Optimising Investments in the Tuberculosis Response of Gauteng Province, South Africa : Findings from a Pilot Application of the Optima TB Model
South Africa remains a high-burden country for tuberculosis (TB) and multi-drug resistant TB (MDR-TB) with an underlying generalised HIV epidemic. TB funding must therefore be allocated to interventions which provide high impact to prevent TB trans...
| Main Authors: | , , |
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| Format: | Report |
| Language: | English |
| Published: |
World Bank, Washington, DC
2020
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/772111581370318152/Optimising-Investments-in-the-Tuberculosis-Response-of-Gauteng-Province-South-Africa-Findings-from-a-Pilot-Application-of-the-Optima-TB-Model http://hdl.handle.net/10986/33377 |
| Summary: | South Africa remains a high-burden
country for tuberculosis (TB) and multi-drug resistant TB
(MDR-TB) with an underlying generalised HIV epidemic. TB
funding must therefore be allocated to interventions which
provide high impact to prevent TB transmission, identify TB
cases and treat them successfully. This report presents the
findings from a pilot application of the Optima TB model in
Gauteng Province, where many challenges remain to
sustainably reduce TB. The modelling analysis focused on
relevant intervention scenarios and optimal resource
allocation to achieve the 2022 TB targets, using the
mathematical optimisation feature of the tool. Findings
suggest that further reductions in TB prevalence and deaths
are possible through improved allocative efficiency. Several
scenarios highlight opportunities especially in HIV negative
populations by improving the TB care cascade with higher
diagnosis rates, enhanced linkage to treatment and better
MDR treatment outcomes using shorter drug regimens. The same
budget allocated differently could, by 2022, reduce active
TB infections by up to 40 and reduce TB deaths by up to 30
perent among HIV positive and HIV negative populations. The
study provided valuable input into the refinement of the
Optima TB model, especially for the HIV/TB co-epidemic
setting. The model outputs support Gauteng's focus on
improving the care cascade and innovating MDR-TB treatment. |
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