Collaborative tuberculosis strategy for EnglandBMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h810 (Published 19 February 2015) Cite this as: BMJ 2015;350:h810
- Marc Lipman, senior lecturer and consultant physician12,
- Jacqui White , lead tuberculosis nurse23
- 1Division of Medicine, University College London, UK
- 2North Central London TB Service, London, UK
- 3Royal Free London NHS Foundation Trust, London, UK
- Correspondence to: M Lipman
Public Health England and NHS England have just launched their collaborative five year tuberculosis strategy for England.1 The consistent decline reported by most western Europe countries over the past decade in tuberculosis incidence has not been seen in England, where in 2013 there were 7290 cases of active tuberculosis.2 Although this is peanuts in comparison with the number in Africa and Asia, cases in England may exceed those in the United States within the next few years on current trajectories.1 Indicators of the incidence and treatment outcomes in tuberculosis have already been included in the NHS public health outcomes framework,3 so why a strategy now?
One reason may be a convergence of political will and external pressure. The World Health Organization’s End Tuberculosis strategy calls for a 50% reduction in tuberculosis incidence between now and 2025.4 That will be a tall order as incidence fell by 2% between 2003 and 2013, according to Public Health England data.
More cynically, it could be suggested that because the disease mainly affects people born outside the UK and indigent people (over two thirds of cases occur among those in the two most socially deprived quintiles in England) there has …