WHO releases updated guidance on surveys of costs faced by households affected by TB

19 June 2025 | GENEVA — The World Health Organization (WHO) has released a major update of its guidance on Surveys of costs faced by households affected by tuberculosis (TB). This guidance, now published as Module 4 of WHO’s consolidated guidance on TB data generation and use, supports countries to implement national surveys of the financial burden of TB on individuals and their households using standardized methods.

These surveys are critical for monitoring progress towards the End TB Strategy target that no TB-affected households face total costs due to TB that are catastrophic (defined as >20% of annual household income). The updated guidance replaces the first, 2017 edition titled “Tuberculosis patient cost surveys: a handbook”.

“Financial costs associated with accessing health care and completing TB treatment continue to undermine the diagnosis and treatment of all people with TB, especially those in the poorest households” said Dr. Tereza Kasaeva, Director of WHO’s Global Programme on Tuberculosis & Lung Health. “This updated guidance offers countries a practical, standardized approach to measure the cost burden and inform targeted interventions and policies to reduce it.”

The updated Module 4 includes key additions based on country experience in implementing these surveys between 2017 and 2024 as well as methodological developments, such as:

•   Updated terminology;
•   A new objective focused on access to social protection;
•   Expanded guidance on survey planning and budgeting;
•  Enhanced guidance on survey sampling, data collection (including quality control), analysis and interpretation of results;
•   Expanded guidance on the dissemination of results and their use in policy dialogue to inform multisectoral action to reduce costs faced by people with TB and to enhance social protection measures;
•   Practical examples and experiences from 35 countries.

The guidance is accompanied by an updated version of a generic questionnaire for data collection and a generic version of code that can be used for data analysis (available on the publication webpage).

To support uptake, WHO will be organizing technical and information-sharing webinars throughout 2025. Production of French and Spanish versions of the guidance is underway; these will be published in the coming months.

Access the guidance and associated resources: Module 4: Surveys of costs faced by households affected by tuberculosis

For more information on WHO guidelines on TB, visit the WHO TB knowledge sharing platform

For more TB updates, check out the TB CAB Weekly Newsletter (Issue #20, 22 June 2025).

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