October/November 2001, issues of the Stop TB Communiqué

STOP TB COMMUNIQUE

Issue 14, October/November 2001

1. NEWS FROM THE STOP TB PARTNERSHIP SECRETARIAT

To continue to build on the momentum gained at the Partners’ Forum, Stop TB would like to receive your written endorsements of the Washington Commitment before Friday 7 December. Your endorsement should be presented on your organisation’s letter head and mailed or faxed to the Partnership Secretariat.

Please note that the Stop TB Partners' Forum Washington Commitment does not constitute a resource commitment by the endorsing agency(ies).

Stop TB is currently finalising the Forum report and proceedings. These will be sent to you 50 days after the Forum with the printed final Washington Commitment to Stop TB, which will include a compilation of endorsements.
Further information is available from the Stop TB website: /events/partners_forum/2001/default.asp

On November 15th 2001, the Global Drug Facility shipped first line TB drugs to the Democratic People's Republic of Korea. The drugs will make it possible to treat nearly 33,000 people suffering from TB in the country.

Following country visits made by the GDF Secretariat, WHO and Stop TB partners, four additional countries have been approved for support from the GDF. This brings the total to 14 countries which will receive support, after Moldova and DPR Korea: DR Congo, Djibouti, Kenya, Liberia, Myanmar, Nigeria, Pakistan, Congo Brazzaville, Somalia, Sudan, Tajikistan, Togo, Uganda, Yemen.

Last month the GDF newsletter was launched, with updates on the facility and countries receiving support. Please visit the GDF website for more details: www.stoptb.org/GDF/default.asp
Further information is available from the Stop TB Partnership Secretariat at stoptbinfo@who.int and from gdf@who.int

The first meeting of the Stop TB Coordinating Board ("the Board") was held in Annapolis, United States, on 24 October 2001 and hosted by the United States Agency for International Development (USAID). The meeting’s two most important outcomes are detailed below.

Several months of work by the Stop TB Partnership Secretariat and Dr C Lovelace of the World Bank came to fruition when the Director General of WHO, Dr Gro Harlem Bruntland, and the chair of the Stop TB Co-ordinating Board, Ernest Loevinsohn, signed the Memorandum of Understanding regarding the Global TB Drug Facility. This agreement confirms that the Global TB Drug Facility will be managed by the Stop TB Partnership Secretariat in WHO with the active involvement and input of the Stop TB Co-ordinating Board.

The Co-ordinating Board agreed that a revised Partnership Secretariat workplan and budget will be prepared and presented by the end of November 2001.

The proposed next meeting of the Stop TB Coordinating Board will be in Japan on 19-20 February 2002.
Further information is available from the Stop TB Partnership Secretariat at stoptbinfo@who.int.

Stop TB is pleased to announce that the theme selected for World TB Day 2002 is "Stop TB to fight poverty". The theme has been chosen from over 130 entries submitted for consideration from many sources - health and community care workers, doctors, non-governmental organizations and others with interest in TB. Responses came from all around the world: Brazil, Canada, India, Nepal, Pakistan, the Philippines, and the United States, among others.

The theme stresses the sense of urgency of tackling TB, one of several illnesses that affect the poor. Stopping TB promotes economic development and reduces poverty.

The theme supports DOTS expansion, the cornerstone of the recently launched Global Plan to Stop TB, and urges all stakeholders to accelerate action.

The Stop TB Partnership Secretariat is welcoming secondments from Stop TB partner-organizations. The team in Geneva needs to be strengthened with expertise in communications & advocacy, budget/ administration/ management, information management and resource mobilization. Please contact the Secretariat (stoptbinfo@who.int)

Dr Ernesto Jaramillo from Colombia joined the DOTS-Plus Team of TBS seconded by Partners in Health. Dr Jaramillo is a MD and has a PhD in Health Education as well as a wealth of experience in TB control in his home country.

The Stop TB Partnership Secretariat team also welcomed Lucy Morgan this month. Lucy has been seconded to the Secretariat by Procter and Gamble to work on several Communications projects including the Stop TB Communiqué and World TB Day 2002, and on IT projects including the Stop TB Partnership website.
Further information is available from the Stop TB Partnership Secretariat at stoptbinfo@who.int.

Global Working Group on TB among HIV-infected people /wg/TB_HIV/

One of the main themes of the Stop TB Partners’ Forum was TB/HIV. The video shown as an introduction to the Session "New threats: overlapping epidemics of TB and HIV" reported on the ProTEST project in Lilongwe, Malawi.

This project aims to Promote TESTing for HIV using voluntary counselling and testing for HIV as an entry point for access to a range of interventions for TB and HIV prevention and care. The project is a successful example of a field initiative to establish the links between the TB and HIV programmes necessary to improve delivery of a packager of TB/HIV prevention and care.

All the Forum participants received the executive summaries of the Report on the First Meeting of the Global TB/HIV Working Group held in Geneva in April 2001 and of the Global Strategic Framework to Control TB/HIV. Discussions in the Session "New threats: overlapping epidemics of TB and HIV" and in the roundtable presentation on the Global TB/HIV Working Group indicated the growing consensus on the need for TB and HIV programme collaboration to implement the strategy of expanded scope to control TB in high HIV prevalence populations. This strategy includes interventions directly against TB, i.e. the DOTS strategy, intensified case finding and isoniazid preventive treatment, and against HIV (and therefore indirectly against TB), e.g. condoms, treatment of sexually transmitted infections and HIV voluntary counselling and testing linked to care provision. The Global TB/HIV Working Group provides the opportunity for a wide range of partners to work together in delivering this strategy and make a bigger and more effective contribution to global control of TB/HIV.

DOTS Expansion Working Group /wg/DOTS_Expansion/default.asp

2nd meeting of the DOTS Expansion Working Group: Paris 31 October 2001

The 2nd Meeting of the DOTS Expansion Working Group of the Stop TB Partnership, held on 31 October, was attended by some 165 people, including the NTP managers of 21 High-Burden Countries (India was absent), all main technical partners (including the International Union Against TB and Lung Disease, The Royal Netherlands Tuberculosis Association, US Centers for Disease Control, American Lung Association, American Thoracic Society, the Damien Foundation, the German Leprosy Relief Association and the international Paediatric Association), most financial partners, and the WHO network for DOTS expansion at Regional and Country Offices.

Following presentations on the progress in DOTS implementation globally and in two countries (Uganda and Cambodia), NTP managers presented their plans, progress, constraints, financial needs and gaps in standard posters summarized in plenary sessions by 5 facilitators. Since Cairo progress has been enormous: 21 of the 22 high burden countries had or were developing team plans for DOTS expansion, drugs were secured in 15 countries, and additional funding for TB control was documented in 17 countries. However, 7 countries still had very unreliable drug supply.

The WHO regional advisors on TB control presented their regional plans, followed by some partners outlining their initiatives. This process allowed for the identification of priorities for action. These include: finalization of country plans for some 7 countries, assistance to Zimbabwe for preparation of a plan, completion of collection of information for financial needs and gaps to be incorporated into the future report on DOTS expansion. Importantly, the meeting confirmed the tremendous motivation by the entire international community involved in TB control to achieve the targets set by the World Heath Assembly for 2005. It also allowed donors to have a direct contact with NTP managers and discuss support plans.

As a conclusion of the meeting, lists of action points for countries, technical and financial partners and for WHO were compiled.

As well as stressing the need for seven countries to finalize their 5 year DOTS expansion plan and for Zimbabwe to develop a plan, there was emphasis on the need to establish a National inter-agency co-ordination committee, for the assessment of training needs, for collaboration with HIV/AIDS programmes and for the establishment of links between MDR-TB management projects and DOTS expansion.

Technical partners were requested to: standardize and co-ordinate better international training; train consultants; develop and provide expertise on decentralisation processes; involve private practitioners; and mobilise resources for technical support.

The role of financial partners has been identified as crucial to fill gaps to expand DOTS through direct funding or through the Global Fund to fight AIDS, TB and Malaria.

Finally WHO was requested to continue to carry out its normative function for cost estimates and financial monitoring of global TB control, and to continue to co-ordinate the DOTS Expansion Working Group.

DOTS Plus Working Group /wg/DOTS_Plus/

The next meeting of the STOP TB Working Group on DOTS-Plus for MDR-TB will take place in Tallin, Estonia, 10-12 April 2002 at the Radisson SAS Hotel. Estonia National TB Control Programme (NTP) will kindly host the meeting. Topics for discussion will include progress of the GLC-approved DOTS-Plus pilot projects, prospects for the future linkage/convergence of GLC and the Global TB Drug Facility (GDF), global monitoring of pilot projects, fitness of drug-resistant M. tuberculosis strains, proficiency testing of second-line drugs, a training session for developing applications to the GLC, administrative issues, and site visits of the Estonia NTP. A block of 150 rooms has been set aside at the Radisson SAS Hotel at the special price about 88 US$ inclusive of breakfast. Lunch and dinner will be provided. For registration to the meeting and hotel reservation please contact Ms Evelyn Silvet at Frens Conference Services in Tallin, Estonia (e-mail: conference@frens.ee telephone: 372 69 79 290). Formal letters of invitation will be available and sent shortly to last year’s participants, and interested others. For any other information please contact the DOTS-Plus team at WHO headquarters (dotsplus@who.int) in Geneva, Switzerland, or Dr Kai Vink (kai.Vink@kliinikum.ee) programme manager of the tuberculosis control program of Estonia. 

2. NEWS FROM PARTNERS /stop.TB.Partners/default.asp#Partners

Excerpted from a press release issued by Global Alliance for TB Drug Research & Development http://www.tballiance.org/home.cfm

November 15, 2001. New York-- Fuelled by the growing tuberculosis epidemic, the market for drugs to treat TB will approach $700 million by 2010, according to a new report issued by the Global Alliance for TB Drug Development.

The report, entitled The Economics of TB Drug Development, estimates that the current market for TB drugs is $450 million -- with 67 percent representing private sales. It is expected to grow by more than 50 percent within the decade. A single, new anti-TB drug that reduces the treatment course from six months to less than two months will capture about $325 million of the market. This could expand to more than $400 million, because of the premium some markets may be willing to pay for a shortened treatment course.

This first in-depth analysis of the TB market in 30 years reveals a market larger and more accessible than expected. A close look reveals that partnerships will be necessary to ensure that the necessary investments are made for new drugs this decade. The tremendous social and public-health benefits warrant the involvement of the public sector alongside industry in public-private partnerships.
For the full report please visit http://www.tballiance.org/3_keyfindings.cfm?rm=sf&sub=keyfindings

3. CALENDAR OF EVENTS /events/archive.asp

2001

2002

2003

The Stop TB Communiqué is issued monthly by email to global partners in order to share information on progress in the global partnership movement to stop TB. Partners are invited to submit news items, progress updates, comments and suggestions to reynoldsk@who.org. Stop TB Partnership Secretariat, World Health Organization, 20 avenue Appia, CH-1211 Geneva 27. Visit the Stop TB website at www.stoptb.org. The site is sponsored by the American Lung Association www.lungusa.org. Stop TB is a partnership hosted by the World Health Organization www.who.int.

Throughout the Stop TB Communiqué, "DOTS" is used as a brand name in its broadest sense as an umbrella term for all DOTS-based strategies, including DOTS-Plus for MDR-TB and expanded strategies to address TB/HIV.

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