News from the Stop TB Partnership Secretariat
Special Announcements
New Publication - Building National Partnerships
The Stop TB Partnership is keen to stimulate the formation of national partnerships to stop TB. These partnerships represent the interests of important stakeholders and bring the actors together for a true national response to fight tuberculosis. To assist countries in this endeavor, the Secretariat has produced a booklet of practical partnership-building guidelines and considerations for national programmes and professionals entitled The Power of Partnership, together with a small summary brochure for quick reference.
All WHO regional offices and country representatives in high-burden countries have received copies for free distribution to interested parties. The publication can also be accessed on our web site by clicking here. You are welcome to request additional printed copies from the Partnership Secretariat via email to stoptbpartnerships@who.int.
Advocacy and Communications
Stop TB Advocacy and Communication Task Force
The Task Force held its annual meeting from 7-9 September in Johannesburg , South Africa , with 50 participants that included representatives from five national TB programs. The principal outcomes were:
- Recommendations for the Partnership Secretariat's 2004-2005 advocacy and communication work plan
- Formulation of strategic frameworks for TB/HIV advocacy and capacity building for national/subnational TB communication
- Creation of a Task Force 'core group' to plan, coordinate, implement and monitor activities
Copies of the meeting report can be provided on request to stoptbadvocacy@who.int
New advocacy and communication tools
The Partnership Secretariat has developed the following audiovisual products to support key TB media events:
- 60-second video spot on TB/HIV for World AIDS Day 2003, marketed to TV stations in Africa and the UK in collaboration with UNAIDS ( English only )
- 6-minute flash film on the WHO 'Tuberculosis' report for global distribution in the run-up to World TB Day 2004 ( 9 languages )
- 7-minute flash film on TB/HIV for global distribution in run-up to World TB Day 2004 and the Partners Forum ( English only)
- 10-minute video on TB aid worker Annalena Tonelli, who was killed in Somalia in October, for screening at the opening of the Partners Forum ( English only )
All of these products will be advertised on the Stop TB Partnership web site and made available on request
Joint campaign for World TB Day and Partners' Forum
With the postponement of the 2nd Stop TB Partner's Forum to coincide with World TB Day 2004, the Partnership Secretariat will implement a strategy that combines advocacy and communication activities for both events under a unified theme of 'Keeping the Pledge" to meet the 2005 targets for global TB control. Details of the theme, rationale, objectives, information products and activities will be released to WHO regional offices and Stop TB partners by 5 December.
New Advocacy and Communications staff
As part of its ongoing efforts to strengthen advocacy and communication as a core component of global TB control efforts, two new staff members have joined the Partnership Secretariat staff:
- Ms. Shalu Rozario is now providing project management support for the development of audiovisual and information products for World TB Day and the Partners' Forum.
- Mr. Thaddeus Pennas will begin work in early December as an advocacy officer for the Global Drug Facility to strengthen branding and marketing of GDF at country level.
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.
To subscribe or change subscriptions visit: http://lists.cdcnpin.org/mailman/listinfo/tb-update
The Stop TB Working Groups
Global Alliance for TB Drug Development
November 2003, TB Alliance Fall Newsletter http://www.tballiance.org/newsletter_nov.htm
DOTS Expansion
Western Pacific Regional Office (WPRO): Fourth Technical Advisory Group ( TAG) Meeting, November 17-19 2003
"Urgent call to countries: Only two years left to reach TB targets" This was the message that was stressed during the three day Technical Advisory Group (TAG) meeting that was held in the Western Pacific Regional Office (WPRO), Manila , 17 to 19 November 2003. Country activities are critical in the next two years (2004-2005) if the targets set by the WPRO Special Project to Stop TB of 100% region-wide DOTS coverage and 70% case detection rate are to be reached by 2005.
The key objective of the meeting was for the TAG to provide guidance to national TB programme (NTP) managers to explore ways countries can step up their TB control efforts. The main recommendations were to China to strengthen human capacity building, adopt a province-by-province approach to expanding DOTS coverage and case detection, and to organize a mini TAG to review progress.
The meeting was attended by 72 participants and observers, including 8 TAG members, 24 NTP managers, 22 representatives from partner agencies, and WHO staff representing Headquarters, WPRO and its country offices.
DOTS Expansion Symposium at the 34th IUATLD World Conference on Lung Health, 28 October, 2003
The critical obstacles to reaching the 2005 TB targets came to the fore as DOTS Expansion Working Group (DEWG) members gathered in Paris for the annual conference of the International Union Against TB and Lung Disease. More than a thousand delegates attended the symposium between the 29th of October and the 3rd of November at the Palais Des Congres.
On the first day the international television broadcaster, TV5, invited Acting WHO Co-ordinator Dr Leopold Blanc, from TBS, to participate in a live studio discussion on tuberculosis. The interview focused on the current global status of TB control and the emergence of a TB workforce crisis. A recent DEWG paper recommended improved investment in human resources, especially in poorer countries, to ensure more staff remain fully committed to combating TB.
A similar theme ran through a speech by Stop TB Director Dr Mario Raviglione at the opening ceremony when he compared the containment of SARS to the challenge of the 2005 TB targets: "Achieving these goals will take 'people power' - the same power and urgency that brought armies of health workers together to disarm the SARS threat. Every day people who do extraordinary work."
Workshop on childhood TB convened by IUATLD, Paris, 28-29 October 2003
Following a successful workshop in 2002 aimed at developing a research agenda for childhood TB, the IUATLD convened this workshop to develop guidance for National TB Programmes (NTPs) on ensuring that their routine operations cover childhood TB. Participants included paediatricians in clinical practice in high TB incidence countries, researchers, and representatives of NGOs, professional associations, bilateral development assistance agencies and the World Health Organization (WHO).
The participants largely reached consensus in endorsing current international guidelines for case finding and treatment of children with TB, contact tracing of children at high risk of TB for preventive TB treatment, and including all childhood TB cases in routine NTP recording and reporting activities. Those health care staff specifically involved in child health represent a human resource which the childhood TB sub-group could potentially mobilise in order to promote the implementation of these guidelines as part of routine NTP operations.
A writing committee coordinated by Lisa Nelson, USA Centers for Disease Control (CDC), will develop guidance for NTPs on mainstreaming childhood TB care as part of routine NTP operations, based on the discussions at the workshop and review of current international guidelines. Key partners involved in the development of the childhood TB sub-group of the DOTS Expansion Working Group include the IUATLD, International Paediatric Association (IPA), CDC , USA National Institutes for Health (NIH) and the WHO Stop TB and Child and Adolescent Health Departments.
The 4 th DOTS Expansion Working group meeting in the Hague , the Netherlands , 7-8 October, 2003
The 4th DOTS Expansion Working group meeting was attended by the NTP managers from 22 High TB Burden countries, technical and financial partners. The focus of the meeting was to identify major constraints preventing countries from reaching the global TB control targets (70% case detection and 85% cure rate of infectious TB cases by 2005).
Health workforce crisis has been identified as one of the stumbling blocks for DOTS expansion along with poor access to health services, week political commitment and HIV/AIDS epidemic. However, a positive spirit of STB Partnership has been recognized as a driving force in many countries. Some have achieved substantial progress despite difficulties and some a close to targets. STB Partners present at the meeting have strongly urged against complacency and declared year 2004 as the year for accelerating actions in TB control.
EURO: Meeting of the Collaborative on Training and Education 24-25 November, 2003
WHO and International Partners Continue Joint Efforts in Coordinating TB Training and Educational Activities in the WHO European Region
The coming biennium sets demanding tasks for TB control globally and in the WHO European Region in particular, aimed at achieving the global TB control targets by the end of 2005. DOTS expansion in the Region is a key tool for this. Development of human resources through training and education is crucial for effective TB control, especially for accelerating expansion of the WHO TB control strategy.
The 8th meeting of the Collaborative for Training and Education for TB control in the Russian Federation, the Baltic States and the CIS states took place on 24-25 November 2003 in Copenhagen at the WHO Regional Office for Europe. There were totally 30 participants representing 15 international partner agencies involved in TB control training activities in the Region, WHO EURO TB programme and WHO HQ Stop TB Department.
The tight schedule allowed to cover within the two days many important topics, such as development of the TB Guide for Primary Health Care providers, the new TB/HIV Framework for the WHO European Region, problems of DOTS expansion and related training needs, training in management of multidrug-resistant TB and DOTS+. The Global and European training courses for TB consultants, as well as the new tools for finding TB education and training resources provide extra opportunities to strengthen capacities for TB control.
Started in May 2000 on the initiative of the WHO HQ and CDC in order to share information and coordinate training activities of the international partners in the Region, the Collaborative meets twice a year and has become an important forum for discussing the most important problems in TB training and education, as well as for building new partnerships for effective TB control in the WHO European Region.
TB/HIV
TB/HIV Symposium at the 34th IUATLD Conference, 31 Paris, France
The main objective of the symposium was to debate the pros and cons of ways in which TB programs can support HIV/AIDS programs on antiretroviral delivery within the context of the 3 by 5 initiative-providing 3 million people with antiretroviral by 2005. The interim TB/HIV policy was well accepted following presentations of the rationale, the interim TB/HIV policy itself and experiences of TB/HIV from Malawi and Tanzania. An active debate developed especially around the research agenda the 3 by 5 imitative should generate. A general consensus was reached that closer collaboration between the TB and HIV/AIDS programmes in high TB and HIV countries is indeed important and both communities need to work together to ensure antiretroviral access to eligible TB/HIV patients.
Further information and presentations are available at: http://www.who.int/gtb/TBHIV/symposium_paris_31oct03/
TB/HIV and 3 x 5 session at the Africa Region National TB Programme Manager's Meeting, Pretoria, South Africa, 12 November 2003
A one-day TB/HIV session to discuss and reach consensus on the potential contribution of TB control programmes to the '3 x 5' initiative (to get 3 million people on antiretroviral treatment by 2005) was held on 12 November 2003 in conjunction with the Africa Region National TB Programme Manager's Meeting in Pretoria, South Africa. The meeting was attended by 25 TB control programme managers from the Africa Region.
The rationale for collaborative TB/HIV activities, the interim TB/HIV policy, the 3x5 initiative and issues related to antiretroviral drug supply management were presented and discussed. Dr. Elizabeth Madraa, AIDS programme manager of Uganda, also shared the AIDS programme manger's perspective on collaborative TB/HIV activities and the 3 by 5 initiative. There was an interactive plenary discussion on key TB/HIV issues . Following the discussions, it was generally agreed that the 3 by 5 initiative offered a unique opportunity to TB programmes to enhance antiretroviral access to TB patients. Countries committed to accelerate the implementation of collaborative TB/HIV activities and to assist the implementation of the 3 by 5 initiative, provided the performance of TB control programme is not affected.
New Drug Development
Stop TB Working Group on TB Drug Development Annual Meeting, Paris, 30 October, 2003
Dr. Maria C. Freire, working group (WG) chair, reviewed activities of the last year, and highlighted results of the mapping exercise of projects and compounds submitted by WG members. The map will be presented at the Partners Forum from 24-26 March 2004 in New Delhi, India. WG members are invited to send additions and suggestions to the map at stoptbwg@tballiance.org.
Dr. Rick O'Brien, WG Secretary, and Core group members Dr. Barbara Laughon and Dr. Ken Duncan reviewed progress and challenges in three areas: drug discovery, compound screening and clinical trials. Their presentations are available online here.
Dr. Phil Hopewell of the Stop TB Partnership stressed the importance of the new tools working groups within the Partnership and introduced Dr. Sarah England, who will take over from Dr Hopewell in 2004.
TB MONITORING AND EVALUATION
Third Regional Workshop on TB Epidemiology and Surveillance, Budapest, Hungary, 12-15 November 2003 (previous meetings in Cairo and Harare).
The goals of the workshop were:
- To review TB survey and surveillance methods, especially those relating to case detection, and especially those relevant to EUR
- To make a fuller compilation of data on TB epidemiology and NTP performance from EUR countries
- To discuss the accuracy of case notification data and of case detection estimates
- To examine ways in which these data can be more systematically collected and analysed in future.
Attendees included NTP programme managers, epidemiologists and statisticians from 20 countries in the WHO Region for Europe, plus staff from EURO TB (Paris). The workshop was devised and facilitated by C. Dye, J. Scholten, I. Toskin and B. Williams, with assistance from Euro TB, and with simultaneous English/ Russian translation.
The main outcomes were:
- A Compact Disc containing the workshop aims, programme, participants, presentations, exercises and data sheets; and distributed to all participants.
- A fuller compilation of data and analyses by participants from 20 countries, and their deeper understanding of analytical methods in TB epidemiology, and of methods that can be used to improve control programme performance.
All workshop materials will be posted on the WHO/HQ website www.who.int/gtb (but are available from any of the above participants in the interim).
The next workshop will be held in Manila for the WHO Regional Office for the Western Pacific in May 2004.
GLOBAL DRUG FACILITY (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 reviewed for a second year of support.
Country visits
As follow up from the 7th TRC, the GDF is currently organizing country visits to Burkino Faso, Zambia, Equatorial Guinea, Algeria, Syria, Angola and Turkmenistan.
Consultants database
The secretariat is currently creating a database of consultants to take part in GDF country and monitoring missions.
Procurement/Supply Update
To date, 39 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.
Prequalified list of TB drug and product manufacturers
The GDF is delighted to announce the first publication of its Prequalifed list of TB drug and product manufacturers, meeting WHO/ international standards. The list has been developed as a result of the Procurement, Quality and Sourcing Project: Access to Anti-Tuberculosis Drugs of Acceptable Quality, which was initiated in 2002 by the GDF in conjunction with WHO Department for Essential Drugs and Medicines Policy/Quality Assurance and Safety: Medicines (EDM/QSM). These prequalified manufacturers have been invited to submit proposals for the GDF tender which will be opened for adjudication on 15 December.
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. The patient kits will be in the GDF catalogue before the end of this year. The Philippines direct procurement order will be the first to received the patient kits, in 2004.
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.
This month: Along with the Direct Procurement order for the Phillipines funded by the World Bank, an order was placed for Cambodia funded by the Japanese Government. Bringing the total DP orders placed for 6 countries with a possibility of 4 more at the beginning of 2004.
Monitoring
- The secretariat is currently organizing monitoring visits to countries, to take place approximately 6 months after TB drug delivery in country. Thanks to huge support from our partners, we have been able to organize monitoring missions to 10 countries in the last quarter of 2003 with 6 more in the first quarter of 2004. The monitoring missions planned in the next month are: Congo Brazzaville, Liberia, Mauritania, Pakistan and the Philippines.
- Reports from all monitoring visits must be reviewed for completeness, consistency and credibility by an independent Desk Auditor. Once cleared through the desk audit process, monitoring reports will then be submitted to the GDF Technical Review Committee, which will make recommendation on continued GDF support to the relevant grantee.
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.
GDF Calendar
Opening and adjudication of GDF tender Proposals:
15 December 2003
CALENDAR OF EVENTS
December 2003 - January 2004
- World AIDS Day (theme: Stigma and Discrimination)
December 1 - 8th World STI/AIDS Congress,
Uruguay, Punta del Este, 2-5 December 2003 - Human Rights Day,
10 December 2003 - The World Summit on the Information Society,
Switzerland, Geneva, 10-12 December 2003 - 58th National Conference to TB & Chest Diseases
Organised by Maharashtra State Anti TB Association. Any organisation wishing to join, please contact: lionsatish@hotmail.com
Mumbai, India, 2-4 January 2004
Relevant Websites
- Stop TB Website
www.stoptb.org - Global Drug Facility for TB
www.stoptb.org/gdf/ - WHO TB Website
http://www.who.int/gtb/
The Stop TB Partnership is a global movement with more than 200 member organizations(including the World Health Organization) that are engaged in TB control efforts around the world. The Stop TB Partnership Secretariat is hosted by WHO in Geneva and coordinates the activities of the Partnership.
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