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Ranzani et al.  elegantly describe the research priority framework to address the deteriorating TB situation for the mainly LMIC countries of Latin America, which has relevance to other regions. Although the countries of WHO Europe have reduced the overall TB burden (by an average 5.1% annually from 2014-18), multidrug resistant TB rates (MDRTB) are persistently high with the proportion of Rifampicin-resistant and MDRTB among new (18%) and previously TB treated (54%) cases significantly exceeding the global average (3.4% and 18% respectively) . The HIV situation in this region is also dire; 1.4 million people were living with HIV in Eastern Europe and Central Asia in 2017, with the two highest proportions in Russia and Ukraine , creating a significant TB-HIV co-infection problem where 13.1% of TB patients tested were HIV infected .
The COVID-19 pandemic has impacted all countries, but acutely on TB diagnostics and treatment especially in high TB burden LMICs. Recently the StopTB partnership examined the diagnosis and treatment statistics for nine countries, including Ukraine, representing 60% of the global TB burden; TB diagnosis and treatment enrolment in 2020 declined by 1 million or an average 23% in individual countries compared to 2019 .
The WHO leads global efforts to prioritise research (and research is a key intervention as one of the pillars of the WHO End TB Strategy) with regional variations [5,6,7]. For Eastern Europe, the global i...
The WHO leads global efforts to prioritise research (and research is a key intervention as one of the pillars of the WHO End TB Strategy) with regional variations [5,6,7]. For Eastern Europe, the global importance of TB and HIV is clear but carefully planned priorities, pre the COVID epidemic, might not be as relevant to clinical investigators on the ground during the pandemic.
Drawing on current and planned research priority topics within the WHO European region , to frame our questionnaire, we surveyed respiratory and infectious disease specialists in the TB and HIV field in four cities in Ukraine, Russia and Moldova, to understand whether the view on these priorities was changing due to the ongoing COVID19 epidemic. Even if the main priorities for the programmes were to remain, would the delivery objectives remain similar? A questionnaire piloted in English, Ukrainian, Russian and Moldovan was cascaded via a senior infectious disease specialist and 42 respondents completed the survey: 17 Moldova (Chisinau), 13 Ukraine (Kharkiv, Vinnytsya) and 12 Russia (Arkhangelsk).
Priorities identified within each country;: 90 to 100% of all respondents prioritised: a whole genomic sequencing or targeted DNA generation sequencing approach for TB drug susceptibility testing from TB cultures or direct from patient sputa; improving HIV community testing and/or replacement of HIV diagnosis confirmation by Western blotting to address late presentation by HIV positive patients; implementation of integrated diagnostic testing strategies for TB, HIV and viral hepatitis (including a mobile laboratory solution).
Additionally, in Moldova between 90 and 100% of respondents prioritised research on a prospective non-sputum biomarker to establish TB diagnosis of TB and to establish cure of MDRTB patients.
In Ukraine, all respondents prioritised research on the effects of internal migration due to conflict – including the healthcare needs of displaced populations. In Russia, all respondents would also pursue research on a clinical trial of short course 12 months therapy of an all oral MDRTB drug regimen.
But reflecting the current pandemic, all Russian specialists, 89% Moldovan and 77% Ukrainian also prioritised understanding effects of COVID on TB and HIV healthcare issues.
In conclusion, we report a high level of interest in understanding COVID-19 impacts on TB and HIV, but overall, a clear determination to continue the core research priorities for TB and HIV which align with WHO European regional priorities [2,4,5,6,7].
 Ranzani, OT, Pescarini, JM, Martinez, L and Garcia-Basteiro, AL. Increasing TB burden in Latin America: an alarming trend for global control efforts. BMA Global Health 2021;6;e005639 doi10.1136/bmjgh-2021-005639.
 ECDC and WHO Regional Office for Europe. TB surveillance and monitoring in Europe: 2020-2018 data. ECDC Stockholm; 2020).
 Ending AIDS:UNAIDS, 2018
 StopTB partnership TB and COVID: One year on Media Brief FINAL 19 March 2021. http://www.stoptb.org/webadmin/cms/docs/20210316_TB%20and%20COVID_One%20...).
 Fifth European Laboratory Initiative (ELI) on TB, HIV and Viral Hepatitis Core Group Meeting Copenhagen, Denmark 14-15 November 2019 https://www.euro.who.int/__data/assets/pdf_file/0015/428001/5th-ELI-meet...
 WHO Regional Workshop on Advancing Implementation Science on HIV and Viral Hepatitis in Eastern Europe and Central Asia. 10–11 February 2020 Berlin, Germany. WHO Europe 2020.
 World Health Organization. (2019). WHO recommends countries move away from the use of western blotting and line immunoassays in HIV testing strategies and algorithms: policy brief. World Health Organization. https://apps.who.int/iris/handle/10665/329915.