The first Core Group (CG) meeting of the Global Drug-resistant TB Initiative (GDI) was held on 1-2 May in Geneva chaired by Dr Charles Daley. All 16 members of the CG attended the meeting, along with observers from the Global Laboratory Initiative (GLI) and the Global TB Drugs Facility (GDF). On the first day of the meeting, the members were briefed on the how the GDI came to be established and its proposed role, on global progress in scale-up of MDR-TB services, key areas of work for the Stop TB Partnership in 2014 including those of the GDF, and the progress in implementation of regional plans in response to MDR-TB in each of the WHO Regions, and in particular the work of the respective 6 regional Green Light Committees (rGLCs). The second day of the meeting was devoted to the development of strategic priorities and activities of the GDI.
The following areas were actively discussed by the CG members:
- Need to improve capacity to treat MDR-TB patients ensuring alignment with the expansion of diagnostics, especially the rapid molecular tests.
- Low global treatment success rate (48%) amongst MDR-TB patients and specifically the high rates of "lost to follow-up" and "not evaluated", which significantly contribute to the overall low treatment success rates.
- Advocacy for MDR-TB needs to be strengthened for increasing the resources available for the required scale up of services.
- Need for rapid scale-up of second line drug susceptibility testing capacity in order to detect and correctly treat the XDR-TB cases.
- Need for agreed MDR-TB disease burden indicators and their appropriate use.
- Strengthening supply chain systems and access to quality assured second-line drugs through GDF support.
- Need for coordination of technical assistance being provided through the various funding agencies and technical partners.
- The essential need for the involvement of the private sector in programmatic management of DR-TB (PMDT) activities, however as yet this has not received the required attention that it deserves.
Based on the discussions, the following strategic priorities and activities were agreed by the CG members:
- Develop targeted advocacy strategies and resource mobilization for DR-TB management scale-up.
- Facilitate integration and coordination of efforts to align diagnostic services for patients with access to high-quality care.
- Build global consensus on the management of DR-TB for patient centred care delivery ("care for cure").
- Promote strategies to facilitate patient access to high-quality DR-TB care, through a long-term, in-country capacity building approach targeting both the public and private sector.
- Support prioritization of research to generate evidence for PMDT scale-up.
All Task Forces will be led by an identified GDI partner and progress in its work will be monitored by the Core Group on a regular basis.