Guidance onsocial protection forpeople affected bytuberculosis

Publication Year 28 Oct 2024

Download this article in PDF format

Foreward

The World Health Organization (WHO) has set ambitious targets to end the tuberculosis (TB) epidemic, which include a 90% reduction in TB deaths, an 80% reduction in TB incidence, and the elimination of the catastrophic total costs incurred by people with TB and their households by 2030 compared with 2015, all in line with the United Nations (UN) Sustainable Development Goals (SDGs).
The inequities fuelling the TB epidemic have been accentuated by the COVID-19 pandemic, geopolitical instability, and global financial crises, making it even more urgent to implement policies that address the social determinants of TB. Social protection, a component of the WHO End TB Strategy (1), has been upheld by WHO Member States as an essential component of the response to TB in the 2017 Moscow Declaration to End TB (2) and in the 2023 Political Declaration of the High-level Meeting of the United Nations General Assembly on the Fight Against Tuberculosis (3). This recognition is reflected in the new target in the 2023 political declaration, to ensure that 100 per cent of people with TB have access to a health and social benefits package so they do not have to endure financial hardship because of their illness. Similarly, the political declaration of the 2023 United Nations High-level Meeting on Universal Health Coverage includes a commitment to reverse the trend of rising catastrophic out-ofpocket health expenditure by providing measures to ensure financial risk protection and eliminate impoverishment due to health-related expenses, with special emphasis on the poor as well as those who are vulnerable or in vulnerable situations..
In 2021, delegates of the 109th International Labour Conference asked the International Labour Organization (ILO) to take urgent action towards universal social protection to accelerate the reduction of inequalities and address the financial and societal consequences of the COVID-19 pandemic. This call built on International Social Security Standards and in particular the Social Security (Minimum Standards) Convention, 1952 (No. 102) and the Social Protection Floors Recommendation, 2012 (No. 202), which include the establishment of national social protection systems accessible to all to guarantee that people have effective access to health care without hardship, and to income security across the life course (4,5).
Social protection is a human right. However, most of the global population is not yet covered by any form of social protection, leaving billions of people unprotected. Likewise, most WHO Member States are not yet including social protection in the programmatic response to TB in a comprehensive and sustainable way.
Recognizing these significant challenges, the WHO Global Tuberculosis Programme and the ILO have jointly developed this technical guidance to assist countries with the adaptation and implementation of social protection programmes to maximize their coverage and impact on people affected by TB.
This guidance is intended to be implemented as part of the multistakeholder and multisectoral response to TB. The translation of social protection policies that serve the needs of people affected by TB requires a coordinated effort within and beyond the health sector, with strong accountability of all actors involved. Through this guidance providers of TB services, including staff and managers in TB programmes and in ministries of health, and relevant social protection stakeholders, will be equipped with both the conceptual and operational tools to plan and implement social protection programmes to accelerate progress towards ending the TB epidemic, while protecting the human rights of people affected by TB.