Impact of military conflict in Ukraine on the achievement of the goals of the WHO “End TB” strategy

Abstract

BACKGROUND. In 2014, the World Health Organization approved the “End TB” strategy with the goal of eliminating tuberculosis (TB) as a global threat by 2035. OBJECTIVE. To assess the impact of military conflicts in Ukraine on the dynamics of TB incidence, prevalence, and mortality indicators within the framework of achieving the “End TB” strategy goals. MATERIALS AND METHODS. An analysis of TB epidemiological indicators in Ukraine in general and in the Chernivtsi region in particular was conducted from 2013 to 2023. RESULTS. Military actions in eastern Ukraine in 2014 led to delays in TB diagnosis and treatment. The incidence and mortality rates of TB in Ukraine remained higher than the target levels set by the “End TB” strategy. The 2020 quarantine resulted in a 29.8 % reduction in TB incidence. The onset of military actions in 2022 caused massive population migration, destruction of healthcare facilities, and increased health risks, creating epidemiologically unfavorable conditions for TB. By 2023, TB incidence had decreased by 31.3 % and mortality by 36.1 % compared to 2015; however, the TB epidemiological situation remains threatening. CONCLUSIONS. Achieving the strategy’s 2025 target indicators appears unlikely due to the negative impact of war and post-pandemic consequences, considering recent trends of gradually increasing TB incidence.

Keywords

• tuberculosis
• incidence
• prevalence
• mortality
• military conflicts
• war
• end tb