5.4 WHO multisectoral accountability framework to end TB (MAF-TB)

Ending tuberculosis (TB) requires sustained political leadership, coordinated action across government and society, and strong accountability to translate commitments into measurable results. Recognizing that the drivers and determinants of TB extend far beyond the health sector, the WHO Multisectoral Accountability Framework to End TB (MAF-TB) provides a practical framework to strengthen political commitment, foster multisectoral collaboration and establish accountability mechanisms at all levels.

Since its endorsement by the World Health Assembly in 2019, the MAF-TB has increasingly guided national efforts to operationalize multisectoral engagement and accountability for the TB response (1).

Its importance was further reinforced in the political declaration of the second United Nations (UN) high-level meeting on TB in 2023, in which heads of state and government committed to strengthening multisectoral accountability based on the MAF-TB as a key enabler of progress towards ending TB (2).

This webpage highlights recent efforts to strengthen multisectoral accountability based on the MAF-TB and the current status of progress, first at global and then at national level.

1. Global level

WHO continues to lead global efforts to advance multisectoral engagement through global monitoring, reporting and accountability, while also providing technical support and guidance on the MAF-TB. These efforts form part of the WHO Director-General’s flagship initiative to end TB in the period 2023–2027 (3).

During 2025–2026, WHO supported countries to operationalize the MAF-TB through global advocacy, capacity-building, technical guidance and the promotion of cross-sector collaboration.

Convening of partners and MAF-TB promotion

WHO continues to facilitate and convene a global multisectoral and multistakeholder platform. This brings together several UN agencies and other partners, with a focus on maintaining high-level political attention to multisectoral accountability in the TB response.

Key efforts since November 2025 have included:

• Global #EndTB MAF-TB webinar series. Between October and December 2025, WHO and the TB Europe Coalition (TBEC) organized a 3-part global webinar series to support implementation of the MAF-TB. The series brought together governments, WHO, partners, civil society and affected communities to exchange and discuss country experience of operationalizing the framework. Topics included translating the MAF-TB into implementation, strengthening multisectoral action to address the social determinants of TB, and promoting cross-sectoral collaboration to deliver people-centred TB services for migrants and refugees.

• WHO Global End TB Symposium. This was held at the Union World Conference on Lung Health in November 2025 and attended by more than 2000 participants. The symposium highlighted the importance of multisectoral accountability and the role of the MAF-TB in accelerating progress towards End TB Strategy targets.

• World TB Day 2026. The importance of the MAF-TB in accelerating progress towards ending TB was promoted as one of the key messages in WHO’s World TB Day 2026 campaign. This was showcased in Mongolia during a high-level World TB Day commemoration, where the national “Aim to End TB” campaign placed multisectoral accountability at the centre of the country’s TB response. The campaign brought together high-level political leadership, multisectoral collaboration, accountability and sustainable domestic financing to accelerate progress towards ending TB. WHO also supported a joint TB and HIV programme review, high-level policy dialogue with government leaders, and youth engagement activities to strengthen national implementation, inform strategic planning and reinforce accountability for results.

• End TB youth townhalls and workshops. WHO’s “1+1 Initiative” is enhancing engagement of young people in global efforts to strengthen multisectoral accountability for the TB response. To date, more than 90 000 young people have been engaged through youth town halls, workshops, other in-person events and social media campaigns. Examples include the Global #ENDTB Youth Townhall held at the end of 2025, and a meeting with the International Federation of Medical Students’ Associations (IFMSA) on the sidelines of the 2026 World Health Assembly. Youth organizations that have been engaged include IFMSA, the International Pharmaceutical Students’ Federation (IPSF), the International Student One Health Alliance (ISOHA) and the National Youth Movement Against TB (NYMAT).

Social protection

WHO has continued supporting countries to operationalize the commitment that all people with TB should have access to comprehensive health and social benefits by 2027, using MAF-TB as the platform for multisectoral collaboration. Building on the guidance issued in 2024, WHO has supported countries in conducting baseline assessments, strengthening collaboration with social development sectors, and integrating social protection measures into national TB policies and implementation plans (4). The latest data on social protection (Section 5.2) show both progress and persistent gaps. Although social protection coverage has been gradually improving, only half of the world’s population is currently covered by at least one social protection benefit, with far lower levels of coverage in low- and middle-income countries where the TB burden is highest. As of 2026, 90 countries reported prioritizing collaboration with the social development sector as part of MAF-TB implementation to strengthen the integration of social protection into national TB responses.

Public and private sector engagement and related dashboards

Engaging all health care providers remains an essential component of multisectoral action to end TB. Building on the launch of the public–private mix (PPM) data dashboards in 2025, WHO continued to maintain, update and promote the dashboards within the TB digital platform of the World Health Data Hub (Fig. 5.4.1 below). Covering seven priority countries — Bangladesh, India, Indonesia, Kenya, Nigeria, Pakistan and the Philippines — the dashboards provide standardized, country-level data to strengthen monitoring, accountability and evidence-informed decision-making. They also increase the visibility of private sector contributions to TB prevention and care, enabling countries to track progress, identify implementation gaps and improve the quality and effectiveness of PPM interventions.

Fig. 5.4.1 PPM contribution to case notifications of people diagnosed with TB, World Health Data Hub PPM dashboard for Indonesia

Country support

WHO continues to support countries to accelerate MAF-TB implementation; for example, by providing technical assistance for progress assessments, programme reviews, the development of comprehensive national strategic plans and the integration of robust MAF-TB components into these plans (e.g. legislative, regulatory and other critical measures). WHO is also helping to facilitate national multisectoral consultations and establish mechanisms for multisectoral coordination and review (1, 5).

2. National level

Since 2020, WHO has been collecting data for priority MAF-TB-related indicators from all six WHO regions, as part of annual rounds of global TB data collection. These indicators relate to multisectoral reviews of progress in the TB response and associated key steps for action as outlined in the operational guidance; the production of an annual TB report, to inform high-level reviews; and engagement of different sectors of government. In 2025, additional data were requested about MAF-TB baseline assessments and the development of a related MAF-TB implementation plan.

In 2026, 85 countries reported that they had multisectoral accountability and review mechanisms in place, including 20 of the 30 high TB burden countries (Table 5.4.1 below). A total of 69 countries, including 20 of the 30 high TB burden countries, reported that civil society and affected communities were represented in their multisectoral accountability and review mechanisms. In addition, 102 countries reported publishing an annual TB report on progress towards national TB-related targets and commitments; these 102 countries included 22 of the 30 high TB burden countries.

In 2026, 49 countries reported that they had completed a MAF-TB baseline assessment, and 68 countries reported that a MAF-TB implementation plan had been developed. A total of 21 countries, including 10 high TB burden countries, had all five core elements of the MAF-TB in place.

Table 5.4.1 Status of core elements of multisectoral accountability for the 30 high TB burden countries, WHO regions and globally, 2026

In 2026, the sector that was most frequently reported as being engaged in the TB response was education; 41% of countries reported that this sector was engaged in advocacy, information sharing, education and communication in the TB response (Fig. 5.4.2 below).

Two sectors – defence (in 34% of countries globally) and justice (in 28% of countries globally) – were mostly engaged in TB prevention and care. In contrast, the social development sector (in 26% of countries globally) was mostly engaged in patient support, including the provision of economic, social or nutritional benefits. These data highlight the considerable scope to increase engagement across these key sectors and beyond (Fig. 5.4.2 below, and Fig. 5.4.3).

Fig. 5.4.2 Global percentage of countries with ministries (beyond health) engaged in the TB response in 2026 based on data reported by national TB programmes, for three topic areas

Fig. 5.4.3 Percentage of countries with ministries (beyond health) engaged in the TB response in 2026 based on data reported by national TB programmes, disaggregated by WHO region and for the 30 high TB burden countries

References

1. Multisectoral accountability framework to accelerate progress to end tuberculosis by 2030. Geneva: World Health Organization; 2019 (https://iris.who.int/handle/10665/331934). License: CC BY-NC-SA 3.0 IGO.

2. Resolution 78/5: Political declaration of the second high-level meeting of the General Assembly on the fight against tuberculosis. New York: United Nations General Assembly; 2023 (https://undocs.org/A/RES/78/5).

3. World Health Organization Director-General Flagship Initiative to #ENDTB 2023–2027 [website]. World Health Organization; 2023 (https://www.who.int/publications/m/item/who-director-general-flagship-initiative-to-endtb).

4. World Health Organization, International Labour Organization. Guidance on social protection for people affected by tuberculosis. Geneva: World Health Organization; 2024 (https://iris.who.int/handle/10665/376542). License: CC BY-NC-SA 3.0 IGO.

5. WHO multisectoral accountability framework for TB (MAF-TB): baseline assessment checklist for country use in pursuing a national MAF-TB. Geneva: World Health Organization; 2020 (https://www.who.int/publications/m/item/who-multisectoral-accountability-framework-for-tb-(maf-tb)-baseline-assessment-checklist-for-country-use-in-pursuing-a-national-maf-tb).