31 August -- In early 2009, a meeting was held in Geneva between the World Health Organization (WHO) Stop TB Department and Department of Chronic Diseases and Health Promotion, the World Diabetes Foundation and The Union to discuss how to respond to the growing threat of diabetes-associated tuberculosis.

Now after much collaborative work between these and other stakeholders, the WHO/Union Collaborative Framework for Care and Control of TB and Diabetes has been launched.

The first step in the process was a systematic review and meta-analysis of the existing literature conducted by colleagues at the Harvard School of Public Health and Brigham & Women’s Hospital, Boston, USA. In November 2009 an expert meeting was convened at The Union headquarters in Paris to review the new evidence. Knowledge gaps were identified and a research agenda was proposed. A decision was also made to go ahead and draft recommendations were made on the collaborative activities that would reduce the joint burden of disease from diabetes and tuberculosis.

In May 2010, a draft was presented to the Guideline Review Committee of WHO that gave authorisation for the development of a Provisional Framework for Collaborative Activities for Care and Control, recognising that there was good evidence of the linkage between the two diseases, but little evidence to support interventions.

After several iterations, involving multiple stakeholders and web-based consultation, the Provisional Framework was launched in August2011. Similar to the TB/HIV Policy Document, the Collaborative Framework for care and control of diabetes and tuberculosis emphasises three main activities:

a) Establishment of mechanisms of collaboration;

b) Detection and management of TB in diabetes patients;

c) Detection and management of diabetes in TB patients.

Operational and other research is strongly encouraged, and by 2015, new evidence will be reviewed to determine whether the Framework can be updated, strengthened and made definitive.

To download the Framework, click here. http://whqlibdoc.who.int/publications/2011/9789241502252_eng.pdf

To read the WHO Stop TB feature, click here. http://www.who.int/tb/features_archive/diabetes_link/en/index.html