Central Asian health ministers commit to accelerating TB elimination efforts

Astana, 7 April 2025

WHO/Europe, in partnership with its 5 Central Asian Member States and a range of stakeholders, today launched the TB-Free Central Asia Initiative (CAI) — to accelerate the elimination of tuberculosis (TB), including drug-resistant TB (DR-TB), across the subregion by 2030.

Health ministers and high-level officials from Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan gathered in Astana to mark the launch and sign a joint declaration pledging to strengthen collaboration and drive forward TB elimination efforts in close collaboration with WHO, the Stop TB Partnership, the Global Fund, civil society and other partners.

The WHO/Europe-led TB-Free CAI will encourage coordinated action among countries, introduce innovations, and strengthen national and subregional capacities.

While the 5 Central Asian countries have made huge progress on TB over the past decade – introducing new treatment regimens and investing in stronger surveillance, the TB-Free CAI will turbo-charge their efforts to help end TB in the subregion by 2030.

This will entail:

• ensuring at least 95% of new and relapsed TB cases are tested using WHO-recommended rapid diagnostic tests; all 5 countries in the subregion have transitioned to using these rapid tests;
• scaling up of shorter oral-only treatment regimens for DR-TB, ensuring a treatment success rate of 85% or higher;
• accelerating the distribution and uptake of new and innovative TB vaccines, when they become available;
• embedding TB control and treatment into the primary health care systems of each country, with the WHO European Centre for Primary Healthcare in Almaty, Kazakhstan, playing a crucial leadership role.

“We stand at a pivotal moment in ending TB in Central Asia, where we must build on our gains and take up truly amazing advances in medicine to propel us towards the finish line. This landmark subregional initiative will serve as a model for other countries both in the WHO European Region and beyond that are facing a significant or growing TB burden, providing opportunities for cross-border collaboration at a time when it’s needed more than ever,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe.

The initiative builds upon existing global commitments, including the 2023 Political Declaration of the second United Nations General Assembly High-level Meeting on TB, which sets ambitious global targets for 2023–2027 and emphasizes a subregional approach to addressing TB challenges. It also aligns with the aspirations of the second WHO European Programme of Work (2026–2030), which identifies the elimination of TB and DR-TB as a health security priority. With measurable progress anticipated by 2027, the TB-Free CAI will offer a structured framework for the 5 Central Asian countries to assess and enhance their efforts to eliminate TB.

The burden of TB and DR-TB remains high in Central Asia

Despite good progress, TB and DR-TB have long posed a significant public health threat in Central Asia, with over 35 000 TB and around 8000 DR-TB cases reported annually. Four of the 5 Central Asian countries rank among the top 30 high-burden DR-TB nations worldwide. In 3 of these countries, DR-TB rates exceed 50% among previously treated patients, and range from 26% to 34% among new patients, contributing to a quarter of the global DR-TB burden.

The COVID-19 pandemic severely impacted progress against TB in the Central Asia subregion. The number of newly diagnosed TB cases dropped significantly post-2019 due to service disruptions, resulting in many undiagnosed cases and increased mortality. Consequently, there has been a surge in TB and DR-TB cases and deaths.

TB elimination efforts are being further challenged by ongoing global aid cuts to TB and other complementary health programmes, including those for HIV. The increasing funding gap threatens the sustainability of national and subnational TB responses across Central Asia. This calls for urgent action by governments and donors alike to protect the progress made over the years and ensure countries are on track to end TB.

“I commend the political leadership and health authorities of WHO’s Central Asian Member States for their growing commitment to eradicating this ancient, stubborn scourge once and for all,” concluded Dr Kluge. “We are now closer than ever to achieving success but navigating this final phase will be challenging. It will demand political dedication and consistent investments in diagnostics, treatment and universal health coverage to reach everyone in need. Moreover, we must strive to eliminate TB-related stigma and discrimination, ensuring that all patients receive the empathy and respect they deserve. I believe Central Asia can rise to this challenge, and we are here to provide support every step of the way.”