Improving Global Tuberculosis Control with the "AuTuMN" Platform

Tuberculosis (TB) has now been unequivocally identified as the world’s leading infectious killer, with global control failing to make significant inroads into the huge burden of disease. TB in Australia is driven by this huge global burden, with around 60% of all TB cases occurring in our region and nearly 90% of Australia’s cases occurring in the overseas born. Our group has an established track record of undertaking country-level simulations to better understand TB epidemiology and predict the effectiveness of programmatic interventions in the local context. These applications are linked to a program of theoretical and epidemiological research to improve understanding of TB transmission and strengthen model underpinnings. Recently, we have been working to develop our model into a flexible and robust platform by using principles of software engineering, including object-oriented and modular programming. This approach allows rapid adaptation of our tool (“AuTuMN”) to new objectives without the need to modify many of the constituent modules. In this project, we will extend the AuTuMN structures to undertake multi-country simulations to study key questions in TB control at the global level. A consistent theme of past analyses has been our model’s prediction of considerably higher rates of TB-related mortality than those reported in official statistics. Therefore, our first project will be to produce modelling-based estimates of the global burden of TB-related mortality to determine the proportion of all TB deaths that are missed by current reporting mechanisms, across every country of the world for which input data are available. Next, we will simulate the application of a key intervention for TB control – active case finding – also across all countries worldwide. Despite the power of computer simulations for infectious disease control, this approach to software development is rarely undertaken in infectious disease control and the global extension is entirely novel.