Resource Library

7-1-7

Using timeliness metrics for household contact tracing and TB preventive therapy in the private sector, India

IJTLD

Can 7-1-7 help household contacts of tuberculosis patients get started on preventive therapy? In the International Journal of Tuberculosis and Lung Disease, our colleagues at International Union Against Tuberculosis and Lung Disease used a mixed-methods approach to assess the feasibility of the timeliness metric in the private sector in Chennai, India. Among 263 index patients, 90% had their household contacts (HHCs) line-listed within 7 days. Screening outcomes for 48% of the 556 were achieved in HHCs within 1 day, and 57% began TPT or received a treatment decision within 7 days. 24% of screened HHCs started TPT during the ‘7-1-7’ period, compared to 16% in historical controls. Barriers included HHC reluctance to be evaluated, private providers’ refusal to prescribe TPT, and reliance on facility-based screening instead of home visits. Overall, the introduction of 7-1-7 can effectively enhance HHC screening and management.

Timeliness metrics for screening and preventing TB in household contacts of pulmonary TB patients in Kenya

IJTLD OPEN

In a study published in the International Journal of Tuberculosis and Lung Disease, our colleagues at the International Union Against Tuberculosis and Lung Disease and the Respiratory Society of Kenya evaluated the feasibility of implementing a “7-1-7” timeliness metric for screening and initiating TB preventive therapy (TPT) among household contacts (HHCs) of index patients with tuberculosis (TB) in Kiambu County, Kenya. Over six months in 12 health facilities, 95% of 508 index patients had their HHCs line-listed within 7 days, and 68% of 1,115 HHCs were screened for TB within one day. Only 62% of eligible HHCs initiated TPT within 7 days, compared with 58% in a historical cohort. Main barriers to TPT uptake included HHCs not presenting for treatment or being unwilling to initiate TPT, and drug shortages. Health care workers reported that a timeliness metric was valuable for streamlining management and proposed “3-5-7” as an alternative.

TB preventive therapy: uptake and time to initiation during implementation of ‘7-1-7’

IJTLD OPEN

Can the 7-1-7 target increase the number of household contacts (HHCs) of tuberculosis patients initiated on preventive therapy? In this letter published in he International Journal of Tuberculosis and Lung Disease, our colleagues at International Union Against Tuberculosis and Lung Disease describe how the 7-1-7 metric was adapted for TB preventive therapy (TPT), requiring HHCs to be listed within 7 days, screened within 1 day, and started on TPT within 7 days of screening. In a study involving 1,635 HHCs across sites in India, Pakistan and Kenya, the median initiation time for TPT was 6 days. However, persistent challenges included low attendance at health facilities and hesitance among health workers to prescribe TPT, underscoring the urgent need for enhanced support systems and targeted interventions to boost TPT uptake.

Implementation of the 7-1-7 target for detection, notification, and response to public health threats in five countries: a retrospective, observational study

The Lancet Global Health

The 7-1-7 target supports timely detection, notification, and response to outbreaks. Writing in the Lancet Global Health, experts from Resolve to Save Lives assessed 41 public health events in Brazil, Ethiopia, Liberia, Nigeria, and Uganda between 2018 and 2022 to understand the frequency at which targets for detection (7 days), notification (1 day) and respones (7 days) are being met following implementation of the target. Results showed that 54% met the 7-day detection target, 71% met the 1-day notification target, and 49% completed early response actions within 7 days. Most bottlenecks and enablers were identified at the health facility level, highlighting the need for increased investments in primary health care to enhance outbreak detection and response capabilities.

Impact of a Newly Established Revolving Outbreak Investigation Fund on Timeliness of Response to Public Health Emergencies in Nigeria

Health Security

Revolving outbreak investigation funds (ROIF) can accelerate outbreak response times when coupled with streamlined approval processes. Writing in Health Security, experts from Resolve to Save Lives analyze the impact of ROIF in Nigeria, which were established by our partners at Nigeria’s Centre for Disease Control and Prevention (NCDC) in 2019. Comparing outbreak responses before and after ROIF’s introduction, the median time to response decreased from 6 days to 2 days, highlighting the importance of having immediate access to funds and efficient approval mechanisms during public health emergencies. The study suggests national governments should allocate budgets to sustain such funds, and offers a model for improving outbreak preparedness and response globally.

Feasibility, enablers and challenges of using timeliness metrics for household contact tracing and TB preventive therapy in Pakistan

PLoS One

Experts from Resolve to Save Lives expamined the feasibility of adapting the 7-1-7 target to control tuberculosis in Karachi, Pakistan through timely provision of TB preventive therapy (TPT). From January to June 2023, we successfully line-listed 92% of 450 index patients’ household contacts within seven days of initiating anti-TB treatment. Additionally, we determined screening outcomes for 84% of 1,342 contacts within one day. However, we found that only 35% of eligible contacts received further evaluation and treatment within seven days, facing challenges such as travel costs and fear of diagnosis. Our field staff reported that these timeliness metrics motivated prompt action and recommended their integration into national guidelines to improve TB management within households.

Applying ‘timeliness’ to the screening and prevention of TB in household contacts of pulmonary TB patients

IJTLD OPEN

Timeliness is essential in preventing and controlling infectious diseases like meningococcal meningitis and tuberculosis (TB). Experts from resolve to save lives explored adapting the global 7-1-7 target for outbreak control to the management of household contacts of TB patients. Applying the metric in India, Pakistan, and Kenya improved TB preventive therapy (TPT) initiation rates, though logistical and health care barriers persisted. Field staff recommended a “3-5-7” metric to enhance screening and TPT delivery. Timeliness metrics provide structure and urgency, offering a valuable tool for improving HHC management and global TB prevention efforts.

7-1-7: an organising principle, target, and accountability metric to make the world safer from pandemics

The Lancet

Clear, universal performance standards for outbreak detection, reporting and control can improve accountability, save lives, and accelerate global readiness for future pandemics. For The Lancet’s Viewpoint, experts from Resolve to Save Lives propose 7-1-7 as a global target for timely response to infectious disease outbreaks: detecting a suspected outbreak within 7 days, reporting and initiating a response within 1 day, and mounting an effective early response within 7 days.

Key Resource

7-1-7: rapid improvement for early disease detection and response

7-1-7 Alliance

Introductory brief on the 7-1-7 target, its uses, and how it complements existing tools and assessments.

7-1-7 for Accountability, Monitoring and Evaluation

7-1-7 Alliance

The simplicity of 7-1-7’s timeliness metrics helps monitor performance, evaluate interventions and document progress with full transparency.

Advocacy as easy as 7-1-7

7-1-7 Alliance

Clear data based on simple metrics can help any decision-maker understand the need for support, funding or policy change for better epidemic preparedness.

Continuous improvement with 7-1-7

7-1-7 Alliance

By incorporating 7-1-7 into existing workflows, we can make every outbreak an opportunity to improve how we detect and respond to infectious disease threats.

Why 7-1-7? The evidence behind the global target for containing epidemic threat

7-1-7 Alliance

Overview of the 7-1-7 evidence base.

Overview of the 7-1-7 Alliance

7-1-7 Alliance

Introductory brief on the7-1-7 Alliance, the 7-1-7 target, and the Alliance missions.

Digital toolkit

7-1-7 Alliance

Step-by-step guidance and tools to start putting 7-1-7 to work, in one place.

Operational Planning and Priority-Setting Using 7-1-7 to Strengthen Uganda’s Health Security

Resolve to Save Lives

A case study on how the 7-1-7 approach bolstered Uganda’s National Action Plan for Health Security (NAPHS).

7-1-7 Pilot Project

Resolve to Save Lives

The 7-1-7 framework helps countries strengthen their outbreak detection and response by setting clear targets: 7 days to detect a suspected outbreak, 1 day to inform public health authorities, and 7 days to initiate a response. This pilot project tested the framework in three countries to improve pandemic preparedness and guide performance improvements.