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Title page 1

Contents 4

Acknowledgments 7

Foreword 8

Abbreviations and acronyms 9

Executive summary 10

1. Background and context 13

2. Current TB situation and progress (WHO Global TB Report 2025) 15

2.1. Epidemiological situation (2024) 15

2.2. Progress and performance 15

2.3. Key drivers and inequities 16

3. Key challenges 17

3.1. Closing the detection and diagnosis gap 17

3.2. Improving treatment quality and outcomes, including DR-TB 17

3.3. Addressing social determinants and catastrophic costs 17

3.4. Financing and sustainability 18

3.5. Innovation uptake and system readiness 18

4. Modelling the potential impact of key interventions 19

5. Strategic priorities to close the gap 21

6. Implementation approach and country prioritisation 31

6.1. Principles for prioritisation 31

6.2. What must be safeguarded first 31

6.3. Criteria for country-level prioritisation 32

6.4. Practical steps for national TB programmes 32

6.5. Prioritisation by country context 33

6.6. Intervention prioritisation under constrained resources 33

6.7. Financing, sustainability and partner support 35

7. Community engagement in tuberculosis control in the WHO South-East Asia Region 36

7.1. Why community engagement matters 36

7.2. Progress in the SE Asia Region 37

7.3. Key gaps and challenges 37

7.4. Good practices from the Region 37

7.5. Strategic directions 38

8. South-South collaboration to end TB 39

8.1. Context 39

8.2. Progress 39

8.3. Published evidence and regional learning 39

8.4. Country strengths and resources that can be shared 40

8.5. Cross-border collaboration 40

8.6. How this can be realised 40

8.7. Strategic directions 41

References 42

Annex 1. Projected trends in tuberculosis cases and deaths under alternative intervention scenarios: modelling and cost-effectiveness analysis 48

A1.1. Introduction 49

A1.2. Model structure and assumptions 49

A1.3. Equations 50

A1.4. Model calibration 53

A1.5. Modelling interventions 56

A1.6. Unit costs 58

A1.7. Results 59

A1.8. Intervention prioritization 63

References for Annex 1 68

Tables 6

Table 1. Estimated cumulative impact of modelled intervention packages, WHO South-East Asia Region, 2026-2030 19

Table 2. Country contexts, main risks and priority responses for TB programme prioritisation 33

Figures 6

Fig. 1. TB burden in the WHO South-East Asia Region, 2024 15

Fig. 2. Progress in tuberculosis incidence and mortality reduction in the WHO South-East Asia Region since 2015 15

Fig. 3. Major TB risk factors in the WHO South-East Asia Region, 2024 estimate 16

Fig. 4. Estimated cumulative impact of modelled intervention packages, WHO South-East Asia Region, 2026-2030 20

Fig. 5. Linking modelled intervention packages to strategic priorities 22

Fig. 6. Why a new TB vaccine matters and what needs to be done for preparedness 30

Fig. 7. Intervention prioritisation by incremental cost per death averted, WHO South-East Asia Region, 2026-2030 35

Annex Tables 53

Table A1.1. Calibration targets 53

Table A1.2. Model parameters, values and sources, with calibrated values shown for the WHO South-East Asia Region 53

Table A1.3. Summary of interventions 57

Table A1.4. Unit costs table 58

Table A1.5. Summary of intervention impact 62

Table A1.6. Summary of intervention impact and costs 66

Annex Figures 50

Fig. A1.1. Schematic illustration of the model structure 50

Fig. A1.2. Comparison of calibration indicators with estimated values for the WHO South-East Asia Region 59

Fig. A1.3. Comparison of calibration indicators with estimated values for a high-burden country setting 60

Fig. A1.4. Comparison of calibration indicators with estimated values for a low-burden country setting 60

Fig. A1.5. Impact of interventions on tuberculosis incidence and mortality under different intervention scenarios, WHO South-East Asia... 61

Fig. A1.6. Impact of interventions on tuberculosis incidence and mortality under different intervention scenarios in a high-burden country... 61

Fig. A1.7. Impact of interventions on tuberculosis incidence and mortality under different intervention scenarios in a low-burden country... 62

Fig. A1.8. Incremental costs and percentage of deaths averted in the WHO South-East Asia Region, 2026-2030 63

Fig. A1.9. Incremental costs and percentage of cases averted in the WHO South-East Asia Region, 2026-2030 64

Fig. A1.10. Incremental costs and percentage of deaths averted in a high-burden country setting, 2026-2030 64

Fig. A1.11. Incremental costs and percentage of cases averted in a high-burden country setting, 2026-2030 65

Fig. A1.12. Incremental costs and percentage of deaths averted in a low-burden country setting, 2026-2030 65

Fig. A1.13. Incremental costs and percentage of cases averted in a low-burden country setting, 2026-2030 66

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