Main areas of work

1
Structure Stop TB Partnership
Global Laboratory Initiative
MDR-TB
PPM Poverty Childhood ACSM
Infection control
GLC Research Drugs
Lab strengthening roadmap HR development
strategy Lab biosafety Lab accreditation
Advocacy Advisory Committee and Network
Advisory group on resource mobilization
Advocacy advisory committee network
2
DOTS Expansion Achievements

• A framework for improved and early case detection
  was developed
• Developed protocols to involve non public health
  program providers in collaborative TB/HIV
  MDR-TB activities
• Engage professional associations in TB control
  including MDR-TB
• Documented pro-poor health system interventions
  for special groups
• Revision of treatment guidelines (to be ready
  before the end of 2009). Include guidance to
  identify earlier DR-TB and better treatment for
  TB patients with HIV
• Expand TBTEAM scope to include network of GLI,
  GLC, ACSM, civil society and others)

3
DOTS Expansion opportunities for further
collaboration

• Ensure/strengthen representation in core groups
  of other working groups and exchange of
  information
• Increase coordination and harmonization of
  Technical Assistance to Countries topics through
  TBTEAM avoiding fragmentation of support
• Jointly address health systems challenges
• Strengthen focus on TB poverty
• Facilitate rapid scale up of interventions to
  address TB-HIV and M/XDR TB by non public health
  programme providers and incorporate more
  prominently PPM components into GF proposals
• Work with the GLI to develop strategies and
  approaches for involving private sector
  laboratories in TB control efforts
• Engage more the communities (ACSM) and informal
  providers in TB control activities

4
TB/HIV Achievements .

• Catalyzed nationwide expansion of HIV/TB
  activities in more countries
• Launch of Three Is for HIV/TB (ICF, IPT and IC)
  campaign, with emphasis on implementation
• ME harmonization of indicators (WHO, UNAIDS,
  PEPFAR)
• Raise global visibility/funding of HIV/TB
• Support community mobilization
• Infection control policy advocacy strategy
  developed

5
TB/HIV Opportunities for further collaboration

• DOTS Expansion - 100 HIV testing in TB clinics
• Research, Diagnostics - Research revolution
  dipstick, shorter, better TB
• regimens, regimens for different HIV ART
  regimens
• GLI - Integrated HIV and TB laboratory
• MDR-TB - Find and stop MDR/XDR
• Cross cutting issue infection control measures
  implemented incorporated in all working group
  work plans
• Goal TB rates in HIV population plunge and
  contribute to goals of
• reducing TB burden globally

6
MDR-TB Achievements

• Policy advice to WHO reflected in 2008 MDR-TB
  guidelines
• 141 approved project applications for 95 sites in
  62 countries approved by the GLC mechanism
• 53,268 MDR-TB patients having access to quality
  assured 2nd line anti-TB drugs.
• Assistance to GDF on monitoring and reporting
  short-term demand and supply of Quality Assured
  second line drugs (SLDs)
• Monitoring of long-term trends, regulatory and
  pricing characteristics for SLDs for strategic
  and management purposes
• Coordination of partners to increase long-term
  supply of quality-assured SLDs, including
  mobilisation of manufacturers in MDR-TB HB
  countries
• Research agenda focusing on scale-up of PMDT
• Research subgroup launches RESIST-TB (clinical
  trials)

7
MDR-TB Opportunities for further collaboration

• Global Drug Facility
• Global Laboratory Initiative
• New Tools Working Group
• HIV-TB Working Group Infection control and
  integrated management
• DOTS Expansion Working Group Human resources for
  health and ACSM
• New Drugs WG
• New Diagnostics WG

8
Achievements

• Established GLI partnership projects
• Developing a template for country-specific
  roadmaps for laboratory strengthening
• Developing human resource strategies, including
  consultant training, training of different
  laboratory technical cadres, strategies for
  career development and retention
• Developing appropriate and adequate laboratory
  bio-safety norms and standards, strategies and
  documents
• Developing a TB laboratory accreditation system
• Moving new TB diagnostics into countries (UNITAID
  supported project in 16 priority MDR-TB
  countries)
• Expanding the network of Supranational Reference
  Laboratories

9
Opportunities for further collaboration

• Moving new diagnostics into countries aligning
  road maps, retooling, and integrated National
  Laboratory Strategies for TB laboratory
  strengthening
• Developing innovative models for sustainable,
  prolonged, on-site mentoring and laboratory HR
  capacity development
• Facilitating coordinated technical assistance
  based on WHO-recommended laboratory norms and
  standards
• Developing integrated accreditation systems for
  TB laboratories (eg. biosafety)
• Promoting formal liasons with other WGs to ensure
  that laboratory issues are adequately addressed

10
New Drugs Achievements

• Taskforce on host targeting and immune
  interventions (Biology/Targets subgroup)
• Database for information on TB targets
  compounds from screening campaigns (Candidates
  subgroups)
• Global Survey of Tools and Biomarkers with public
  website (Tools subgroup)
• Site capacity building From assessment to
  implementation (Clinical Trials/Capacity
  subgroup)
• Workshop on Regulatory Issues in the Development
  of Drugs for Improved Treatment of susceptible
  and drug-resistant TB (Clinical Trials/Capacity
  subgroup)

11
New Drugs Opportunities for further collaboration

• Tools, Biomarker Discovery
• vaccines, diagnostics, TB/HIV, MDRTB
• Detection of MDR and XDR TB appropriate drug
  selection
• vaccines, diagnostics, TB/HIV, MDRTB
• Drug Interactions
• TB/HIV, MDRTB
• Host-based therapies (Immunotherapy)
• vaccines, TB/HIV, MDRTB
• Strengthen Clinical Trial Capacity Site
  development
• vaccines, diagnostics, TB/HIV, MDRTB

12
New TB Diagnostics Achievements

• WHO endorsement of
• a) new smear positive case definition
• b) reduced no. of sputum specimens examined by
  smear microscopy
• c) liquid culture, rapid speciation and DST
• d) line probe assays for rifampicine and INH
  resistance
• Information on diagnostics in pipeline published
  (with RTF)
• Scientific Blueprint for TB diagnostics
  development (Publication scheduled 15th June
  2009)
• Working Group restructured into 9 Subgroups and
  funding.
• WHO/GLI/UNITAID/FIND Initiative on MDR-TB in 14
  priority countries
• Several large-scale multi-country trials of new
  tools underway

13
New TB Diagnostics Opportunities for further
collaboration

• New Diagnostics WG sub-groups
• HIV and TB diagnostics
• Paediatric TB and diagnostics
• TB diagnostics and poverty
• Opportunities for greater collaboration with
• Global Laboratory Initiative
• ? SG arising from Retooling Task Force

14
New TB Vaccines Achievements

• Keeping the Pipeline filled
• More than 40 TB vaccine candidates in the
  preclinical TB vaccine pipeline
• Performing clinical trials
• 6 TB vaccine candidates have entered Phase I
  (safety) clinical trials
• 3TB vaccine candidates have entered Phase II
  (immunogenicity) trials
• 1 TB vaccine candidate has entered Phase III
  (efficacy) clinical trials
• Ongoing activities to support objectives
• Harmonizing existing and developing new
  immunological and functional markers for
  protection against TB
• Developing reliable economic estimates for TB
  vaccine development and introduction
• Supporting the development of field sites for
  large-scale clinical trials and addressing issues
  in clinical research
• Strengthening developing country regulators
• Mobilizing resources for TB vaccine development

15
New TB Vaccines Opportunities for further
collaboration

• Linking up with national TB control programmes
  for development of appropriate new tools
  introduction implementation strategies
• Development of an integrated TB prevention
  control package to achieve the 2050 elimination
  goal
• Identification of high incidence hotspots -
  where vaccine trials could be performed!
• Strengthening of capacity/quality of TB
  diagnostic laboratories
• Improved diagnosis of difficult TB endpoints in
  clinical trials (smear neg., infants/children,
  etc)
• Mobilizing resources for all aspects of the
  Global Plan
• Expanding the base of constituency groups and
  stakeholders to increase awareness, advocacy and
  support for all parts of the Stop TB Strategy