Towards universal social protection for people affected by tuberculosis in the Western Pacific Region: a social protection baseline assessment and policy entry points.

backgroundAchieving universal social protection (SP) coverage for people affected by tuberculosis (TB) is increasingly recognised as an essential component of its response, as well as other diseases of poverty. Realising this goal requires to clearly understand the SP needs of people affected by TB and to identify means to maximise their access to existing or new SP benefits in an efficient, effective, and sustainable manner. MAIN BODY: To address these questions, between 2022 and 2023, the WHO Western Pacific Regional office conducted the first SP baseline assessment for people affected by TB in Mongolia, Lao People's Democratic Republic, the Philippines, Cambodia, and Viet Nam. This exercise encompassed a desk review of SP programmes operating in these countries, followed by an expert consultation to discuss barriers and entry points to expand SP coverage among people affected by TB. Overall evidence gathered from publicly available reports and publications suggests that existing SP programmes in these countries are insufficiently accessible and inadequate to meet the needs of people affected by TB. Most countries provide TB-specific benefits only to people with multidrug-resistant TB, leaving most people with TB unserved. The most reported barriers to access to SP included lack of awareness, stigma, poverty, as well as programmes' fragmentation, and administrative and financial constraints. Identified solutions included raising awareness about SP, extending TB-specific SP benefits to all people with TB in need, advocating for a better inclusion of people with TB into existing governmental programmes, and strengthening the referral system across the health and SP sectors.

conclusionsBy identifying concrete policy entry points and actionable solutions, this SP baseline assessment provided a foundation for these five countries to embed social protection more systematically into their national TB responses. Ideally, this effort should now be replicated in all high TB-burden countries willing to achieve universal SP coverage among people affected by TB. The lessons that emerged from this baseline assessment are consistent with the recommended actions and principles underlying the Western Pacific Regional Framework for Reaching the Unreached and are thus transferrable to other diseases of poverty.