Epidemiological review against Tuberculosis in Morocco

Context

Tuberculosis (TB) is the leading cause of death from infectious disease worldwide. In addition, drug-resistant TB, a growing problem, is causing an increasing number of deaths. In Morocco, according to the WHO Global TB Report 2025, the incidence of TB is estimated at 98 (79-118) cases per 100,000 inhabitants in 2024. With 33,000 TB patients reported in the same year, TB diagnosis and treatment coverage is estimated at 89% (74-110), with a gap of 4,000 people missing. Despite the progress made in recent decades, TB still represents a public health problem in Morocco, and the number of new episodes of TB of all forms reported to the PNLAT increased in 2024. Although declining since 2000, incidence and mortality rates remain too high to hope to achieve the targets set for 2030 under the End TB Strategy and the Sustainable Development Goals (SDGs). The most affected age group is young people aged 25 to 34, and the northern regions of Morocco (Tangier-Tetouan Al Hoceima, Rabat-Salé-Kénitra and Casablanca-Settat) have a higher number of TB cases. The National Strategic Plan (NSP) for Tuberculosis Prevention and Control has set targets for the period 2024-2030 to reduce the tuberculosis mortality rate by 60% and the incidence rate by 35% compared to 2015. To achieve this, it targets people living with HIV and other identified high-risk groups. In order to achieve these results, the National Tuberculosis Control Programme, which oversees the fight against TB in Morocco, plans to conduct a mid- term review of the NSP. This will be accompanied by an epidemiological review, which is a key step in adjusting the NSP’s guidelines, if necessary, and accelerating progress towards the elimination of TB.

An epidemiological review is a strategic exercise to assess the dynamics of tuberculosis, the quality of the data used for its monitoring and the adequacy of the responses implemented. The review focuses on two areas: (i) examining the capacity of the surveillance system to accurately measure the extent of tuberculosis, and (ii) analysing the available data to determine the level and trends of the disease and the possible causes of their variations. It has multiple objectives. First, it aims to describe and evaluate the national tuberculosis surveillance system and the civil registry, analyse geographical and population disparities, gender and age differences, and strengthen programme capacity, thereby helping to identify the priority investments needed to improve the direct measurement of the disease burden in the future, in particular by strengthening surveillance tools, analytical capacities and data availability. As part of this review, the analysis focuses in particular on the current architecture of the national TB surveillance system, which can be represented by a diagram linking the main public health actors: laboratories, health facilities and communities (including the workplace and the home).

Finally, the epidemiological review is part of the schedule for submitting the future grant application under the Global Fund’s 8th funding cycle at the end of the first half of 2026. The results of the TB epidemiological review will be taken into account and will inform the thinking behind the funding application.

Overall objective :

Support the PNLAT in achieving the national targets of the 2024-2030 PSN for tuberculosis prevention and control, and in the medium and long term, prepare the country to move as close as possible to eliminating tuberculosis over the next decade.

Specific objectives :

1. Analyse the epidemiological profile of tuberculosis in Morocco and the current capacity of the national surveillance system to measure the level and trends in the disease burden and mortality (drug-sensitive tuberculosis (pulmonary and extrapulmonary), drug-resistant tuberculosis, tuberculosis-HIV co-infection and latent tuberculosis infection).

2. Propose possible reasoned adjustments to the target projections to be achieved through the implementation of the 2024-2030 NSP.