Optimising Investments in the Tuberculosis Response of Gauteng Province, South Africa : Findings from a Pilot Application of the Optima TB Model

World Bank ; Optima Consortium for Decision Sciences ; Government of South Africa

World Bank, Washington, DC

关键词: TUBERCULOSIS;    OPTIMA MODEL;    HEALTH CARE;    DISEASE CONTROL;    ALLOCATIVE EFFICIENCY;   

RP-ID  :  145899

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

South Africa remains a high-burdencountry for tuberculosis (TB) and multi-drug resistant TB(MDR-TB) with an underlying generalised HIV epidemic. TBfunding must therefore be allocated to interventions whichprovide high impact to prevent TB transmission, identify TBcases and treat them successfully. This report presents thefindings from a pilot application of the Optima TB model inGauteng Province, where many challenges remain tosustainably reduce TB. The modelling analysis focused onrelevant intervention scenarios and optimal resourceallocation to achieve the 2022 TB targets, using themathematical optimisation feature of the tool. Findingssuggest that further reductions in TB prevalence and deathsare possible through improved allocative efficiency. Severalscenarios highlight opportunities especially in HIV negativepopulations by improving the TB care cascade with higherdiagnosis rates, enhanced linkage to treatment and betterMDR treatment outcomes using shorter drug regimens. The samebudget allocated differently could, by 2022, reduce activeTB infections by up to 40 and reduce TB deaths by up to 30perent among HIV positive and HIV negative populations. Thestudy provided valuable input into the refinement of theOptima TB model, especially for the HIV/TB co-epidemicsetting. The model outputs support Gauteng's focus onimproving the care cascade and innovating MDR-TB treatment.