Mongolia commits to end TB - the world’s deadliest infectious disease

World TB Day is observed annually on 24 March to amplify the urgent need to eliminate tuberculosis (TB). TB, the world’s deadliest infectious disease, continues to devastate millions globally, inflicting severe health, social, and economic consequences.  In 2023 alone, an estimated 10.8 million people fell ill with TB worldwide, and 1.25 million lost their lives to the disease.  The Western Pacific Region, including Mongolia, accounted for 17% of these cases.

TB challenge in Mongolia

Mongolia is categorized as one of the 30 countries with a high TB and multidrug-resistant TB (MDR-TB) burden. In 2023, it was among four high-burden countries with low treatment coverage, highlighting the urgent need for stronger interventions.

Despite global efforts that saved 79 million lives since 2000, TB continues to pose a significant challenge in many countries including Mongolia. The country’s vertical, centralized TB care model relies heavily on specialized dispensaries for TB diagnosis and treatment and requires patients to attend daily treatments for up to nine months. This approach contributes to treatment non-adherence, increasing the risk of drug-resistant TB. Additionally, two in three TB patients face catastrophic costs due to lost income and frequent treatment visits.

A national plan for change

Mongolia is taking decisive steps to combat TB. Aligned with WHO’s End TB Strategy and the Sustainable Development Goals, the country is finalizing its National Strategic Plan for TB 2025 – 2028 to accelerate its goal of ending TB. The plan sets an ambitious target of bringing down TB incidence from 491 per 100 000 in 2023 to 197 per 100 000 by 2028.

To accelerate progress, Mongolia hosted a high-level WHO mission in November 2024, bringing together experts from WHO headquarters and the regional office. The mission aimed to support the finalization of the National Strategic Plan and focused on advancing a health system-wide optimization approach to address systemic barriers and improve the detection, treatment, and care of TB cases.

TB system optimization approach

Mongolia’s health system optimization approach, guided by WHO, is a key pillar in strengthening its health system, particularly PHC, to improve TB prevention and care. Aligned with global priorities set by WHO, this approach involves a major policy and operational shift towards integrating TB services into primary health care, making care more accessible, increasing TB case notifications, improving patient outcomes and reducing the burden on specialized TB facilities. 

Photo caption: In November 2024, Mongolia hosted a high-level WHO mission, bringing experts to finalize the National Strategic Plan and advance a health system-wide approach for stronger TB detection, treatment, and care. Photo credit: WHO / Tsolmon Boldoo

WHO is working with the government to enhance the health care and public health system to deliver the full cascade of TB care, incorporating both horizontal and vertical integration. This involves integrating TB diagnosis, management and treatment across different levels of the healthcare delivery system, while strengthening primary health care.

This approach includes:

• Expanding screening to outpatient departments in state national referral hospitals, private health facilities, Family Health Centres, and Soum Health Centres.
• Enhancing diagnostic capacities at different health system levels, particularly in PHC settings.
• Introducing Digital Adherence Technologies to improve patients’ access and adherence to TB treatment.
• Strengthening PHC to provide integrated communicable disease services for early diagnosis and treatment.

The successful implementation of the TB health system optimization approach will also rely on:

• Digital health tools and real-time data systems to enhance surveillance, patient management, and real-time treatment monitoring.
• Enhancing the skills of PHC health workers to deliver high-quality TB prevention, diagnosis and treatment services.
• Engaging community and civil society organizations, including community groups and TB survivors, to promote TB awareness and advocacy. 

By shifting from a centralized, specialized approach to a community-based, people-centred model, Mongolia aims to increase TB case identification, elevate the treatment coverage rate to over 70%, and the boost treatment success rate to 90%.

Address by the WHO Assistant Director-General Dr Jérôme Salomon during the launch of the Health Systems Optimization Strategy to accelerate ending TB in Mongolia.