Reid Michael J A, Goosby Eric
Division of HIV, Infectious Diseases, Global Medicine, University of California, San Francisco, USA.
Global Health Delivery, Diplomacy & Economics, Institute for Global Health Sciences | UCSF, 550 16th Street, 3rd Floor, San Francisco, California, USA.
J Clin Tuberc Other Mycobact Dis. 2020 Feb 27;19:100156. doi: 10.1016/j.jctube.2020.100156. eCollection 2020 May.
The Lancet Commission on Tuberculosis (TB) set out to establish a roadmap for how high burden countries could get on track to meet the goals established by the UN High Level Meeting (UNHLM) in September 2018. The report sought to answer the question It provides a comprehensive analysis and specific recommendations to address this question and, ultimately, remove the barriers to building a TB-free World. Notably, the report highlights the importance of improving the quality of care as an essential component of ending the epidemic. Strategies for improving quality must be hard-wired into how National TB Programs are organized, to ensure greater equity in TB service provision and implementation of evidence-based practices and clinical guidelines. Investing in TB research and development, especially implementation, policy and programmatic research to determine how to deliver high quality care must also be high priority. In addition, improving the quality of TB programs is contingent on strategies that enhance accountability at all levels, from the level of Head of State to the local TB clinics. To this ends it is essential that TB survivors and their advocates have a voice to raise inconvenient truths and demand improvements in quality. The Commission concludes that the prospect of a TB-free world is a realistic objective that can be achieved with the right commitment of leadership and resources but will only be realized as and when quality of care is prioritized as a central tenet of all TB programs.
《柳叶刀》结核病委员会着手制定一份路线图，以指导高负担国家如何走上正轨，实现2018年9月联合国高级别会议（UNHLM）设定的目标。该报告旨在回答这个问题，它提供了全面的分析和具体建议来解决这个问题，并最终消除建立无结核病世界的障碍。值得注意的是，该报告强调提高医疗质量作为终结结核病流行的一个重要组成部分的重要性。提高质量的策略必须融入国家结核病规划的组织方式中，以确保结核病服务提供和循证实践及临床指南实施方面有更大的公平性。投资于结核病研究与开发，尤其是实施、政策和项目研究，以确定如何提供高质量医疗，也必须是高度优先事项。此外，提高结核病规划的质量取决于加强各级问责制的策略，从国家元首层面到当地结核病诊所。为此，结核病幸存者及其倡导者必须有发声的机会，以揭示令人不快的真相并要求提高质量。委员会得出结论，无结核病世界的前景是一个现实的目标，通过正确的领导承诺和资源投入是可以实现的，但只有当医疗质量被优先作为所有结核病规划的核心原则时才会实现。
