Tackling TB in vulnerable populations

A key component of pillar one of the World Health Organization’s End TB Strategy, namely, integrated patient-centred care and prevention, is the provision of universal access to TB care and prevention with greater attention on vulnerable and hard-to-reach populations. These populations are at higher risk of being exposed to TB, or developing TB once exposed, due to biological, structural or socioeconomic factors. Furthermore, access to health services for these populations and successful treatment outcomes may be sub-optimal when compared to other populations. This means that enhanced efforts and dedicated investments are needed to ensure equitable access to the full range of TB services, with additional efforts directed towards removing prejudice, stigma and human rights violations. Vulnerable populations may include refugees and migrants, people with substance use disorders (alcohol and drugs), people deprived of liberty - such as people in prisons and other places of detention,  pregnant and post-partum women, children and adolescents, indigenous populations, miners, people living in slums and other groups.  

The World Health Organization’s Global Tuberculosis Programme is working with all stakeholders, including civil society and affected communities to undertake mapping of TB vulnerability, develop guidance to promote access to TB services for vulnerable populations, including guidance on TB prevention and care, social protection, ethics, human rights and equity. WHO promotes people centred strategies for TB prevention and care using a multi-sectoral approach. WHO also aims to promote equitable access to health services for everyone affected by TB and to catalyse policy uptake through support to countries, through the collection and generation of data, promotion of research, scientific advocacy, target setting and monitoring progress, and the promotion of best practices.