Ending tuberculosis in China: health system challenges

Abstract

China has made remarkable progress in reducing tuberculosis cases and deaths during the past three decades; however, it is still far from achieving the targets set out in the WHO End TB Strategy. Since the 2000s, China has tried to transform its vertical tuberculosis control programme led by the Chinese Center for Disease Control and Prevention (CDC) into an integrated system under the collaboration of CDC, tuberculosis-designated hospitals, and primary health centres. Such a transition has faced many challenges. Profit-driven practices in hospitals designated to tuberculosis and an absence of adequate tuberculosis-related training for health professionals are partially jeopardising the quality of tuberculosis care. In addition, primary health-care providers are not incentivised to make referrals and manage cases effectively. The CDC does not have the administrative power to influence hospital practices or deploy resources to support community-based tuberculosis control activities. Furthermore, an absence of policy coherence and effective coordination causes challenges for quality tuberculosis care that is affordable and accessible. Improving policy dialogues and multi-level coordination within the government is fundamental to successfully ending tuberculosis in China and other countries facing similar challenges.

The impact of Mycobacterium tuberculosis complex in the environment on one health approach

“…On the one hand, medical staff and animal husbandry practitioners abide by relevant regulations and laws on epidemic prevention in the process of medical treatment, breeding, and sales, and do a good job in environmental disinfection to avoid the spread of MTBC ( 50 ). On the other hand, the government and tuberculosis prevention and control institutions should enhance the subjective perception that MTBC in the environment harms the human and animal health and pay adequate attention to the MTBC in the environment causing tuberculosis ( 60 ). At the national level, the government needs to establish a feasible MTBC monitoring and prevention system in the environment.…”

Machine learning analysis of SERS fingerprinting for the rapid determination of Mycobacterium tuberculosis infection and drug resistance

“…Currently, it is estimated that around 2 billion people are infected with Mtb [5] , which makes TB the leading fatal single infectious disease worldwide [6] . Globally, the severity of TB epidemics differs among countries and regions while China ranked the second among the top 30 high-burden TB countries just behind India, which accounted for 9% of all the TB cases [7] and indicated that China was still far from achieving the targets set out in the WHO End TB Strategy [8] . Thus, it is important to strengthen the national health policy and improve capacities of TB screening, diagnosis and outpatient treatment so as to prevent, control and finally terminate TB infections in China.…”

The clinical characteristics and risk factors for severe COVID-19 in patients with COVID-19 and tuberculosis coinfection

“…The WHO estimated that 9.9 million people fell ill with tuberculosis (TB) worldwide in 2020, and TB is always one of the most important public health concerns in the world. China has the second-highest number of TB cases (8.5%) in the world and is still one of the countries with the highest TB burden (Long et al, 2021). In the past 2 years, the COVID-19 pandemic has caused enormous health, social and economic impacts, including the provision of and access to essential TB services, the number of people diagnosed with TB and the notifications of TB cases through the national disease surveillance systems and TB disease burden (Umubyeyi Nyaruhirira et al, 2022).…”