Geneva New World Health Organization WHO guidance will help countries accelerate efforts to stop people with tuberculosis TB infection becoming sick with TB by giving them preventive treatment A quarter of the world s population is estimated to be infected with TB bacteria These people are neither sick nor contagious However they are at greater risk of developing TB disease especially those with weakened immunity Offering them TB preventive treatment will not only protect them from becoming sick but also cut down on the risk of transmission in the community As we mark World TB Day 2020 the disease remains the world s top infectious killer In 2018 10 million people fell ill with TB worldwide and 1 5 million people lost their lives to this disease COVID 19 is highlighting just how vulnerable people with lung diseases and weakened immune systems can be said Dr Tedros Adhanom Ghebreyesus WHO Director General The world committed to end TB by 2030 improving prevention is key to making this happen Millions of people need to be able to take TB preventive treatment to stop the onset of disease avert suffering and save lives Dr Tedros highlighted the importance to continue efforts to tackle longstanding health problems including TB during global outbreaks such as COVID 19 At the same time programmes already in place to combat TB and other major infectious diseases can be leveraged to make the response to COVID 19 more effective and rapid Although some progress has been made towards targets set at the UN high level Meeting on TB in 2018 TB preventive treatment has been largely neglected Global leaders committed to ensuring access to TB preventive treatment to at least 24 million contacts of people with active TB and 6 million people living with HIV by 2022 To date only a fraction of that target has been reached with countries putting less than 430 000 contacts and 1 8 million people on TB preventive treatment in 2018 TB remains the top cause of death among people with HIV TB preventive treatment works synergistically with antiretroviral therapy to prevent TB and save lives Reinvigorated efforts by governments health services partners donors and civil society will be needed to increase access to TB preventive treatment to the levels targeted The new consolidated guidelines recommend a range of innovative approaches to scale up access to TB preventive treatment WHO recommends a scale up of TB preventive treatment among populations at highest risk including household contacts of TB patients people living with HIV and other people at risk with lowered immunity or living in crowded settings WHO recommends an integration of TB preventive treatment services into ongoing case finding efforts for active TB All household contacts of TB patients and people living with HIV are recommended to be screened for active TB If active TB is ruled out they should be initiated on TB preventive treatment WHO recommends that either a tuberculin skin test or interferon gamma release assay IGRA be used to test for TB infection Both tests are helpful to find people more likely to benefit from TB preventive treatment but should not become a barrier to scale up access Testing for TB infection is not required before starting TB preventive treatment in people living with HIV and children under 5 years who are contacts of people with active TB WHO recommends new shorter options for preventive treatment in addition to the widely used 6 months of daily isoniazid The shorter options that are now recommended range from a 1 month daily regimen of rifapentine plus isoniazid to 3 months weekly rifapentine plus isoniazid 3 months daily rifampicin plus isoniazid or 4 months of daily rifampicin alone As people around the globe come together to commemorate World TB Day WHO is calling on governments affected communities civil society organizations health care providers donors partners and the industry to unite forces and step up the TB response notably for TB preventive treatment to ensure no one is left behind said Dr Tereza Kasaeva Director of WHO s Global TB Programme The new WHO guidance shows the way forward for millions to rapidly access new tools and shorter safer options for preventive treatment The time for action is now TB preventive treatment is an affordable intervention that can prevent families from sliding into poverty and preserve the health and economy of whole communities WHO anticipates that as new and safer drugs come onto the markets and as prices fall it will become a highly cost effective way to save millions of lives NOTES FOR EDITORS WORK BY WHO AND PARTNERS WHO works closely with Member States including the US Government and technical and funding partners such as UNITAID to enhance access to shorter TB preventive treatment regimens UNITAID supported projects such as IMPAACT4TB and Cap TB projects enabled by WHO with partners in Brazil Cambodia Cameroon C te d Ivoire Democratic Republic of Congo Ethiopia Ghana India Indonesia Kenya Lesotho Malawi Mozambique South Africa Uganda United Republic of Tanzania and Zimbabwe are leading the way The new treatment options are also now more affordable thanks to the significant price drop of rifapentine a key drug facilitated recently by UNITAID the Global Fund to Fight AIDS Tuberculosis and Malaria and global biopharmaceutical company Sanofi along with forthcoming arrangements underway with generic manufacturers MORE ABOUT THE GUIDELINES The new consolidated WHO guidelines come with an operational handbook to help guide countries step by step as they take TB preventive treatment to scale This includes guidance on how to prioritize and invest from demand creation for TB prevention to supervision and monitoring of the programme The guidelines and operational handbook are also accompanied by an innovative mobile application Prevent TB to help health care workers manage TB preventive treatment in their communities Its online dashboard allows programme managers to visualize and monitor data in real time The application can be customized by countries to suit their specific settings and is currently being adopted in India and Philippines WORLD TB DAY The new guidelines and tools are being released ahead of World TB Day World TB Day is observed on March 24 each year to raise public awareness and understanding about the world s deadliest infectious killer TB and its devastating health social and economic impact on people around the world Under the theme It s Time the spotlight this year is on urgently accelerating the TB response to save lives and end suffering