abstract: 'The World Health Organization''s End TB Strategy aims to eliminate

  tuberculosis (TB) by 2050. Low-burden countries such as Australia are

  targeted for early elimination (2035), which will require an increase in

  the intensity and scope of case finding and treatment of people with

  latent TB infection (LTBI). Because 80 \% of TB disease in Australia

  occurs in metropolitan Sydney (New South Wales) and Melbourne

  (Victoria), the commitment to move towards elimination has major

  implications for TB programs in these jurisdictions. We report on a case

  study analysis that compares and contrasts key attributes of each of

  these healthcare organizations. Such analysis has important implications

  for all countries seeking to implement international agreements within

  local health structures. Differences in the organizational structure,

  culture and systems of care in NSW and Victoria may facilitate or create

  barriers to changes in organizational system functions, especially the

  way in which TB prevention and LTBI treatment is delivered. Ratification

  of global health treaties and the development of national strategies,

  alone, is insufficient for realizing the promised outcomes. Even in high

  income countries, global health agendas such as TB elimination can be

  complicated by differences in local system structure and funding. As the

  timelines tighten towards 2035, more work must be done to identify the

  organizational conditions and service models that will facilitate

  progress towards TB elimination. (C) 2019 Elsevier B.V. All rights

  reserved.'
affiliation: 'Degeling, C (Corresponding Author), Univ Wollongong, Australian Ctr
  Hlth Engagement Evidence \& Values, Bldg 15,Room 230, Wollongong, NSW 2522, Australia.

  Degeling, Chris, Univ Wollongong, Fac Social Sci, Australian Ctr Hlth Engagement
  Evidence \& Values, Wollongong, NSW, Australia.

  Carroll, Jane, Bupa Med Visa Serv, Commonwealth, Sydney, NSW, Australia.

  Denholm, Justin, Univ Melbourne, Victorian TB Program, Melbourne, Vic, Australia.

  Denholm, Justin, Univ Melbourne, Doherty Inst, Melbourne, Vic, Australia.

  Marais, Ben, Univ Sydney, Western Sydney Local Hlth Dist, Sydney, NSW, Australia.

  Marais, Ben; Dawson, Angus, Univ Sydney, Marie Bashir Inst, Sydney, NSW, Australia.

  Dawson, Angus, Univ Sydney, Sch Publ Hlth, Sydney Hlth Eth, Sydney, NSW, Australia.'
author: Degeling, Chris and Carroll, Jane and Denholm, Justin and Marais, Ben and
  Dawson, Angus
author-email: 'degeling@uow.edu.au

  Jane.Carroll@bupa.com.au

  justin.denholm@mh.org.au

  ben.marais@health.nsw.gov.au

  angus.dawson@sydney.edu.au'
author_list:
- family: Degeling
  given: Chris
- family: Carroll
  given: Jane
- family: Denholm
  given: Justin
- family: Marais
  given: Ben
- family: Dawson
  given: Angus
da: '2023-09-28'
doi: 10.1016/j.healthpol.2019.11.009
eissn: 1872-6054
files: []
issn: 0168-8510
journal: HEALTH POLICY
keywords: 'Australia; Health system reform; Organizational analysis; Population

  screening; Global health; Policy implementation'
keywords-plus: 'HEALTH-CARE; SOCIAL-ORGANIZATION; DECENTRALIZATION; INNOVATIONS;

  CLINICIAN; HOSPITALS; NETWORKS; TAXONOMY; CULTURE; SYSTEMS'
language: English
month: JAN
number: '1'
number-of-cited-references: '50'
orcid-numbers: Degeling, Chris/0000-0003-4279-3443
pages: 106-112
papis_id: 8c304007eba22bf7330df8c31b871eeb
ref: Degeling2020endingtb
researcherid-numbers: 'Marais, Ben/AAX-2626-2021

  Degeling, Chris/ABE-2049-2020'
times-cited: '8'
title: 'Ending TB in Australia: Organizational challenges for regional tuberculosis
  programs'
type: article
unique-id: WOS:000508750500014
usage-count-last-180-days: '1'
usage-count-since-2013: '8'
volume: '124'
web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
year: '2020'