Hybrid review of epidemiology of TB in Myanmar: TB control efforts ongoing during crisis

Myanmar continues to be one of the countries with the highest TB burden. The incidence rate of TB was 558 per 100,000 population in 2023 and close to 50,000 deaths are attributed to the disease. To better understand the epidemiology of TB during ongoing crisis, an innovative hybrid review was held.

The review began with virtual consultations with all partners in March 2025. Following the earthquake of 28 March 2025, international and national experts visited Mon State and Yangon region during 7 to 10 April 2025. The review has generated vital evidence for addressing TB burden and plan interventions for future. The evidence will also guide actions in the Myanmar Tuberculosis Strategic Plan for 2026-2030.

Using a standard WHO review tool, the mission scrutinized TB control efforts in the various parts of the country, inspected surveillance standards and tools, observed recording and reporting practices, and studied monitoring and evaluation systems at the central and field levels.

Ministry of Health, partners and WHO were lauded for ensuring essential TB services during ongoing crisis. The mission also acknowledged that the TB surveillance system in Myanmar is of a very good standard. The national TB response was appreciated for its alignment to the context of the country and improvement of TB notification towards pre-pandemic levels.

Reduction of TB control efforts contributed to increased transmission resulting in TB being a predominant communicable disease problem in the country and a concern for the entire region. Access to TB care in different parts of the country are inequitable, which the review pointed out as a key concern. Over 3.5 million internally displaced people, consequences of the earthquake, and worsening poverty have increased TB vulnerability.

The mission recommended urgent attention to improve access to TB services, systemic TB screening, scaling up molecular testing, expanding community-based TB care, strengthening TB-HIV coordination, and to align interventions with Myanmar’s high-burden context.

This review marks another milestone in the collaborative efforts between the Ministry of Health, WHO, and various partners in the shared goal of eliminating TB in Myanmar. The hybrid review introduced by WHO is cost effective and can be emulated in crisis and resource constraint settings.