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These findings illustrate that much more needs to be done to prevent people living with HIV from developing and dying from TB co-infection.

Children are especially vulnerable to TB. In , 1 million children fell ill with TB 1 , and approximately , children aged died from it. Nevertheless, governments must clearly do more to ensure the new paediatric formulations are reaching patients.


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Treatment for DR-TB can be shortened to 9 months in certain circumstances; for people who are eligible, shorter treatment is equally effective and spares them from months of terrible side effects, and saves money. Out of Step reveals that countries are too conservative in implementing new treatment regimens that could significantly improve cure rates for DR-TB, and help curb the spread of drug-resistant strains. Access to new treatments must be accelerated. This requires that governments take bold steps in how drugs are regulated and made available in their countries.

TB can be prevented.

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Countries must pay more attention to TB prevention if they are to make serious inroads in stopping the spread of this debilitating and deadly disease. The Out of Step findings clearly show that governments must re-commit to fighting and winning the battle against TB, with urgency. We are still out of step in preventing and diagnosing TB, providing patient-centred care, and accelerating research into, registration and delivery of new, life-saving medicines.

We urgently need political will and adequate resources to fight TB; only a third of the annual funding needed to meet the targets is being provided.

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Group Subscription. Outdated policies, practices and tools for diagnosing, as well as conservatism and inaction in registering and using new TB medicines, are key barriers to turning around the TB epidemic. But the Out of Step report reveals that many countries still lag behind in ensuring full implementation of the WHO guidelines and policies that are proven to reduce TB incidence and death.

Out of Step includes the results of a country survey on national TB policies and practices.

Hearts, and Lives, Out of Step

The report was created to identify gaps in implementation and monitor progress towards ending TB. While countries have made progress since the Out of Step report , much more work needs to be done to make sure that these policies are fully implemented across all communities, so that they will make a real difference to people affected by TB. Additional publications in the Out of Step report series are available here.

In , world leaders endorsed the United Nations Sustainable Development Goals, which include an ambitious but achievable target to end the TB epidemic by Diagnosing TB quickly and accurately, so that people receive appropriate treatment, is an imperative first step.

Paper statistics

While many countries have adopted WHO guidelines and policies for diagnosis, the glacial pace of implementation is costing both lives and livelihoods. For people with rifampicin-resistant RR TB, additional drug-sensitivity testing DST should be available so that they can be treated with medicines most likely to be effective. With such a low proportion of countries having fully implemented recommended tests, the diagnostic gap remains massive; this deadly gap must be closed so that countries can reduce TB illness and death.

Once a person with TB has been properly diagnosed and started on treatment, ongoing care must be patient-centred, and easily accessible to all who need it. It has been more than 50 years since WHO recognised that limited resources were best used for ambulatory TB care, instead of hospital beds.