Taskforce for Patient-centred Programmatic Management of Drug-resistant Tuberculosis (PMDT)

The Taskforce to establish Patient-centred PMDT has had a fruitful first year. The concept note was agreed in July 2014 and the funds transferred to International Council of Nurses at the beginning of September 2014.

The first training course for Nurse Consultants was held in Quezon City in the Philippines from 17-21 November 2014 in collaboration with rGLC, WPRO, Philippine NTP and the Philippine Nurses Association. The training included theoretical input, practical exercises and site visits arranged in collaboration with Philippines NTP Manager. Participants were from 10 different countries: Cambodia, China, Ethiopia, Latvia, Lao, Papua New Guinea, Philippines, South Africa, Thailand and Viet Nam.

Comments re the Nurse consultant training

"After the Manila workshop, my attitude on patient-centred approach is much clearer and stronger. I've gained more understanding and have tried every way to integrate it into my work here in Thailand. Next week, I am a solo training facilitator of 60 community health nurses in Bangkok. I have applied all aspects of the patient-centred approach to the whole day agenda." Sirinapha Jittimanee, Thailand (15/12/14)

PCC plans in 2015

  • Follow up and expand burse consultant training in other regions aiming at having a nurse consultant on each rGLC to address "Patient support, nursing care and case holding"
  • Establish the repository of information re PCC and develop a social media network
  • Support a piece of work to cost implementation of PCC
  • Consolidate efforts for advocacy and communication around PC

GDI Triage Task Force

The Task Force for Drug-resistant Tuberculosis Research has been renamed the GDI Triage Task Force since November 2016 in light of the urgent need to assist countries, and collect information and create a body of evidence supporting the introduction and scale-up of the implementation of the Shorter Treatment Regimen (STR) for M-/XDR-TB and the utilization of second-line LPA, in the framework of the Patient Triage Approach.

Full Report

Attachment 1 - Meeting notes, GDI TTF Liverpool 29 Oct,
Attachment 2 Meeting notes, GDI TTF TC 18 Nov 2016,
Attachment 3 - ND_R_Kyrgyzstan_DR_TB_STAT_Febr_2017

Report of the GDI Triage Task Force June 2017

Taskforce on Advocacy for PMDT

The Human Spirit Project is a collection of individual stories showing people in their fight against tuberculosis, including drug resistant TB. The goal of showing these individual battles is to highlight that the TB epidemic is not a distant, abstract epidemic comprised of data, but rather a very real collection of individuals.

The Human Spirit Project is borne from the notion that the TB epidemic is not a single, harmonized epidemic, but rather a collection of individuals fighting against the disease every day. This frame of reference allows us to see the heterogeneity of the epidemic: that each individual's battle is different, and that all must work together to overcome the disease.

This is a slight but important distinction. It indicates that our best chance in overcoming the TB epidemic is sustaining the small, individual battles just as much as the grand, overarching plans to eradicate this disease. It also indicates that our data represent people - and fluctuations in our data reflect the number of individual battles won or lost.

There will not be one grand, sweeping gesture that overcomes the TB epidemic. It will take hard work and sustained determination. Policies and practices geared towards ameliorating the burden on patients, clinic managers, physicians, and researchers facilitate the number of individual battles won, which, when combined show progress in the global epidemic.

To visit the Human Spirit Project website, please visit: http://www.humanspiritproject.com

DR-TB STAT: Update on Programmatic Introduction of New TB Drugs

DR-TB STAT, an officially recognized task force of the Global Drug-Resistance Initiative (GDI) since July, 2015, continues to host monthly meetings to facilitate the introduction of bedaquiline and delamanid under program conditions. The group, which was formed in response to the "Call to Action" on new drug introduction, began meeting in May of 2015 and has reviewed the progress of new drug introduction in key countries, including South Africa, India, Indonesia, Georgia, the Philippines, Lesotho, Kenya, Swaziland, Peru and Vietnam. Multiple stakeholders have come together during the calls to help troubleshoot issues in new drug introduction.

DR-TB STAT Global Data March 2018

 

Global Update Maps are provided below:

TB, Human Rights and the Law Task Force

11 October, 2016

Objective

The TB, Human Rights and the Law Task Force was convened by the Global Drug-resistant TB Initiative in October 2016. The objective of the task force is to mainstream a human rights-based approach to TB and MDR-TB into national policies and programming. The approach aims to promote concrete actions that reduce human rights barriers to TB and MDR-TB diagnosis, prevention, and treatment and to improve the lives and health of all individuals affected by TB and MDR-TB. The task force will serve as a mechanism to foster meaningful collaboration and take collective action in addressing issues of human rights, TB (with a focus on MDR-TB), and the law.

Background

There has been a paradigm shift in global TB policy and practice, with a goal to eliminate all forms of TB by the year 2030. The End TB Strategy has at its core a program of patient-centered care that is grounded in a human rights-based approach to the entire spectrum of TB services. The third of four principles of the End TB Strategy calls for the "Protection and promotion of human rights, ethics and equity."

In spite of a stated global commitment to embracing human-rights driven TB policies and practices, there have been limited formal interactions between the medical/public health communities working on TB elimination and the legal/judicial/human rights communities. Such collaborations are essential given that there is frequent overlap between these areas when it comes to TB - especially multidrug-resistant forms of TB (MDR-TB) - where legal and human rights issues abound. Some examples of these include forced isolation and imprisonment of people living with the disease; discrimination in the workplace and in health care facilities; and lack of access to diagnostic and treatment services that limit an individual’s right to life and health.

Similar collaborations in the field of HIV have been extremely productive in ensuring that the legal, judicial, and human rights communities are informed by evolving medical and public heath practice and that medical and public health providers and policy makers are aware of the legal, judicial, and human rights implications of their work. These formal collaborations have also been essential in ensuring that persons living with HIV are able to access legal services and recourse when they face human rights barriers and violations. The End TB Strategy framework issued by the WHO demands that similar collaborations are developed and strengthened in the field of TB, with special attention given to MDR-TB, where many of these barriers are most acutely felt.

In order to make substantial progress in enshrining a human rights and an enabling legal environment for eliminating TB and MDR-TB, the TB, Human Rights and the Law task force aims to engage:

  • Legal and human rights experts who can provide direct services to affected populations, move forward with TB-related litigation, and help inform the medical, public health, and policy communities about the potential legal implications and ramifications of their guidelines and practices.
  • Judicial representatives who often hear cases involving TB and the law, are involved in interpreting international and constitutional law and public health implications of TB elimination practices, and who serve as activists promoting human rights in the area of TB.
  • National governments and TB Programs who legislate medical, legal, and public health standards in the countries and communities.
  • International donors and stakeholders, including the Global Fund, who are responsible for funding work on TB and MDR-TB elimination, have specifically espoused a human-rights framework for TB, and require input from accountable experts to ensure that all individuals affected by TB receive services that promote their human rights and liberties.
  • Medical and scientific experts who are responsible for providing a sound empirical evidence base to inform the legal, judicial, and human rights communities about optimal diagnostic, preventive, and therapeutic services for persons with all forms of TB and whose medical and policy decisions must be informed by experts in the legal and judicial fields.
  • Affected community members who often face serious human rights and legal barriers along the continuum of TB care and whose testimonies are essential in informing the judicial, legal, medical, human rights and public health communities.
  • TB activists who often serve as a bridge between the different legal, human rights, judicial, medical and public health groups working on TB.

"Tuberculosis, Human Rights and the Law: A Compendium of Case Law" is designed to serve as an archive of case law involving tuberculosis, human rights and law from domestic and regional jurisdictions. The case law is summarized for convenience and use by readers and arranged based on broad thematic issues. The aim of the arrangement is to illustrate the international scope of the legal issues involved and to provide insights to readers in one jurisdiction about how cases have been adjudicated elsewhere.