WMA Resolution on Tuberculosis


Adopted by the 57th WMA General Assembly, Pilanesberg, South Africa, October 2006
and revised by the 68th WMA General Assembly, Chicago, United States, October 2017

PREAMBLE

1.     According to the World Health Organization, tuberculosis is a significant global public health problem. South East Asian and African countries are most affected.

2.     In developing countries, the incidence of tuberculosis has risen dramatically because of high prevalence of HIV/AIDS, increasing migration of populations, urbanisation and over-crowding. The incidence and severity of the disease is closely associated with the social and economic living conditions within a population.

3.     The emergence of strains of tuberculosis bacteria resistant to first line drugs have become a major public health threat in the forms of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB). MDR-TB and XDR-TB are indicators of the growing antimicrobial resistance whose drivers are multifactorial and complex and require a multisectoral approach. MDR-TB and XDR-TB is a significant threat to development and the safety of global health.

4.     Community awareness and public health education and promotion are essential elements of tuberculosis prevention.

5.     Screening of high risk groups including PLHIV (people living with HIV) and vulnerable populations including migrants, prisoners, and the homeless should be considered within each national epidemiological context as a component of tuberculosis prevention. Systematic screening of contacts of infected persons is also recommended.

6.     Rapid diagnosis with molecular tests and supervised daily treatment started early should help arrest the spread of disease.

7.     BCG (Bacille Calmette-Guérin) vaccination as early as possible after birth should continue, in line with International Union against Tuberculosis and Lung Disease (IUATLD) criteria, until a new more effective vaccine is available.

8.     Intensified research and innovation is also considered imperative if attempts to address the epidemic and emerging resistance are to be successful.

 

RECOMMANDATIONS

9.     The World Medical Association, in consultation with WHO and national and international health authorities and organizations, will continue its work to generate community awareness about symptoms of TB and increase capacity building of health care providers in early identification and diagnosis of TB cases and to ensure complete treatment utilizing Directly Observed Treatment Short course or other appropriate therapy.

10.  The WMA supports the WHO “End TB Strategy” and its visions, goals and milestones.

11.  The WMA supports calls for adequate financial, material and human resources for tuberculosis and HIV/AIDS research and prevention, including adequately trained health care providers and adequate public health infrastructure, and will participate with health professionals in providing information on tuberculosis and its treatment.

12.  Health care professionals should have access to all required medical and protective equipment to guard against the risk of infection and spread of the disease.

13.  The WMA encourages continuing efforts to build up the capacity of health care professionals in the use of rapid diagnostics methods, their availability in the public and private sector and in the management of all forms of TB, including MDR and XDR.

14.  The WMA calls on National Medical Associations to support their National TB Programmes by generating awareness among healthcare professionals about TB management and early reporting of cases in the community.

15.  The WMA calls on National Medical Associations to promote methods of TB prevention including respiratory hygiene, cough etiquettes, and safe sputum disposal.

16.  National Medical Associations should encourage their members to notify in a timely manner to relevant authorities, about all patients diagnosed with TB or put on TB treatment for initiation of contact screening and adequate follow up till the completion of treatment.

17.  In addition, National Member Associations should encourage the development of strong pharmacovigilance and active TB drug-safety monitoring and management, to detect, manage and report suspected or confirmed drug toxicities, and encourage all their members to contribute actively to these systems.

18.  National Medical Associations should co-ordinate with their TB National Programme and promote the adopted guidelines to all members.

19.  The WMA supports WHO’s efforts and calls upon all governments, communities, civil society and the private sector to act together to end tuberculosis world-wide.

Resolution
MDR-TB, Multi-Drug-Resistant TB, Tuberculosis