQUE
BURMA
PHILIPPINES
VIETNAM
SOUTH AFRICA
TAJIKISTAN
UGANDA
UKRAINE
TANZANIA
UZBEKISTAN
ZAMBIA
ZIMBABWE
11FY2018 | TUBERCULOSIS REPORT TO CONGRESS
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ISLAMIC REPUBLIC OF AFGHANISTAN
0
10000
20000
30000
40000
50000
60000
70000
80000
2005
2006
2007
2008
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2010
2011
2012
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2015
2016
2017
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2022
40 X 22 Targets
estimated burden
0
Number of Patients Started on Treatment for Tuberculosis
2000
4000
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10000
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14000
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
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30%
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2014
Number of Children Started on Treatment for Tuberculosis
2015 2016 2017
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500
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1500
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Percent of Patients Successfully Treated
2015 2016 2017 2018
estimated burden
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10000
20000
30000
40000
50000
60000
70000
2017
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
2018 202230X22 Targets
Number of Patients on Preventive Treatment for Tuberculosis
0
1000
2000
3000
4000
5000
6000
7000
8000
0-4 5-14 15-24 4425-34 35- 45-54 55-64 65+
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
12FY2018 | TUBERCULOSIS REPORT TO CONGRESS
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ISLAMIC REPUBLIC OF AFGHANISTAN
0 5000 10000 15000 20000 25000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
38%
25%
38%
Number of Tuberculosis Cases Attributable to Top Risk Factors
Person-Centered Care
Heath Systems Stregthening
Strategic Information
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
Data not available
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PEOPLE’S REPUBLIC OF BANGLADESH
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
0-4 5-14 15-24 4425-34 35- 45-54 55-64 65+
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
50000
100000
150000
200000
250000
300000
350000
400000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
Number of Patients Started on Treatment for Tuberculosis
5000
10000
15000
20000
25000
30000
35000
2015 2016 2017 2018 2022
40x22 Targets
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Number of Children Started on Treatment for Tuberculosis
2014 2015 2016 2017
0
1000
2000
3000
4000
5000
6000
Percent of Patients Successfully Treated
7000
2015 2016 2017 2018
estimated burden
0
50000
100000
150000
200000
250000
300000
350000
400000
2017
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
2018 202230X22 Targets
Number of Patients on Preventive Treatment for Tuberculosis
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PEOPLE’S REPUBLIC OF BANGLADESH
0 10000 20000 30000 40000 50000 60000 70000 80000 90000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
43%
11% 11%
19%
5%
Number of Tuberculosis Cases Attributable to Top Risk Factors
10% Person-Centered Care
Procurement and Supply-Management
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
Research
Multi-Drug-Resistant TB
Health-System Strengthening
Strategic Information
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BURMA
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
0-4 5-14 15-24 4425-34 35- 45-54 55-64 65+
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Pateints Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
20000
40000
60000
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40 X 22 Targets
estimated burden
0
Number of Patients Started on Treatment for Tuberculosis
5000
10000
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20000
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40000
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40x22 Targets
0%
10%
20%
30%
40%
50%
60%
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80%
90%
Number of Children Started on Treatment for Tuberculosis
100%
2014 2015 2016 2017
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2000
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6000
8000
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Percent of Patients Successfully Treated
2015 2016 2017 20180
20000
40000
60000
80000
100000
120000
140000
160000
2017 2018 2022
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
30X22 Targets
estimated burden
Number of Patients on Preventive Treatment for Tuberculosis
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BURMA
0 5000 10000 15000 20000 25000 30000 35000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
32%
7%
40%
8%
12% 1%
Number of Tuberculosis Cases Attributable to Top Risk Factors
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
Person-Centered Care
Procurement and Supply-Management
Multi-Drug-Resistant TB
Research
Health-System Strengthening
Strategic Information
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KINGDOM OF CAMBODIA
0
1000
2000
3000
4000
5000
6000
0-4 5-14 15-24 4425-34 35- 45-54 55-64 65+
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
10000
20000
30000
40000
50000
60000
2005
2006
2007
2008
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2010
2011
2012
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2022
40 X 22 Targets
estimated burden
0
Number of Patients Started on Treatment for Tuberculosis
1000
2000
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4000
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7000
8000
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Number of Children Started on Treatment for Tuberculosis
2014 2015 2016 2017
0
200
400
600
800
1000
1200
Percent of Patients Successfully Treated
2015 2016 2017 2018
estimated burden
0
5000
10000
15000
20000
25000
30000
2017 2018 2022
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
30X22 Targets
Number of Patients on Preventive Treatment for Tuberculosis
18FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
KINGDOM OF CAMBODIA
0 2000 4000 6000 8000 10000 12000 14000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
50%
13%
6%
16%
14%
Number of Tuberculosis Cases Attributable to Top Risk Factors
Person-Centered Care
Research
Multi-Drug-Resistant TB
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
Health-System Strengthening
Strategic Information
19FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
DEMOCRATIC REPUBLIC OF CONGO
0
5000
10000
15000
20000
25000
30000
35000
0-4 5-14 15-24 4425-34 35- 45-54 55-64 65+
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Pateints Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
50000
100000
150000
200000
250000
300000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
Number of Patients Started on Treatment for Tuberculosis
5000
10000
15000
20000
25000
30000
35000
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Number of Children Started on Treatment for Tuberculosis
2014 2015 2016 2017
0
1000
2000
3000
4000
5000
6000
7000
2015 2016 2017 2018
Percent of Patients Successfully Treated
estimated burden
0
50000
100000
150000
200000
250000
300000
350000
400000
2017 2018 202230X22 Targets
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
Number of Patients on Preventive Treatment for Tuberculosis
20FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
DEMOCRATIC REPUBLIC OF CONGO
0 5000 10000 15000 20000 25000 30000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
46%
23%
5%
18%
Number of Tuberculosis Cases Attributable to Top Risk Factors
1%
1% 7%Person-Centered Care
TB/HIV
Procurement and Supply-Management
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
Research
Multi-Drug-Resistant TB
Health-System Strengthening
Strategic Information
Data not available
Data not available
21FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
FEDERAL DEMOCRATIC REPUBLIC OF ETHIOPIA
0
5000
10000
15000
20000
25000
30000
0-4 5-14 15-24 4425-34 35- 45-54 55-64 65+
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Pateints Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
20000
40000
60000
80000
100000
120000
140000
160000
180000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
Number of Patients Started on Treatment for Tuberculosis
2000
4000
6000
8000
10000
12000
14000
16000
18000
20000
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Number of Children Started on Treatment for Tuberculosis
2014 2015 2016 2017
0
200
400
600
800
1000
1200
1400
1600
1800
2015 2016 2017 2018
Percent of Patients Successfully Treated
0
20000
40000
60000
80000
100000
120000
140000
2017 2018 2022
30X22 Targets
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
estimated burden
Number of Patients on Preventive Treatment for Tuberculosis
22FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
FEDERAL DEMOCRATIC REPUBLIC OF ETHIOPIA
0 10000 20000 30000 40000 50000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
33%
2% 3%
19% 2%
Number of Tuberculosis Cases Attributable to Top Risk Factors
33%
6% Person-centered Care
TB/HIV
Procurement Supply Management
MDR-TB
Research
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
Health System Strengthening
Strategic Information
23FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF INDIA
0
50000
100000
150000
200000
250000
300000
0-4 5-14 15-24 44 45-54 55-64 65+25-34 35-
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
500000
1000000
1500000
2000000
2500000
3000000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
20000
Number of Patients Started on Treatment for Tuberculosis
40000
60000
80000
100000
120000
140000
160000
180000
200000
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2014
Number of Children Started on Treatment for Tuberculosis
2015 2016 2017
0
20000
40000
60000
80000
100000
120000
140000
2015 2016 2017 2018
Percent of Patients Successfully Treated
0
500000
1000000
1500000
2000000
2500000
2017 2018 2022
30X22 Targets
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
estimated burden
Number of Patients on Preventive Treatment for Tuberculosis
24FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF INDIA
0 100000 200000 300000 400000 500000 600000 700000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
54%
8%
12%
26%
Number of Tuberculosis Cases Attributable to Top Risk Factors
TB/HIV
Person-centered Care
MDR-TB
Research
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
25FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF INDONESIA
0
20000
40000
60000
80000
100000
120000
140000
160000
0-4 5-14 15-24 44 45-54 55-64 65+25-34 35-
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
100000
200000
300000
400000
500000
600000
700000
800000
900000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
10000
Number of Patients Started on Treatment for Tuberculosis
20000
30000
40000
50000
60000
70000
80000
90000
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Number of Children Started on Treatment for Tuberculosis
2014 2015 2016 2017
0
5000
10000
15000
20000
25000
30000
2015 2016 2017 2018
Percent of Patients Successfully Treated
0
100000
200000
300000
400000
500000
600000
2017 2018 2022
30X22 Targets
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
estimated burden
Number of Patients on Preventive Treatment for Tuberculosis
26FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF INDONESIA
0 20000 40000 60000 80000 100000 120000 140000 160000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
30%
18% 6%
10%
11%
18%
7%
Number of Tuberculosis Cases Attributable to Top Risk Factors
Person-centered Care
TB/HIV
Procurement Supply Management
MDR-TB
Research
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
Health System Strengthening
Strategic Information
27FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF KENYA
0
5000
10000
15000
20000
25000
30000
0-4 5-14 15-24 44 45-54 55-64 65+25-34 35-
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
20000
40000
60000
80000
100000
120000
140000
160000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
2000
Number of Patients Started on Treatment for Tuberculosis
4000
6000
8000
10000
12000
14000
16000
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Number of Children Started on Treatment for Tuberculosis
2014 2015 2016 2017
0
500
1000
1500
2000
2500
2015 2016 2017 2018
Percent of Patients Successfully Treated
estimated burden
0
20000
40000
60000
80000
100000
120000
140000
160000
180000
200000
2017 2018 202230X22 Targets
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
Number of Patients on Preventive Treatment for Tuberculosis
28FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF KENYA
0 10000 20000 30000 40000 50000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
97%
3%
Number of Tuberculosis Cases Attributable to Top Risk Factors
Person-centered Care
Procurement Supply Management
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
29FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
KYRGYZ REPUBLIC
0
100
200
300
400
500
600
700
800
900
1000
0-4 5-14 15-24 44 45-54 55-64 65+25-34 35-
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
100
Number of Patients Started on Treatment for Tuberculosis
200
300
400
500
600
700
800
900
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2014
Number of Children Started on Treatment for Tuberculosis
2015 2016 2017
0
500
1000
1500
2000
2500
Percent of Patients Successfully Treated
3000
3500
2015 2016 2017 20180
1000
2000
3000
4000
5000
6000
7000
8000
9000
2017 2018 2022
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
30X22 Targets
Number of Patients on Preventive Treatment for Tuberculosis
30FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
KYRGYZ REPUBLIC
0 100 200 300 400 500 600 700 800 900 1000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
40%
39%
12%
9%
Number of Tuberculosis Cases Attributable to Top Risk Factors
MDR-TB
Person-centered Care
Health System Strengthening
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
Strategic Information
31FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF MALAWI
0
500
1000
1500
2000
2500
3000
3500
4000
4500
5000
0-4 5-14 15-24 44 45-54 55-64 65+25-34 35-
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
5000
10000
15000
20000
25000
30000
35000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
500
Number of Patients Started on Treatment for Tuberculosis
1000
1500
2000
2500
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Number of Children Started on Treatment for Tuberculosis
2014 2015 2016 2017
0
50
100
150
200
250
300
Percent of Patients Successfully Treated
350
400
450
2015 2016 2017 2018
estimated burden
0
10000
20000
30000
40000
50000
60000
70000
80000
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
90000
100000
2017 2018 2022
30X22 Targets
Number of Patients on Preventive Treatment for Tuberculosis
32FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF MALAWI
0 2000 4000 6000 8000 10000 12000 14000 16000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
36%
15% 2%
38%
5% 4%
Number of Tuberculosis Cases Attributable to Top Risk Factors
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
Person-centered Care
Procurement Supply Management
TB/HIV
MDR-TB
Research
Strategic Information
33FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF MOZAMBIQUE
0
10000
20000
30000
40000
50000
60000
70000
80000
90000
0-4 5-14 15 +
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
20000
40000
60000
80000
100000
120000
140000
160000
180000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
5000
Number of Patients Started on Treatment for Tuberculosis
10000
15000
20000
25000
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2014
Number of Children Started on Treatment for Tuberculosis
2015 2016 2017
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
Percent of Patients Successfully Treated
2015 2016 2017 2018
estimated burden
0
50000
100000
150000
200000
250000
2017 2018 2022
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
30X22 Targets
Number of Patients on Preventive Treatment for Tuberculosis
34FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF MOZAMBIQUE
0 10000 20000 30000 40000 50000 60000 70000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
58% 25%
17%
Number of Tuberculosis Cases Attributable to Top Risk Factors
TB/HIV
Person-centered Care
MDR-TB
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
35FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF NIGERIA
0
10000
20000
30000
40000
50000
60000
70000
0-4 5-14 15-24 44 45-54 55-64 65+25-34 35-
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
50000
100000
150000
200000
250000
300000
350000
400000
450000
500000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
5000
Number of Patients Started on Treatment for Tuberculosis
10000
15000
20000
25000
30000
35000
40000
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2014
Number of Children Started on Treatment for Tuberculosis
2015 2016 2017
0
5000
10000
15000
20000
25000
2015 2016 2017 2018
Percent of Patients Successfully Treated
estimated burden
0
100000
200000
300000
400000
500000
600000
700000
2017 2018 2022
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
30X22 Targets
Number of Patients on Preventive Treatment for Tuberculosis
36FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF NIGERIA
0 10000 20000 30000 40000 50000 60000 70000 80000 90000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
43%
5% 17%
11%
15%
9%
Number of Tuberculosis Cases Attributable to Top Risk Factors
Person-centered Care
MDR-TB
Procurement Supply Management
Research
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
Health System Strengthening
Strategic Information
37FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF THE PHILIPPINES
0
10000
20000
30000
40000
50000
60000
70000
80000
0-4 5-14 15-24 44 45-54 55-64 65+25-34 35-
Age Group
0
100000
200000
300000
400000
500000
600000
700000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Male: Burden
Male: On Treatment
Female: Burden
Female: On Treatment
40 X 22 Targets
estimated burden
0
10000
Number of Patients Started on Treatment for Tuberculosis
20000
30000
40000
50000
60000
70000
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2014
Number of Children Started on Treatment for Tuberculosis
2015 2016 2017
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
Percent of Patients Successfully Treated
20000
2015 2016 2017 2018
estimated burden
0
50000
100000
150000
200000
250000
300000
350000
400000
450000
2017 2018 2022
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
30X22 Targets
Number of Patients on Preventive Treatment for Tuberculosis
38FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF THE PHILIPPINES
0 20000 40000 60000 80000 100000 120000 140000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
30%
14% 13%
14%
21%
9%
Number of Tuberculosis Cases Attributable to Top Risk Factors
Person-centered Care
MDR-TB
Procurement Supply Management
Research
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
Health System Strengthening
Strategic Information
39FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF SOUTH AFRICA
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
0-4 5-14 15-24 44 45-54 55-64 65+25-34 35-
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
50000
100000
150000
200000
250000
300000
350000
400000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
5000
Number of Patients Started on Treatment for Tuberculosis
10000
15000
20000
25000
30000
35000
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2014
Number of Children Started on Treatment for Tuberculosis
2015 2016 2017
0
2000
4000
6000
8000
10000
12000
14000
2015 2016 2017 2018
Percent of Patients Successfully Treated
estimated burden
0
100000
200000
300000
400000
500000
600000
2017 2018 2022
30X22 Targets
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
Number of Patients on Preventive Treatment for Tuberculosis
40FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF SOUTH AFRICA
0 20000 40000 60000 80000 100000 120000 140000 160000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
44%
1% 5%
33%
6% 6% 6%
Number of Tuberculosis Cases Attributable to Top Risk Factors
Person-centered Care
TB/HIV
Procurement Supply Management
MDR-TB
Research
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
Health System Strengthening
Strategic Information
41FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF TAJIKISTAN
0
200
400
600
800
1000
1200
0-4 5-14 15-24 44 45-54 55-64 65+25-34 35-
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
1000
2000
3000
4000
5000
6000
7000
8000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
100
Number of Patients Started on Treatment for Tuberculosis
200
300
400
500
600
700
800
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2014
Number of Children Started on Treatment for Tuberculosis
2015 2016 2017
0
200
400
600
800
1000
1200
1400
1600
1800
2000
2015 2016 2017 2018
Percent of Patients Successfully Treated
estimated burden
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
2017 2018 2022
30X22 Targets
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
Number of Patients on Preventive Treatment for Tuberculosis
42FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF TAJIKISTAN
0 50 100 150 200 250 300 350 400
Undernourishment
Smoking
HIV
Diabetes
Alcohol
25%
5%
4%
46%
8% 4%
8%
Number of Tuberculosis Cases Attributable to Top Risk Factors
Person-centered Care
TB/HIV
Procurement Supply Management
MDR-TB
Research
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
Health System Strengthening
Strategic Information
Data not available
Data not available
43FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF UGANDA
0
5000
10000
15000
20000
25000
0-4 5-14 15-24 44 45-54 55-64 65+25-34 35-
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
20000
40000
60000
80000
100000
120000
140000
160000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
2000
Number of Patients Started on Treatment for Tuberculosis
4000
6000
8000
10000
12000
14000
16000
18000
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Number of Children Started on Treatment for Tuberculosis
2014 2015 2016 2017
0
200
400
600
800
1000
1200
1400
1600
1800
Percent of Patients Successfully Treated
2000
2015 2016 2017 20180
estimated burden
20000
40000
60000
80000
100000
120000
140000
160000
180000
2017 2018 2022
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
30X22 Targets
Number of Patients on Preventive Treatment for Tuberculosis
44FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF UGANDA
0 10000 20000 30000 40000 50000 60000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
68% 2%
30%
Number of Tuberculosis Cases Attributable to Top Risk Factors
Person-centered Care
MDR-TB
Procurement Supply Management
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
45FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
UKRAINE
0
2000
4000
6000
8000
10000
12000
14000
16000
0-4 5-14 15-24 44 45-54 55-64 65+25-34 35-
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
10000
20000
30000
40000
50000
60000
70000
80000
90000
100000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
1000
Number of Patients Started on Treatment for Tuberculosis
2000
3000
4000
5000
6000
7000
8000
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2014
Number of Children Started on Treatment for Tuberculosis
2015 2016 2017
0
200
400
600
800
1000
1200
1400
1600
2015 2016 2017 2018
Percent of Patients Successfully Treated
estimated burden
0
20000
40000
60000
80000
100000
120000
140000
160000
2017 2018 2022
30X22 Targets
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
Number of Patients on Preventive Treatment for Tuberculosis
46FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
UKRAINE
0 5000 10000 15000 20000 25000 30000 35000 40000 45000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
41%
3% 8% 23%
5% 5%
15%
Number of Tuberculosis Cases Attributable to Top Risk Factors
Person-centered Care
TB/HIV
Procurement Supply Management
MDR-TB
Research
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
Health System Strengthening
Strategic Information
47FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
UNITED REPUBLIC OF TANZANIA
0
1000
2000
3000
4000
5000
6000
7000
8000
0-4 5-14 15-24 44 45-54 55-64 65+25-34 35-
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
500
Number of Patients Started on Treatment for Tuberculosis
1000
1500
2000
2500
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Number of Children Started on Treatment for Tuberculosis
2014 2015 2016 2017
0
2000
4000
6000
8000
10000
12000
14000
2015 2016 2017 2018
Percent of Patients Successfully Treated
estimated burden
0
10000
20000
30000
40000
50000
60000
2017 2018 2022
30X22 Targets
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
Number of Patients on Preventive Treatment for Tuberculosis
48FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
UNITED REPUBLIC OF TANZANIA
0 1000 2000 3000 4000 5000 6000 7000 8000 9000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
24%
2%
63%
8% 3%
Number of Tuberculosis Cases Attributable to Top Risk Factors
TB/HIV
Person-centered Care
MDR-TB
Research
Strategic Information
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
49FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF UZBEKISTAN
0
500
1000
1500
2000
2500
0-4 5-14 15-24 44 45-54 55-64 65+25-34 35-
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
5000
10000
15000
20000
25000
30000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
500
Number of Patients Started on Treatment for Tuberculosis
1000
1500
2000
2500
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2014
Number of Children Started on Treatment for Tuberculosis
2015 2016 2017
0
500
1000
1500
2000
2500
3000
3500
4000
4500
Percent of Patients Successfully Treated
5000
2015 2016 2017 2018
estimated burden
0
5000
10000
15000
20000
25000
2017 2018 2022
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
30X22 Targets
Number of Patients on Preventive Treatment for Tuberculosis
50FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF UZBEKISTAN
0 500 1000 1500 2000 2500 3000 3500
Undernourishment
Smoking
HIV
Diabetes
Alcohol
19%
15%
4% 48%
3% 5% 5%
Number of Tuberculosis Cases Attributable to Top Risk Factors
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
Person-centered Care
Procurement Supply Management
TB/HIV
MDR-TB
Research
Health System Strengthening
Strategic Information
51FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
SOCIALIST REPUBLIC OF VIETNAM
0
5000
10000
15000
20000
25000
30000
0-4 5-14 15-24 44 45-54 55-64 65+25-34 35-
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
20000
40000
60000
80000
100000
120000
140000
160000
180000
200000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
2000
Number of Patients Started on Treatment for Tuberculosis
4000
6000
8000
10000
12000
14000
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2014
Number of Children Started on Treatment for Tuberculosis
2015 2016 2017
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
2015 2016 2017 2018
Percent of Patients Successfully Treated
estimated burden
0
10000
20000
30000
40000
50000
60000
70000
80000
90000
100000
2017 2018 2022
Number Started on Treatment for Drug-Resistant Tuberculosis
30X22 Targets
Number of Patients on Preventive Treatment for Tuberculosis
52FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
SOCIALIST REPUBLIC OF VIETNAM
0 5000 10000 15000 20000 25000 30000 35000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
39%
35%
5% 6%
15%
Number of Tuberculosis Cases Attributable to Top Risk Factors
MDR-TB
Person-centered Care
Research
Health System Strengthening
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
Strategic Information
53FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF ZAMBIA
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
0-4 5-14 15-24 44 45-54 55-64 65+25-34 35-
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
10000
20000
30000
40000
50000
60000
70000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
500
Number of Patients Started on Treatment for Tuberculosis
1000
1500
2000
2500
3000
3500
4000
4500
5000
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Number of Children Started on Treatment for Tuberculosis
2014 2015 2016 2017
0
500
1000
1500
2000
2500
3000
3500
2015 2016 2017 2018
Percent of Patients Successfully Treated
0
estimated burden
20000
40000
60000
80000
100000
120000
2017 2018 2022
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
30X22 Targets
Number of Patients on Preventive Treatment for Tuberculosis
54FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF ZAMBIA
0 5000 10000 15000 20000 25000 30000 35000 40000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
50% 50%
Number of Tuberculosis Cases Attributable to Top Risk Factors
MDR-TB
Person-centered Care
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
55FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF ZIMBABWE
0
1000
2000
3000
4000
5000
6000
0-4 5-14 15-24 44 45-54 55-64 65+25-34 35-
Age Group
Male: Burden
Male: On Treatment
Female: Burden
Burden and Number of Patients Started on Treatment by Age and Sex (2018)
Female: On Treatment
0
10000
20000
30000
40000
50000
60000
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2022
40 X 22 Targets
estimated burden
0
500
Number of Patients Started on Treatment for Tuberculosis
1000
1500
2000
2500
3000
3500
2015 2016 2017 2018 2022
40x22 Targets 0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2014
Number of Children Started on Treatment for Tuberculosis
2015 2016 2017
0
200
400
600
800
1000
1200
1400
1600
2015
Percent of Patients Successfully Treated
2016 2017 2018
estimated burden
0
20000
40000
60000
80000
100000
120000
2017 2018 2022
Number of Patients Started on Treatment for Drug-Resistant Tuberculosis
30X22 Targets
Number of Patients on Preventive Treatment for Tuberculosis
56FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB
REPUBLIC OF ZIMBABWE
0 2000 4000 6000 8000 10000 12000 14000 16000 18000 20000
Undernourishment
Smoking
HIV
Diabetes
Alcohol
43%
0.4%
2%
28%
2%
Number of Tuberculosis Cases Attributable to Top Risk Factors
22%
1% Person-centered Care
TB/HIV
Procurement Supply Management
MDR-TB
Research
Distribution of Funding from the U.S. Agency for International Development for Tuberculosis
Health System Strengthening
Strategic Information
57FY2018 | TUBERCULOSIS REPORT TO CONGRESS
ACCELERATING ACTION TO END TB