The Global Tuberculosis Programme of the World Health Organization has the mandate to develop and disseminate evidence-based policy for tuberculosis prevention, diagnosis, treatment, and care. Regular review of evidence, and assessment of country needs for policy across the cascade of care is part of its core function. In this regard, GTB organized a fourth consultation assembling scientists, public health experts, partners, civil society, and countries to exchange views on emerging areas of need for evidence and for global TB policy guidance to achieve the goals and targets of the WHO End TB Strategy. The present report summarizes the outcome of this meeting.

Regular review of evidence, and assessment of country needs for policy across the cascade of care is part of the core function of the Global Tuberculosis Programme of the World Health Organization (WHO/GTB). In this regard, GTB organized a consultation (2-4 March 2021) assembling scientists, public health experts, partners, civil society and countries to exchange views on emerging needs of Member States for policy guidance; to discuss critical evidence gaps related to emerging global TB policy development needs; and, to identify topical strategies best positioned to enhance the implementation and evaluation of global TB policy guidance. The present report summarizes the discussions from this meeting.

Research along its full spectrum is critical for developing new tools and strategies for better tuberculosis (TB) prevention, diagnosis, treatment and care and to provide scientific evidence for programmes, practitioners and policy-makers working to alleviate morbidity and mortality from TB. Under the leadership of WHO, a global strategy for TB research and innovation was developed and adopted by Member States in 2020 to advance research and innovation, by translating political commitments made in the Moscow Declaration to End TB (2017) and the political declaration at the United Nations high-level meeting on TB (2018) into concrete actions. The present document is a checklist that allows for a robust analysis of the current situation at country level, to build an evidence base for prioritizing the implementations of the recommendations made in the global strategy through changes in policies, programmes and interventions. It is designed as a reference for ministries of health and other entities responsible for overseeing the implementation of the global strategy.

WHO has published a global TB report every year since 1997. The main aim of the report is to provide a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease, at global, regional and country levels. This is done in the context of recommended global TB strategies and targets endorsed by WHO?s Member States, broader development goals set by the United Nations (UN) and targets set in the political declaration at the first UN high-level meeting on TB (held in September 2018). The 2019 edition of the global TB report was released on 17 October 2019. The data in this report are updated annually. Please note that direct comparisons between estimates of TB disease burden in the latest report and previous reports are not appropriate. The most recent time-series of estimates are published in the 2019 global TB report.

Between 2011 and 2019, WHO has developed and issued evidence-based policy recommendations on the treatment and care of patients with DR-TB. These policy recommendations have been presented in several WHO documents and their associated annexes, including the WHO Consolidated Guidelines on Drug Resistant Tuberculosis Treatment, issued by WHO in March 2019. The policy recommendations in each of these guidelines have been developed by WHO-convened Guideline Development Groups, using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach to summarize the evidence, and formulate policy recommendations and accompanying remarks. The present WHO Consolidated Guidelines on Tuberculosis, Module 4: Treatment - Drug-Resistant Tuberculosis Treatment includes a comprehensive set of WHO recommendations for the treatment and care of DR-TB. The document includes two new recommendations, one on the composition of shorter regimens and one on the use of the BPaL regimen (i.e. bedaquiline, pretomanid and linezolid). In addition, the consolidated guidelines include existing recommendations on treatment regimens for isoniazid-resistant TB and MDR/RR-TB, including longer regimens, culture monitoring of patients on treatment, the timing of antiretroviral therapy (ART) in MDR/RR-TB patients infected with the human immunodeficiency virus (HIV), the use of surgery for patients receiving MDR-TB treatment, and optimal models of patient support and care. The guidelines are to be used primarily in national TB programmes, or their equivalents in Ministries of Health, and for other policy-makers and technical organizations working on TB and infectious diseases in public and private sectors and in the community.