With an emphasis on treatment that reaches all people sick with tuberculosis, and systems responsive to and supportive of patients, the World Health Organization has released an update to its tuberculosis care guidelines, highlighting issues that many of the countries with the highest burden of TB disease continue to fall short of confronting.
The update adds weight to recommendations that include immediate antiretroviral treatment for all people with HIV, drug susceptibility testing to ensure appropriate care, daily treatment, and care that reaches patients where they live, with community-based workers to directly observe treatment or, when that is not possible, treatment directly observed by video. The guidelines call for education of both patients and practitioners to provide improved understanding of the demands, challenges and potential problems involved in completing treatment for tuberculosis.
They are measures the Médecins Sans Frontières/Stop TB Partnership 2015 Out of Step report of TB policies in 24 countries, noted are missing, but critical in countries from Armenia to Zimbabwe where resources and training to confront tuberculosis are outstripped by prevalence of the disease. That report noted that the 24 countries surveyed continue to adapt policies and capacities to meet standards widely accepted as essential to effective control of tuberculosis. The updated WHO guidelines provide a metric through which they can measure their progress.