We are delighted to announce that Dr Marcos Espinal is the new Executive Secretary for the Stop TB Partnership Secretariat. Dr Marcos Espinal will be leaving his position as Project Manager for the DOTS-Plus Initiative at the TB Strategy and Operations (TBS) unit of the Stop TB Department of WHO in Geneva. He will begin his new position immediately after the Stop TB Coordinating Board meeting (10-12 October).  Dr Marcos Espinal Biography

We would like to thank Dr Nils Billo for his excellent commitment and guidance to the Secretariat. He has voluntarily offered his time and efforts as Acting Executive Secretary since March 2003, which is very much appreciated. We wish him all the best back at the International Union Against TB and Lung Diseases (IUATLD) in Paris. The new Executive Secretary  was selected and interviewed by the Coordinating Board and the WHO recruitment panel.  Full selection process

2nd Stop TB Partners' Forum - 4-5 December 2003, New Delhi, India The Stop TB Partnership Secretariat urges everyone to return the participation form to attend the Forum as soon as possible. Once this is done, the local conference organizer Attitude will contact every participant for the hotel registration and logistical arrangements. The Stop TB Partners' Forum web site continues to announce online the latest information on preparations for the Forum. If you have any queries about the 2nd Stop TB Partners' Forum, please contact stoptbinfo@who.int

Stop TB Partners Directory CD-ROM We are currently updating the partners directory in preparation for a CD-ROM to be launched at the Partners' Forum in Delhi in December 2003. This CD-ROM will be distributed at the forum and circulated worldwide. All current partners are requested to visit our website and ensure their details are up to date. The deadline for this is 17th October 2003. For partners who have not submitted their compliance statement - please do so now!!  Otherwise your information/status will not be reflected on the partners directory/ CD-ROM. We encourage new applicants to join the Partnership. To do so, please read the link information, fill out the form and submit before 17th October 2003.  In memoriam Johan Stekelenburg With Johan Stekelenburg’s passing, those of us active in tuberculosis control in the Netherlands mourn the loss of an extremely involved and engaging board member and ambassador. Johan was appointed chairman of the Netherlands Tuberculosis Foundation in 1997. Under his direction, the KNCV Christmas Stamp Campaign, the De Emmabloem Foundation, and the Foundation for National Fund-Raising for Tuberculosis Control in Developing Countries were combined to form a Dutch fund-raising organization dedicated to fighting tuberculosis at the global level. With his wide-ranging experience and personable manner, he oversaw the Netherlands Tuberculosis Foundation and was a great supporter of the further integration of the activities carried out by the Tuberculosis Foundation and KNCV. Because of his personal experience with illness, Johan was a persuasive advocate of tackling the enormous problem of tuberculosis in Eastern Europe, Africa, and Asia. As a child, he suffered from tuberculosis and spent a prolonged period of time in a sanatorium. He recounted that, during the first few months of his stay there, he was administered no medication, which was not yet available; it was only months later that he finally received treatment and recovered. This experience allowed him to serve as an example to our donors. We will greatly miss his dedication. In addition, we pledge to continue the fight against tuberculosis with his sense of commitment and motivation.

International Symposium in commemoration of 100 years KNCV Tuberculosis Foundation
‘NGOS on the front lines of tuberculosis control’

On 9 October 2003; KNCV Tuberculosis Foundation commemorates its 100th birthday in the Royal Theatre, The Hague, The Netherlands. This centennial symposium focuses on NGOs on the front lines of tuberculosis control.

KNCV Tuberculosis Foundation, a Dutch NGO working in tuberculosis control, was founded in 1903 in the Netherlands. Over the years KNCV Tuberculosis Foundation has evolved into an international NGO, working globally and collaborating with numerous national tuberculosis programs and with national and international organizations active in international tuberculosis control. Local, national, and international NGOs have always played an important role in tuberculosis control, frequently complementary to governmental efforts.

Today, this role is becoming increasingly crucial. While NGOs may be flexible, having direct relationships with communities and clients and operating in a transparent and accountable way, they also have their limitations. In this symposium, we hope to help clarify the current and potential complementary role of NGOs in DOTS expansion and in strengthening DOTS. In this regard, it is important to distinguish between local/regional, national, and international NGOs and to recognize the implications of the developmental stage of the DOTS program for the collaboration of the NGO with the TB program.

Objectives of the symposium

• To explore the optimum role in tuberculosis-control activities of local, national, and international NGOs in relation to the role and responsibilities of governments.
• To formulate conditions required for successful involvement of local, national, and international NGOs in tuberculosis-control activities.

Outcome  

• Clear definition of the role of local, national, and international NGOs in national tuberculosis programs, defining explicit objectives, resources, conditions, and expected outcome.
• Explicit inclusion of the role and activities of local, national, and international NGOs in the meetings of all working groups of the Stop TB Partnership, particularly in the Global DOTS Expansion Working Group.

Global Alliance for TB Drug Development

Global Alliance for TB Drug Development - Annual Stakeholders Meeting
30 October 2003, Paris, FRANCE

Our Stakeholders representatives and guests (per invitation only) are invited to join the Annual Stakeholders Meeting of the TB Alliance, to be held during the lunch and afternoon of 30 October 2003, in Paris.

Through presentations and panel discussions, we will review the progress of the TB Alliance and present the expanded portfolio and investments in platforms to support drug development.   We will also strategize on joint advocacy initiatives for new TB drug development. We will end with a formal business session restricted to voting representatives of official member organizations of the Stakeholders Association.

We anticipate starting over lunch at 12.30 pm with a keynote address, and ending by late afternoon in time for the official opening of the IUATLD Conference.

As we approach the date, a formal invitation including agenda and meeting location will be mailed to attendees.  In the meantime, please address any questions to: joelle.tanguy@tballiance.org

Over the past several years there has been steady progress towards the development of new drugs for TB, with the Global Alliance for TB Drug Development playing a leading role in this field.  In this session, the current status of work in this area, from drug discovery to clinical trials, will be reviewed and progress in several specific programmes highlighted.

Objectives:

• To describe recent progress in identifying drug targets against latent TB bacilli
• To review work on new lead compounds with promising activity against novel targets
• To present information on experimental (mouse) studies of new drugs in early clinical development
• To summarise the results of recent studies from clinical trials groups that impact TB treatment

This Symposium is an integral part of the IUATLD World Conference on Lung Health and participation requires registration to the Conference.  Updated information on all aspects of the Conference is available at the IUATLD Web site: http://www.iuatld.org.

The meeting attracted a dynamic mix of 50 participants, including representatives of WHO/AFRO, national TB programmes (Kenya, Malawi, South Africa, Tanzania, Zimbabwe), donor institutions (DFID, USAID, GFATM), new strategic partners for national level capacity building (Johns Hopkins University - Center for Communication Programmes, Consortium on Communication for Social Change, Soul City), and key partners in the HIV/AIDS community (Treatment Action Group, UNAIDS, activist Winstone Zulu). There were multiple representatives from advocacy groups Results International (Canada, UK, USA) and Massive Effort Campaign (France, India, South Africa, Switzerland), and the Global Alliance for New TB Drugs made a number of interventions on the urgent need to strengthen advocacy for R&D in new diagnostics, drugs and vaccines.

The agenda and participants were structured into three working groups - global advocacy, national/subnational interventions and TB/HIV advocacy - and work plans developed in each area. A full report on the meeting will be prepared and circulated by the Stop TB Partnership Secretariat by end-September, but following are the main outcomes and recommendations that were adopted in the final plenary session:

1. Integrate advocacy and communication as fundamental components of global TB control efforts. 
At the global level, A&C is critical to strengthening political commitment and funding, and at national level, to accelerating case detection to meet the 2005 targets.

2. Increase funding for advocacy and communications
Of the $9.1 billion called for by the Global Plan to Stop TB for 2001-2005, only $20 million - or little more than .2% - is loosely recommended for advocacy and communication. Yet less than half of this fractional funding has been provided and must increase significantly, especially to support new national and subnational level interventions.

3. Consider upgrading the A&C Task Force to a Working Group
Formulation of a Core Group was the first step in adopting a more formal and disciplined modus operandi for the Task Force, and it was recommended that the Coordinating Board consider constituting the body as a Working Group.

4. Strengthen capacity in Stop TB governance structures
Two key recommendations were made:
(a) add A&C experts to the WHO Strategic and Technical Advisory Group (STAG) and Stop TB Coordinating Board to improve policy guidance, and
(b) form a "Core Group" within the A&C Task Force to improve planning, integration, implementation, monitoring and reporting of activities. The new Core Group was elected with 12 members representing the areas in parentheses:

• Michael Luhan, Secretariat (global advocacy)
• Satyajit Sarkar, Secretariat (national and subnational capacity building)
• Joanne Carter, Results USA (legislative outreach)
• Kraig Klaudt/Bobby John, Massive Effort Campaign (media strategy)
• Gwynne Oosterbaan, Global Alliance (R&D advocacy)
• Rachel Fletcher, EQUI - TB Knowledge Programme (TB and poverty)
• Mark Harrington, Treatment Action Group (TB/HIV)
• Winstone Zulu, TB/HIV activist (patients)
• Paula Maketesi (AFRO region)
• Three additional members of the Core Group will be appointed to represent the AMRO, EMRO and WPRO regions

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 September 2003.

Lupin Limited
Suite 1, Victoria Court, Bexton Road,
WA16 0PF,Knutsford
Cheshire
United Kingdom
Email : andrew@lupineurope.com
Web : http://www.lupinworld.com/

Sarada Society for Care & Counselling of AIDS(SSCCA)
HIG(U) Block-4,Flat-4
 Birati AbasonM.B.Road
700049,Kolkata
West Bengal
India
Email : mkdinda@cal.vsnl.net.in
Web : http://www.geocities.com/sid_calcutta/

The new partners have been accepted after due consideration and having completed all the required steps for joining the partnership.

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)

Stop TB Working Group on New Drugs - Annual Meeting
October 30, 2003 
Maison de l'Amerique Latine
217, boulevard Saint Germain
75007 Paris, FRANCE
[To be held in conjunction with the IUATLD World Conference on Lung Health in Paris, France]

This is an all-morning series of consultations and presentations. We will review the progress in the field of TB drug development, map activities of the Working Group members, and chart the course for the coming months.  We anticipate starting at 8:30 am (CET).  As we approach the date, further information including the day’s agenda and meeting location, will be posted here. In the meantime, please address any questions to info@tballiance.org.

For information on the IUATLD 34th Annual World Conference on Lung Health, please visit the IUALTD website at http://www.iuatld.org

To go to the TB Alliance home page, click here

DOTS Expansion Working Group (DEWG)

Consultations on TB and health system themes

The outcomes of a series of five consultations on TB and key health system themes informed the deliberations of the 2nd ad hoc Committee on the TB epidemic (Montreux, Switzerland, 18 - 19 September 2003). The 1st ad hoc Committee on the TB epidemic met in London in 1998 and made several far-reaching recommendations, including the establishment of the Global Partnership to Stop TB and of the Global TB Drug Facility. The 2nd ad hoc Committee will define a strategic direction for the DOTS expansion movement to implement fully the Global DOTS Expansion Plan and achieve the WHA 2005 targets. In collaboration with key partners, the DEWG secretariat convened this series of five consultations involving selected groups of public health experts for input in areas beyond the current more specific TB scope of the Stop TB Partnership. For further details, please contact the WHO focal point for each consultation.

• Broadening the Stop TB Partnership, Durban, 9 June 2003 (Sarah England)
• Communication and Social Mobilisation, Cancun, Mexico, 29 June - 1 July 2003 (Satya Sarkar)
• Health Sector Reform and the Poverty Reduction Strategy Process, Washington, USA, 30 June - 1 July 2003 (Diana Weil)
• Primary Health Care Service Providers, Kampala Uganda 3-4 July 2003 (Giuliano Gargioni)
• Human Resource Development for TB Control, WHO Headquarters, Geneva 27-28 August 2003 (Karin Bergstrom)

Please note a report on the meeting of the 2nd ad hoc committee on the TB epidemic will appear in next Month's communiqué

4^th meeting of the Core Group of the TB/HIV Working Group (WG) hosted by RIVM
4-5 September 2003, Bilthoven, The Netherlands

Discussions on the interim policy for TB/HIV activities, M&E, cost-effectiveness and possible contribution of TB programmes to scale up of ARV delivery.

The core group had the following recommendations for priority actions:

• The CG strongly endorsed the interim policy on collaborative TB/HIV activities and recommended that the work be completed before the end of 2003 and that provision be made for specific populations, such IDUs.

• The Monitoring and Evaluation guidelines for TB/HIV activities were also presented and the CG advised that this work should be merged with the situation analysis of TB/HIV activities in countries. A plan will drawn up for a) data collection from district to global level through links with the global TB control report and the HIV equivalent; and b) training of health personnel necessary for the implementation of the TB/IYV activities.

• A work on cost-effectiveness of TB/HIV interventions (based on modelling and real cost from the field where possible) evidenced that improving case detection and cure is the most affordable way to improve TB control and is highly cost effective. With respect to ARV to improve TB control, this is not affordable without significant increased funding. The analysis raised the question of what targets for ARV coverage, overall and for TB programmes are realistic.

• How TB programmes can contribute to the 3 million patients on ARV by 2005 was also discussed. The CG recommended that the secretariat organise a consensus development meeting on the role of TB programmes in the delivery of ARVs. It was also asked to ensure that the community based care TB model to concomitant treatment be fully explored.

• A task force for the International AIDS conference, July 2004, has been constituted. The task force will be responsible for defining a strategy for getting TB/HIV into the agenda and implementing it.

A fourth meeting of the TB/HIV working group is planned for fall 2004.

Divonne, France - 2-3 September 2003

This meeting's aim was to finalize the global interim policy on collaborative TB/HIV activities. The meeting participants represented the HIV and TB communities, and the HIV and TB departments of WHO. The policy advises countries on what should be done, under given circumstances to address the intersecting epidemic of TB and HIV. It also provides concise guidance to accelerate the implementation of collaborative TB/HIV activities. The policy has been formulated by the global TB/HIV working group, which is composed of programme mangers, development agencies, NGOs , academic institutions, activists, patient support groups working on TB and HIV/AIDS. The policy is expected to be released before the end of 2003.

News from the Global Drug Facility (GDF) (web site)

GDF Applications/Review Update:
The Global drug Facility (GDF) has now conducted seven rounds of review of proposals for grants of first-line anti-TB drugs. Of the 70 applications received during these rounds 51 have been awarded grants, most of which are standard 3-year commitments.

The 7th (most recent round of review), was held 16-18th September. Fifteen applications were reviewed: eight new applications from country programmes, two from country programmes under consideration, two resubmitted country programme applications and three from country programmes seeking a second year of support.

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

GDF Procurement/Supply Update:
To date, 34 countries have received deliveries of TB drugs from the GDF. Drugs for an additional 7 countries have been ordered and should be received in 2003.

The process for the production of a pre-qualified list of TB drug and product manufacturers meeting WHO/international standards is still ongoing. Completion of the first list is expected end of September, with publication of a list in the public domain expected October 2003

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 patient kits together with an illustrated instructions booklet have already been field tested in Cambodia and Kenya. It is hoped that the final patient kits will be ready in the last quarter of 2003.

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 a revised information pack to promote the Direct Procurement Service. The one page Direct Procurement information sheet is now available on the GDF website in English, French and Russian. See /GDF/drugsupply/Direct_procurement_process.html

This month direct procurement anti-TB drug order requests were placed for: Armenia and Georgia, funded by the German Bank for Reconstruction (Kreditanstalt für Wiederaufbau) and supported by the German  Agency Technical Cooperation (GTZ) and for 3 states in Nigeria, funded and supported by the Netherlands Leprosy Relief Association (NLRA)

GDF Donor Advocacy 
The final report of the external evaluation of the GDF was circulated together with a one page advocacy document to potential donors. It is hoped that this will produce pledges to overcome the shortfalls currently faced by the GDF for 2004 and 2005.

The Green Light Committee (GLC) converged with the Global Drug Facility
To increase access to and rational use of anti-TB drugs, two initiatives were launched in 2000 and 2001, respectively: the GLC for second-line drugs and the GDF for first-line drugs. Both initiatives are complimentary and the Stop TB Coordinating Board, the Working Group on DOTS-Plus for MDR-TB, and the Stop TB Department of WHO have recommended to converge them. Convergence of the two operations can lead to greater efficiency, better advocacy, increased financing, increased technical knowledge for the GLC and GDF and better TB control. Informal steps toward convergence were initiated via joint GDF/GLC activities in December 2002, and the two bodies formally converged in July 2003 with the secretariat of the GLC now being housed in the GDF. While complete convergence will be an ongoing process, these initial steps will serve to take advantage of the expertise of both initiatives while maintaining the visibility of each.

New Staff
Two new staff have joined the applications and review and monitoring areas of the GDF. This reflects the rapidly increasing workload (represented by the huge increase in country applications) experienced by the GDF since its foundation.  

Calendar
Publication of first "white list" of pre-qualified* manufacturers of first line anti-TB drugs - October 2003

*The level of pre-qualification and what this means will be detailed at the time of publication of the list.

Calendar of events (web site)

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

September - November 2003

• European Respiratory Society Annual Congress,
  Austria, Vienna, 27 September - 1 October 2003
• 4th DOTS Expansion Working Group Meeting
  Netherlands, The Hague, 7-8 October 2003
• 100 Year Celebrations of the KNCV Tuberculosis Foundation
  The Hague, Netherlands, 9 October 2003
  (A symposium focussing on "NGO's on the front lines of tuberculosis control" will take place at the Royal Theatre in The Hague)
• 41st Annual Meeting of IDSA
  San Diego, California, USA9-12 October, 2003
• Stop TB Coordinating Board Meeting
  Netherlands, The Hague, 10-11 October 2003
• International Day for the Eradication of Poverty
  Switzerland, Geneva, 17 October 2003
• 9th European Conference on Clinical Aspects and Treatment of HIV Infection (EACS)
  Poland, Warsaw, 26-29 October 2003
• International Conference for People Living with HIV/AIDS
  Uganda, Kampala, 26-31 October 2003 
• The 4th Meeting of the Working Group on DOTS-Plus for MDR-TB, 
  will be held back-to-back with 34th IUATLD World Conference on Lung Health,
  (This meeting was postponed due to SARS)
  Palais des Congrès in Paris, 27-28 October 2003
• 34th IUATLD World Conference on Lung Health
  - The Late Breaker Session related to Tuberculosis
  Palais des Congrès in Paris, France,  27-28 October 2003
• Taller de tuberculosis 2003
  Barcelona, Spain, 27-28 October 2003
• Second International TB/HIV Community Education & Mobilization Workshop
  (Satellite of the 34th IUATLD Conference on Lung Health)
• Stop TB Working Group on New Drugs - Annual Meeting
  Paris, France, 30 October 2003. 
• IUATLD Symposium: Advances in the Treatment of TB
  Sponsored by the Global Alliance for TB Drug Development
  Paris, France, 31 October 2003. 
• 4th Annual eHealth Developers' Summit 
  San Diego, CA, USA 5-7 November 2003
• First Live Homeopathic Workshop on TB
  Agra, India, 8 November 2003
• Tuberculosis Control Symposium
  Istanbul, Turkey, 13-15 November 2003
• South East Asia Regional Partners' Forum
  Bali, Indonesia, 14 November 2003
• APHA 131st Annual Meeting and Exposition Call for Abstracts, Epidemiology Section Special TB Public Health Poster Session
  For further information, please contact Dr. Zachary Taylor. Phone: (404) 639-8125. E-mail: ztaylor@cdc.gov.
  San Francisco, CA, USA, 15-19November 2003
• Forum of the United Nations, the African Union and the Pan-African Youth Conference on HIV/AIDS in Africa.
  Livingstone, Zambia, 23-28 November 2003

In Print

Stop TB Newsletter, Issue No.9 - August 2003 (pdf 485kb)
GETTING A MOVE ON TB ADVOCACY

Frequently asked questions about the 4-drug fixed-dose combination tablet recommended by the World Health Organization for treating tuberculosis - Global Drug Facility WHO/CDS/STB/2002.18 Rev.1

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