DOTS Expansion WG Progress and Next Steps Karam Shah Chair Lopold Blanc DEWG secretariat

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DOTS Expansion WG Progress and Next
StepsKaram Shah ChairLéopold Blanc DEWG
secretariat
DEWG meeting Versailles, 15-17 October 2005
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DOTS Progress the link with implementation
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Broadening the scope of intervention

• Reaching 70/85 targets is the first step
• Need to engage in broader activities to increase
  access to TB care and go beyond 70/85 to reach
  MDGs
• DEWG contributed to the definition of the Stop TB
  strategy for the future
• DEWG engaged in the definition of International
  standards of TB care
• DEWG strongly involved in the preparation of the
  Global Plan to Stop TB 2006-2015

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Health System Strengthening (HSS)

• HSS global initiatives (High-level Forum,
  Millennium Project, Montreux)
• Supporting countries for HSS applications to
  GFATM round 5
• Global Plan II has a strong focus on HSS
• Contribution to HSS is one of the elements of The
  Stop TB Strategy
• WHO STAG (Jun 05)recommended the creation of a
  HSS Task Force (formed and working)

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Human Resources (HR)

• Support to regions and countries for HR
  development, planning and strategy development
  (TBCTA and WHO)
• Cooperation among countries, technical and
  financial partners to improve HRD
• Development of training and HR assessment tools
  (TBCTA)

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Human Resources (HR)

• HRD included in Regional NTP managers meetings
• Review countries' HRD plans/strategies during
  external monitoring missions
• Regional and sub-regional workshops
• Training for consultants
• Tools developed
• Task Analysis
• Checklist review Human Resource development of
  National plans to control TB
• Management of Tuberculosis Training for District
  TB Coordinators (training modules)

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Expanding the scope

• Exploring new approaches to increase case
  detection and cure FIDELIS
• Practical Approach to Lung health PAL (17
  countries using PAL)
• Coordinated approach for DOTS and TB/HIV
• Close collaboration with DOTS-plus to treat
  MDR-TB within programmes.

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Sub - group activities in brief

• PPM DOTS
• Laboratory capacity strengthening
• Childhood TB
• TB and poverty

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PPM Progress in 22 high TB-burden
countries(Countries underlined have a PPM
component in approved GFATM grants)
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PPM Some key achievements in the current year

• Scaling up PPM India, China, Indonesia,
  Bangladesh, Myanmar, Philippines
• Operational research under way effect of PPM
  scale up on equity and access India
  (Bangalore) and Myanmar
• Major document produced Guidelines on
  implementing PPM DOTS
• Major paper accepted (WHO Bulletin) Using
  village doctors for effective scaling-up of rural
  PPM in Bangladesh
• Start of the implementation of the International
  Standards for TB Care, in Indonesia

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Subgroup on Laboratory Capacity Strengthening
(SLCS) activities 2004-2005

• 1. Technical documents and guidelines
• Laboratory Global Strategy to improve performance
  of TB diagnostic services
• Uniform training curricula for AFB smear
  microscopy
• Framework for SOP guidelines for TB laboratory
• Checklist to evaluate culture and DST technique
• EQA system for culture and DST
• Performance indicators for TB laboratory
• Updating the TB Laboratory guidelines
• Review/revision of TB Laboratory Management
  Training

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Subgroup on Laboratory Capacity Strengthening
(SLCS) activities 2004-2005

• 2. Consortium meeting on Optimizing AFB
  microscopy (1-2 September 2005)
• 3. Organization of TB laboratory management
  training in collaboration with EMRO (18-29
  September)
• 4. Establishment of EURO task force for
  laboratory strengthening for TB

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Subgroup on Childhood TB

• Development of policy on child-friendly
  formulations and preparations of anti-TB drugs
• Revising policy on recommended dose of ethambutol
• Research agenda on NTP implementation issues

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TB and Poverty Sub-groupTo reach and to cure the
poor

• Secretariat for the Network for Action on TB and
  Poverty
• Addressing Poverty in TB Control Options
• For National TB Control programmes
• Published May 2005
• Responds to the demand from
• countries on how to mainstream
• pro-poor TB control
• Normative paper on TB and
• Poverty as policy guiding tool
• and practical roadmap
• Provides strategic and practical
• guidance to countries

http//whqlibdoc.who.int/hq/2005/WHO_HTM_TB_2005.3
52.pdf
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Resource mobilisation

• Link with bilateral financial partners
• Funds for ISAC countries from GFATM, Canada,
  Japan, Italy, UK and USAID among others
• TASK II funded by USAID
• TBCTA TB-CAP (TB Capacity Assistance programme)
  Focussing on USAID priority countries, funded by
  USAID. Coalition of ATS, CDC, FHI, KNCV TB
  foundation, MSH, RIT/JATA, the Union and WHO.
• More than just resources, it is a coordinated
  approach for TB control

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Resource mobilisation

• Link with GFATM
• - Workshop in February 05 for 31 consultants for
  R-5
• - Coordinated support by technical partners to
  prepare proposals for R- 5 in 46 countries
• - Encourage applications in countries with large
  funding gap
• - Support in capacity building for
  implementation and monitoring

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GFATM Status for TB and TB/HIV all rounds

• 73 countries including all HBC have or will
  receive funding from GFATM
• US506 million 2 year
• US1.6 billion life time
• Additional US 50 million potential approved for
  R5
• Myanmar termination of the grant by the GF.
• TB patients will suffer the 18M gap for TB
  control

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GFATM Round 5 TB

• 22 proposals approved (funding available for 13)
• 46 success (22/48 reviewed by TRP)
• All were assisted by Stop TB technical partners
• US196M two year amount
• US500 million lifetime amount (of US1.7 billion
  all diseases 27 TB share as compared to 15 in
  round 4)

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Next steps - round 5

• Support to
• respond to TRP clarification
• preparation of operational plans
• building the capacity to translate funds into
  activities, TB cases identified and patients
  cured

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Beyond DOTS, reaching the MDGs

• Implementation of the Stop TB strategy and the
  Global plan to Stop TB
• Regional plans for the period 2006-2015 (ongoing)
  based on the global plan method
• Country plans for the period 2006-2015 (ongoing)
  based on the global plan method and integrating
  elements of the Stop TB strategy

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Conclusion

• Year 2001 preparation
• Year 2002 implementation
• Year 2003 scaling up
• Year 2004 accelerating actions
• Year 2005 broadening the scope of interventions
• Year 2006 planning to reach the MDGs through
  implementation of Stop TB strategy