National TB Control Programme PAKISTAN

1
National TB Control Programme PAKISTAN
stop TB
Pakistan
2
TB Situation in Pakistan

• 6th among the high TB burden countries in the
  world
• Harbors 43 of disease burden in EMR/WHO
  (250,000 new cases every year)
• Social stigma associated with TB

3
TB Control Programme Historical Review

• 1995 DOTS strategy adopted
  
• 1996 TB Directorate abolished
• 2000 NTP revived to operationalize DOTS
  strategy in the country
• National Emergency Islamabad declaration
• 2004 Launch of STOP TB Pakistan
• 2005 NTP to host the CCM/GFATM
  Secretariat

4
05 Targets

• By December 2005
• DOTS ALL OVER Reached on the 24th May!!!
• 70 Case Detection Rate (CDR)
• 85 Cure Rate

5
DOTS Coverage over time
6
(No Transcript)
7
CDR Target 70
8
Proportion of New Pulmonary SSve cases
9
Treatment Success Rate
10
(No Transcript)
11
Total Funds Released (04/05)

• Directly Available to NTP
• PC-I 1M
• GFATM (R 2) 2.2M
• GFATM (R 3) 5.3M
• FIDELIS IV 250,000
• SGS 50,000
• Sub-total US 9 M
• Funds with partners
• FIDELIS II (ASD) 250,000
• FIDELIS III (Mercy Corps) 250,000
• Sub-total US 0.5 M

• Available through WHO
• USAID 2.3 M
• CIDA LHWs 2004-5 1M
• CIDA Lab 2005 0.9M
• ISAC .250,000
• Stop TB 50,000
• JPRM 77,000
• Sub-total US 4.57 M
• Available for NTP through Partners
• GTZ (for NWFP) 8M
• JICA (for Punjab) 150,000
• Sub-total US 10 M
• Grant Total US 24M

12
Total Funds Approved but not yet released

• Directly Available for NTP
• FIDELIS (R I) 249,000

• Available through WHO
• USAID 2006 1M

Funds requested GFATM
Application Round V 30M Asian Delopment
Bank/Grant for Infectious diseases 10M
13
Major challenges Gaps

• Challenges
• Sustain Resource availability
• Health sector reforms
• Weak Lab network at PHC level
• Weak linkages with private sector
• Governance issues e.g. quality of drugs/reagents

• Programme Gaps
• 1. PC-I under approval
• 2. Still incomplete integration within the PHC
  network
• 2. Need to further strengthen district capacity
• 2. Management capacity including supervision to
  be sustained
• 3. Weak Lab at districts level/QA still to be
  implemented
• 4. Lack of structured strategy for PPPM
• 5.Lack of structured drug management/supplies
  system
• 6.Others
• Lack of community awareness/mobilization
• Need for MDR-TB survey and tuberculin survey
• Need of more operational research
• Surveillance/referral system for TB/HIV

14
Challenges resources

• Enhance the lab network and quality assurance
  (CIDA II/GFATM Round V?)
• Further strengthen district capacity (USAID 2006,
  beyond then?)
• Set up a structured drug management logistics
  system at all levels (USAID/TAMA?)
• Implement DOTS in urban areas (GFATM Round II,
  FIDELIS I, DFID)
• Integration within the PHC network (CIDA I)
• Increase community involvement (ISAC, GFATM 2 and
  3, GFATM V?)
• Enhance operational research (ADB?)
• Increase awareness through advocacy (Stop TB,
  TAMA, ISAC, ADB?)
• Enhance Public-public-private mix (GFATM 2 3,
  DFID)
• MDR-TB survey after 2005 (USAID, GFATM V?)
• Prevalence survey (GFATM V?)
• Surveillance/referral system TB/HIV (ADB?)

15
Striving for a TB free future
stop TB
Pakistan
TB Control Programme, Pakistan