• News from the Stop TB Partnership Secretariat
  - Special Announcements
  - New TB Report From WHO
  - Stop TB Partners' Forum
  - Consultations on TB and Key Health System Themes
  - TB-Related News and Journal Items Weekly Update
• New Partners
• News from the Stop TB Working Groups
  - DOTS Expansion Working Group
  - TB/HIV
  - DOTS-Plus for MDR-TB
• News from the Global Drug Facility (GDF)
  - GDF Applications/Review Update
  - GDF Procurement/Supply Update
  - GDF Product Development
  - GDF Direct Procurement
  - GDF External Evaluation Update
  - GDF/GLC Convergence
• Calendar of  Events
• In Print

   Website access to information:

• Stop TB Secretariat (WHO, Geneva): http://www.stoptb.org
• Global Drug Facility for TB: /GDF/default.asp
• Strategy & Operations, Monitoring & Evaluation: http://www.who.int/gtb

News from the Stop TB Partnership Secretariat (web site)

Special Announcements

• Dr Lee Takes office as the new Director-General of WHO
  
  Dr Lee Jong-wook took office as Director-General of the World Health Organization on 21 July with a pledge to focus the organization on HIV/AIDS, on achieving results in countries, and on helping to tackle the widespread human resources crisis in the health sector.

• Dr Jack Chow, Assistant Director-General for HIV/AIDS, TB and Malaria
  
  Jack Chow served most recently as Ambassador and Deputy Assistant Secretary for Health and Science, US State Department. He will head the new HIV/AIDS, TB and Malaria cluster.

• Dr Mario Raviglione named director of the WHO Stop TB Department
  
  Dr Mario Raviglione has also been confirmed as the new director of the WHO Stop TB Department. Dr Raviglione, who is originally from Italy, joined WHO in Geneva in 1991 after training in internal medicine and infectious diseases in the United States. In the mid-1990s he was responsible for setting up the global TB surveillance and monitoring system. In the late-1990s he co-ordinated TB strategy and operations. Changes announced by the new DG include a greater emphasis on TB with the decision to create a specific cluster of HIV/AIDS, TB and Malaria and separate TB from the Communicable Diseases cluster.

• Deadline closed for Stop TB Executive Secretary applications
  
  The screening process by Coordinating Board and WHO is underway with a final decision expected in August.

New TB Report From WHO

TB was back in the world's headlines following the launch of a bold new WHO report on 15 July. (The report and accompanying flash movie can be viewed on www.who.int/gtb). The report was produced on commission by the editors and photographers of Colors magazine and is intended to influence decision makers in prioritizing TB on public health agendas.

The report was launched at an International AIDS Society meeting in Paris and publicised with reports in the Wall Street Journal, BBC World Service Radio, BBC World TV, the French TV5 and other outlets. Coinciding with the launch were calls by WHO to make free anti-TB drugs (ATDs) widely available to people living with HIV. ATDs and quality care are currently not available for over 70% of TB cases among Africans living with HIV. It's also estimated that one third of the 42 million people living with HIV/AIDS world wide are co-infected with tuberculosis. Approximately 90% of people living with HIV die within a few months of becoming sick with TB if they do not receive proper TB treatment.

Stop TB Partners' Forum – 4-5 December, 2003, New Delhi, India

Agenda - The Forum is two days, starting the evening before with registration.

Day 1: Opportunities and commitments to reach the Stop TB targets in the top four high TB-burden countries (and other HBCs)

Day 2: Challenges and solutions for the Global Partnership to Stop TB through implementation and research beyond 2005
Marketplace: At the end of each day (17:00-18:00) the Stop TB Partners will display their posters/ activities and discuss enhanced collaboration.

Invitees - A maximum of 300 invitees, including ministerial delegations of the 22 high TB-burden countries (3 delegates including ministers of Health & Finance), high level representatives of donor countries and Stop TB Partners, and special guests.

Practical Arrangements & Logistics - A local advisory committee in New Delhi held its first meeting on 20 June and offered strong support for logistical and hotel arrangements, social events, registration, participants' care and local transport. Based on a request for proposals, a professional conference organizer (PCO) has been selected to handle all local arrangements.

* Please mark the dates of 4-5 December 2003 in your calendars. You will be receiving more information over the next months.

Consultations on TB and Key Health System Themes

In collaboration with a variety of different partners, the DOTS Expansion Working Group secretariat has organised a series of consultations this summer on TB and key health sector themes. The outcomes of these consultations will inform the deliberations of the 2nd Ad hoc Committee on the TB Epidemic, which will meet in September to formulate recommendations on the mid-term strategic direction for global TB control. Four of the five planned consultations have so far taken place:

1. Broadening the Stop TB Partnership through corporate sector involvement, Durban, South Africa, 9 June 2003

In conjunction with the launch of the TB workplace guidelines at the World Economic Forum’s Africa Economic Summit, the WEF's Global Health Initiative (GHI) arranged a corporate sector consultation in collaboration with the Stop TB Partnership. This working group, composed of a subset of the GHI task force, discussed barriers and solutions to greater private sector engagement in the Stop TB Partnership. The key lessons which emerged were that country-level business leaders are largely are not aware of the Stop TB Partnership and often have difficulty engaging with national TB programmes. Possible solutions include improved communications through existing HIV/AIDS and business channels which can ensure that communications on TB are added to existing health and HIV/AIDS programmes.

2. TB and social mobilisation, Cancun, Mexico, 29 June - 1 July 2003

The consultation was organized by the Stop TB Partnership and hosted by the Ministry of Health of Mexico with 25 participants participating in the deliberations, including internationally renowned communication experts. Broadly, the group found that for the global TB program to achieve its full potential "… the central strategic challenge is now one of advocacy, communications and empowerment." The group said there is urgent need for in-country advocacy, communication and social mobilisation processes to empower communities to participate in and drive TB control efforts. Broad consensus also emerged on the need to re-position a) advocacy and communications within the Stop TB Partnership, b) communications training capacity-building within high-burden countries, and c) information/data needs for country communication strategies.

3. TB and health system reform, Washington DC, 30 June - 1 July 2003

The World Bank hosted this consultation which reviewed global trends in health system reform, focusing on implications for TB control and developments in four specific countries (Bolivia, Pakistan, Mozambique, and the Philippines) as examples of different global trends. The most important recommendation is for a full engagement between those involved in health system reform and those involved in TB control, so that the outcomes of health system reform include improved TB control and broad movements in health system reform can benefit from the experience of national TB programmes in delivering verifiable health outcomes.

4. TB and primary health care providers, Kampala, Uganda, 3-4 July 2003

Representatives of Ministries of Health, NGOs, international agencies and bilateral development agencies met and considered the challenges in harnessing the contribution of all primary health care providers to TB programme service delivery. Interim recommendations include: a) strengthening national TB programme management capacity in order to fully exercise the role of stewardship of TB control activities; b) establishing national coordinating mechanisms for the full contribution of the wide range of primary health care providers; and c) exploring mechanisms to channel more funds for the activities of primary health care providers. Professor Francis Omaswa, Director-General Health Services, Uganda Ministry of Health, launched a new document "Community contribution to TB care: Practice and policy" on the occasion of this international consultation. The launch included vivid testimony of community TB care in practice from a TB patient and his treatment supporter from Kiboga District in Uganda, and from the district TB programme coordinator and his district public health counterpart.

The fifth consultation, on TB and human resources for health, will take place from 27-28 August in Geneva.

TB-Related News and Journal Items Weekly Update

The Centers for Disease Control and Prevention (CDC) provides the TB-Related News and Journal Items Weekly Update as a public service only. (Providing synopses of key scientific articles and lay media reports on TB does not constitute CDC endorsement.) The Update may also include information from CDC and other government agencies, such as background on articles in Morbidity and Mortality Weekly Report (MMWR), fact sheets, and press releases.

Those interested may subscribe, or change their subscriptions, by visiting the web site http://lists.asciences.com/mailman/listinfo/tb-update.

New Partners
We are pleased to announce the acceptance of the following organizations into the Global Partnership to Stop TB in the month of May 2003.

We at the Secretariat, and on behalf of all the partners in the Stop TB Partnership, extend our congratulations to you and welcome you to the fight to stop TB.

News from the Stop TB Working Groups (web site)

DOTS Expansion Working Group (DEWG)

• Wolfheze Workshop
  
  The Wolfheze Workshop for Tuberculosis Control in Europe took place this year on 15-18 June in The Hague. It was the 9th in a series of workshops since 1990 as a platform for national programme managers to discuss control and elimination of TB in Europe. The workshop was attended by representatives of most of the 51 countries in EURO and organized in plenary sessions and groups work. The programme included discussions on progress towards the DOTS targets, how to improve monitoring of programme including treatment outcomes, and experiences from metropolitan areas in TB control. The "European framework to decrease the burden of TB/HIV" was also discussed and endorsed. A parallel workshop was held for nurses that focused on TB patient education-communication.
  
• Intercountry Proposals Development Workshop
  
  WHO's Regional Office for Africa (AFRO), assisted by WHO's Stop TB Department, organised the first inter-country proposals development workshop for involvement of private health care providers in DOTS expansion for countries in anglophone Africa. The workshop was held from 9-13 June 2003 in Nairobi, Kenya. It was a part of the Public-Private Mix (PPM) DOTS collaborative initiative undertaken by AFRO which includes a) preparation of a Regional Framework on PPM DOTS, b) organization of a multi-country workshop to help countries develop draft proposals to be finalised, adapted and submitted subsequently to appropriate agencies for funding c) provision of seed funding to initiate PPM DOTS activities in selected countries and d) support of mentors to help guide and document country-specific projects.
  
  During the week of the workshop, five of the eight participating countries - Ethiopia, South Africa, Uganda, Zambia and Zimbabwe - prepared proposals for pilots to be undertaken in selected areas. Ghana, Nigeria and Kenya developed larger proposals. Ghana is already implementing PPM DOTS in Accra with support from the GFATM and would like to extend the same to a neighbouring city. Kenya proposes to expand its ongoing PPM initiative to two large slums in Nairobi, while Nigeria plans to have one pilot project in each of its six geographical zones. Draft proposals were developed through a suitable combination of plenary sessions and group work. AFRO and Stop TB will assist in seeking resources for implementation and technical support to these proposed projects.
  
  
• Interagency Workshop on Standardized Monitoring of TB Control Programmes
  
  An interagency workgroup on this issue met several times over the past months involving participants from USAID, CDC, MEASURE, KNCV, IUATLD, WB and WHO. The workgroup aims to develop tools for the standardized monitoring of process indicators for the five DOTS components, similar to the standardized outcome indicators (e.g., case detection and cure rate) that are already in use. The first product of the group will be a manual with standard indicators for the monitoring of TB control programs. The group also plans to develop guidelines for the conduct of periodic monitoring activities, as well as tools to facilitate the implementation of intra-country monitoring systems.

TB/HIV

STOP TB Partnership and WHO - 3rd Global TB/HIV Working Group Meeting, 4-6 June, Montreux, Switzerland.

"Two diseases, one patient, one community" was the message that emerged from the 3rd Global TB/HIV Working Group meeting. The message emphasizes the need for closer collaboration between HIV/AIDS programmes, TB programmes and general health services to ensure comprehensive, patient-centred prevention and care services for the benefit of communities.

This theme was echoed by Stephen Lewis, Kofi Annan's Special Envoy on HIV/AIDS for Africa. In his inspirational speech, he committed himself to raising awareness of the urgent need for a joint response to the dual epidemics of TB and HIV. The statement was welcomed by over 140 delegates who travelled to Montreux from all the WHO regions to attend the meeting.

A broad range of country TB/HIV experiences was presented and discussed in plenary. Participants were given the opportunity to promote or 'sell' their ideas, experiences and work in an innovative information-sharing experience. Separate sessions were held for high burden and low to middle burden countries, to discuss local experience and develop regional responses to the joint epidemics. TB/HIV collaboration clearly improves health services through capacity building and access to a wider range of preventive and care services for people living with HIV/AIDS and TB. Early analysis from Zambia suggests that collaborative activities can also reduce HIV sexual risk behaviour. Research priorities for TB/HIV were developed and participants endorsed the need for the WHO interim TB/HIV policy, which was presented in draft form. A strong spirit of partnership emerged from the three-day meeting with a vision for expanding collaborative TB and HIV activities in all regions.

Presentations from the meeting can be viewed on the website www.who.int/gtb/TBHIV/montreux_june03/index.htm and a report from the meeting will be available shortly.

DOTS-Plus for MDR-TB

• Meeting of the Stop TB Working Group on DOTS-Plus for MDR-TB, Palais des Congrès, Paris, France, 27-28 October 2003
  
  This meeting will replace the Working Group meeting that was planned to be held in Seoul, Korea, 24-26 April 2003, but was cancelled due to the outbreak of Severe Acute Respiratory Syndrome (SARS). The meeting will be held back-to-back with the 34th IUATLD World Conference on Lung Health which will take place from 29 October to 2 November 2003, also at the Palais des Congrès in Paris. Letters of invitation, exact venue, meeting objectives and agenda will be sent shortly to Working Group members.

• New Chair of the Working Group
  
  The 2-year term of Dr Jim Yong Kim, Harvard Medical School/Partners in Health, as chair of the Stop TB Working Group on DOTS-Plus for MDR-TB ended this year. The plan was to re-elect/elect the chair at the Seoul meeting in Korea. Following the decision of Dr Kim not to run for re-election and after consultations with the Core Group, it has been suggested to appoint Dr Kai Vink, Estonia National Tuberculosis Programme, as interim Chair of the Working Group. Dr Vink will serve as interim Chair until the above mentioned meeting, where the definitive election of the Chair will take place.

  We would like to take this opportunity to express our gratitude and recognition to Dr Kim, who has been one of the pillars in the building and setting-up of the DOTS-Plus initiative.
  

• Call for Nomination to Membership - Green Light Committee (GLC) of the Working Group on DOTS-Plus For MDR-TB
  
  Green Light Committee members serve for a period of at least two years. Selection to the GLC is based upon institutional participation in the MDR-TB Working Group, experience in DOTS implementation, and knowledge and experience in clinical and laboratory management aspects of MDR-TB patients. WHO requests applications from participants of the Working Group interested in serving on the GLC, and will evaluate such applications to determine the composition of the GLC for the period 2003-2004. The final decision will be announced at the Working Group meeting planned for Autumn 2003 in Paris.

  If you are interested in being nominated to be member of the GLC please send your CV with a covering letter expressing why you feel suitable for being a GLC member, accompanied by a letter of institutional support, to the below address before 30 July 2003.

  World Health Organization
  Communicable Diseases
  Green Light Committee
  Working Group on DOTS-Plus for MDR-TB
  20 avenue Appia, CH-1210 Geneva 27
  Switzerland
  Fax: +41 22 791 4268
  E-mail: dotsplus@hotmail.com

(web site)

GDF Applications/Review Update:

The GDF has to date received applications for grants of TB drugs from 65 countries, two NGO’s, one federal state, and one public-private partnership initiative. Of these, 46 applications have been approved for support and two are still under consideration. For the complete list, please visit the homepage of the GDF website (www.stoptb.org/GDF). The GDF is now accepting applications for the seventh TRC (Technical Review Committee) which will take place at WHO headquarters in Geneva on 16–18 September 2003. The closing date for receipt of applications is 31 August 2003. Country visits to TFYR Macedonia, Madagascar (both placed under consideration at the sixth TRC meeting) and Egypt (approved at the sixth TRC meeting) will take place during July and August.

Consultants database

The secretariat is creating a database of consultants to take part in GDF country and monitoring missions.

GDF Procurement/Supply Update:

To date, 29 countries have received deliveries of TB drugs from the GDF and drugs for an additional 7 countries have been ordered and are expected to be delivered in 2003. The formal announcement of the new GDF procurement agent awaits negotiation of the final contract. The process for the production of a pre-qualified list of TB drug and product manufacturers meeting WHO/international standards is still ongoing. Publication of the first list is expected in early July. The advertisement for the third "expression of interest" for manufacturers interested in being GDF pre-qualified suppliers was published in international newspapers and magazines. To view the advertisement, please see www.stoptb.org/GDF/drugsupply/procurement.notice.html

GDF Product Development:

GDF has made rapid progress in the development of two patient kits – one for Categories I and III, another for Category II – each containing enough drugs for one full course of treatment for one patient. The Category II patient kit will also contain syringes complying with Safe Injection Technology. Prototypes of both kits have been sent to Ethiopia, Kenya, Myanmar, Vietnam and Cambodia. Initial trials will take place in two countries next month.

GDF Direct Procurement:

The GDF’s Direct Procurement Service enables eligible governments and their partner organizations to purchase high-quality, low-cost drugs directly through the GDF. The aim of the direct procurement mechanism is to promote DOTS expansion.

The GDF has completed an information dossier to promote the Direct Procurement Service. The contents of the dossier can be downloaded from the website, where a Direct Procurement information sheet is also available in English, French and Russian. Please visit:

/GDF/drugsupply/Direct_procurement_process.html

Through the developing GDF partnership programme, we are working with volunteer marketing experts from Proctor and Gamble on how best to market and promote the Direct Procurement Mechanism. Proctor and Gamble volunteers are now also working with members of the GDF team on the branding of the GDF.

GDF External Evaluation Update:

Earlier this year, the GDF, housed at WHO HQ for an initial two-year period, underwent an external evaluation by a team from McKinsey and Company to determine its future and its governance. The final report is currently being circulated to GDF partners and donors.

GDF/GLC Convergence:

As per Coordinating Board recommendations from last year, the Green Light Committee (GLC) for second-line drugs and the GDF for first-line drugs are being converged as one strong mechanism to provide both. Convergence of the two operations will lead to greater efficiency, better advocacy, increased financing, increased technical knowledge and better TB control. The two secretariats have already merged and plans for full convergence will be presented to the Coordinating Board at the next Board meeting.

Calendar of Events (web site)

For more information on upcoming events, please click on the above link:

July/September 2003

• Journalists for Human Rights (JHR) Fundraising Event 
  Toronto, ON, Canada, July 31 
• IFMSA August Meeting,
  Egmond aan Zee, the Netherlands, 2-9 August 
• South African AIDS Conference 2003
  Durban, South Africa, Aug 3-6 2003 
• 12th World Conference on Tobacco or Health
  Helsinki, Finland, Aug 3-8 2003  
• TB Education and Training Network Third Annual Conference
  Atlanta, Georgia, August 13-15
• Gordon Research Conference on Tuberculosis Drug Discovery,
  Oxford, UK, August 31-September 5
• 1st International Conference on TB Vaccines for the World: TBV 2003
  September 17-19, Montreal, Canada
• European Respiratory Society Annual Congress,
  Austria, Vienna, September 27 - October 1

In Print

• Tuberculosis (Colours report)
  WHO/CDS/TB/2003.321 Eng. Fren. Spa.
  
• Management of Tuberculosis - Training for Health Facility Staff
  WHO/CDS/TB/2003.314a/l (11 Modules)
  
• Management of tuberculosis - Training for Health Facility Staff - Facilitor Guide
  WHO/CDS/TB/2003.314k
  
• Draft - Guidelines on the management of public health pesticides.
  Report of the WHO interregional consultation, 25-28 February 2003, Chiang Mai, Thailand.
  WHO/CDS/WHOPES/2003.7
  
• Assessment of the safety of artemisinin coumpounds in pregnancy.
  WHO/CDS/MAL/2003.1094
  
• International working group meeting on integrated management of adolescent and adult illness (IMAI).
  WHO/CDS/STB/2003.22
  
• Expanding DOTS in the context of a changing health system.
  WHO/CDS/TB/2003.318
  
• Guidelines for implementing collaborative TB and HIV programme activities.
  WHO/CDS/TB/2003.319
  
• Guidelines for workplace TB Control Activities - The contribution of workplace TB control activities to TB control in the community.
  WHO/CDS/TB/2003.323
  

All documents are available from the CDS Information Resource Centre; fax: +41 22 791 4285; e-mail: cdsdoc@who.int.

- A list of selected recent articles from refereed journals, book chapters, and other publications on the subject of TB control is available at http://www.who.int/gtb/publications/

 

'Stop TB' - a global movement to accelerate social and political action to stop the spread of tuberculosis around the world. For further information please contact the Stop TB Secretariat at: stoptbinfo@who.int