Innovation and progress towards TB elimination in New South Wales, Australia

<h4>Setting</h4>Despite maintaining a low TB incidence (<10/100,000 population) for decades, progress towards TB elimination targets in Australia remains elusive.<h4>Objective</h4>We describe innovative approaches to improve TB care and control and programmatic components implemented to advance local TB elimination.<h4>Results</h4>Around 90% of people diagnosed with TB in New South Wales (NSW) were born outside Australia, with the greatest number of cases born in India, the Philippines, Nepal, and Vietnam. Routine whole genome sequencing allows local transmission tracking, and optimised data pathways provide better oversight of key performance indicators (KPIs), including the treatment of TB infection. Further efforts are underway to increase primary care involvement in TB preventive treatment (TPT) provision and to achieve stronger cultural engagement of vulnerable groups.<h4>Conclusion</h4>Progress towards TB elimination in low-incidence settings requires renewed commitment and innovation, with careful consideration of local context. In NSW, key areas of innovation include improved transmission surveillance, enhanced data for KPI monitoring and optimised care of drug-resistant TB; however, reducing TB vulnerability, universal contact screening, and increased TPT coverage remain ongoing challenges.