Since 1995, WHO has ensured a consistent approach to national, regional and global TB surveillance by providing standardized definitions, forms and registers for the recording and reporting of individual-level and aggregated data about people diagnosed with and treated for TB, which are used worldwide. This standardization has facilitated the regular reporting of TB data to WHO from 215 countries and areas in annual rounds of global TB data collection, with findings published in an annual WHO global TB report since 1997 and data made publicly available via the online WHO global TB database. The goal of this 2024 edition of WHO guidance on TB surveillance (following the last major update published in 2013) is to ensure the continued worldwide standardization of TB surveillance, in the context of the WHO End TB Strategy, the latest WHO guidelines on TB screening, prevention, diagnosis and treatment, and commitments made at the 2023 UN high-level meeting on TB, while also promoting the establishment or strengthening of digital, case-based TB surveillance that is integrated within the overall public health architecture. This 2024 edition provides a comprehensive and consolidated package, bringing together both updated guidance as well as (within web annexes) closely related WHO products, tools and documentation related to TB surveillance. The web annexes (and associated links to them) are listed below. The package was informed by (and includes a summary of) lessons learned about TB surveillance during more than 100 national TB epidemiological reviews conducted since 2013.

Digital Adaptation Kits (DAKs) are part of WHO’s SMART guidelines initiative. This aims to ensure that the content of WHO’s evidence-based guidelines is accurately reflected in the digital systems being used at country level. The DAKs provide software-neutral, operational, and structured documentation based on WHO recommendations related to clinical care, health systems and use of data, to systematically and transparently inform the design of digital systems. Standard components of each DAK include: (1) linked health interventions and recommendations; (2) user personas; (3) user scenarios; (4) business processes and workflows; (5) core data elements mapped to standard terminology codes (e.g. the international classification of diseases); (6) decision support; (7) programme indicators; and (8) functional and non-functional requirements.

Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy. These consolidated guidelines on tuberculosis. Module 6: tuberculosis and comorbidities summarize the latest WHO recommendations on TB and key comorbidities. It is a living document and will include a separate section for each of the key TB comorbidities or health-related risk factors. This first edition focuses on interventions to address HIV-associated TB and is an update of the WHO policy on collaborative TB/HIV activities: guidelines for national programmes and other stakeholders. People with HIV are 12–16 times more likely to develop TB disease, have poorer TB treatment outcomes and have three-fold higher mortality during TB treatment compared to people without HIV. Despite advances in the screening, diagnosis, treatment and prevention of TB disease, TB remains the leading cause of death among people with HIV worldwide. These consolidated guidelines are intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB, as well as programmes addressing mental health and lung health, implementing partners including technical and funding agencies, civil society and representatives of affected communities, clinicians and public health practitioners.

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.

The WHO consolidated guidelines on tuberculosis. Module 2: screening – systematic screening for tuberculosis disease is an updated and consolidated summary of WHO recommendations on systematic screening for tuberculosis (TB) disease, containing 17 recommendations for populations in which TB screening should be conducted and tools to be used for TB screening. TB screening is strongly recommendations for household and close contacts of individuals with TB, people living with HIV, miners exposed to silica dust, and prisoners. In addition, screening is conditionally recommended for people with risk factors for TB attending health care, and for communities with risk factors for TB and limited access to care (e.g. homeless, urban poor, refugees, migrants). General population screening is recommended in high-burden settings (0.5% prevalence or higher). Symptoms, chest radiography (CXR), and molecular WHO-recommended rapid diagnostic tests for TB are recommended as screening tools for all adults eligible for screening. Computer-aided detection programmes are recommended as alternatives to human interpretation of CXR in settings where trained personnel are scarce. For people living with HIV, C-reactive protein is also a good screening tool. This guideline document is accompanied by an operational handbook, the WHO operational handbook on tuberculosis. Module 2: screening – systematic screening for tuberculosis disease, that presents principles of screening, steps in planning and implementing a screening programme, and algorithm options for screening different populations.

Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy. This WHO operational handbook on tuberculosis. Module 6: tuberculosis and comorbidities aims to support countries in scaling up people-centred care, based on the latest WHO recommendations on TB and key comorbidities, and drawing upon additional evidence, best practices and inputs from various experts and stakeholders obtained during WHO processes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health. This operational handbook is a living document and will include a separate section for each of the key TB comorbidities or health-related risk factors. The second edition includes guidance for HIV-associated TB and on mental health conditions, which are two conditions strongly associated with TB and which result in higher mortality, poorer TB treatment outcomes and negatively impact health-related quality of life. The operational handbook aims to facilitate early detection, proper assessment and adequate management of people affected by TB and comorbidities. Full implementation of this guidance is expected to have a significant impact on TB treatment outcomes and health-related quality of life for people affected by TB.

This consultation report summarizes the key outcomes of the WHO stakeholder meeting, held on 13–14 June 2024, to build consensus on the targets, criteria, and indicators for validating TB elimination efforts.

The WHO Global tuberculosis report 2024 provides 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 global TB commitments, strategies and targets. The 2024 edition of the report is based primarily on data gathered by WHO from national ministries of health in annual rounds of data collection. In 2024, 193 countries and areas (out of 215) with more than 99% of the world’s population and TB cases reported data. 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 this global TB report. Global TB reports from previous years can be found here.

Tuberculosis (TB) strains with drug resistance (DR-TB) are more difficult to treat than drug-susceptible ones, and threaten global progress towards the targets set by the End TB Strategy of the World Health Organization (WHO). There is thus a critical need for evidence-based policy recommendations on the treatment and care of patients with DR-TB, based on the most recent and comprehensive evidence available. In this regard, the WHO consolidated guidelines on drug-resistant tuberculosis treatment fulfil the mandate of WHO to inform health professionals in Member States on how to improve treatment and care for patients with DR-TB. Between 2011 and 2018, 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 treatment guidelines for multidrug- and rifampicin-resistant tuberculosis, 2018 update, issued by WHO in December 2018. The policy recommendations in each of these guidelines have been developed by WHO-convened Guideline Development Groups (GDGs), using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach to summarize the evidence, and formulate policy recommendations and accompanying remarks. The present Consolidated guidelines include a comprehensive set of WHO recommendations for the treatment and care of DR-TB, derived from these WHO guidelines documents. The consolidated guidelines include policy recommendations on treatment regimens for isoniazid-resistant TB (Hr-TB) and MDR/RR-TB, including longer and shorter 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), use of surgery for patients receiving MDR-TB treatment, and optimal models of patient support and care.