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This document contains a series of desk reviews for the eight ENGAGE-TB priority countries supported by the Global Fund (DRC, Kenya, Indonesia, Mozambique, Myanmar, Nigeria, Pakistan and Tanzania). The document provides a situation assessment and gap analysis about the state of community based TB activities in these countries. The focus on these eight countries was justified by the high prevalence of TB and the very high number of missed/unreported cases. To develop the profiles, Global Fund applications, national TB strategic plans and reports, programme review reports, relevant national guidelines and websites of the community stakeholders were examined.
TB patients and health-care providers are surrounded by information and communication technologies. They will be using these tools increasingly to obtain better care. However, in doing so they are often faced with basic questions, such as: Which application is best suited to my circumstances? What is the evidence for effectiveness? How do I implement it? Who will pay?
This handbook aims to address some of these questions. It focuses specifically on three technologies that are being widely used to help TB patients complete their treatment over the many months that their regimens last.
In this context, the purpose of the landscape analysis is ultimately to facilitate improved engagement of private providers, thereby contributing to universal access to quality and affordable TB care and the end of the TB epidemic. It focuses on the role of private for-profit providers and on specific challenges and experiences in engaging them for TB prevention and care.
This document aims to provide concrete, pragmatic guidance for how TB modelling and related technical assistance is undertaken to support country decision-making. The target audience for this document are the participants and stakeholders in country-level TB modelling efforts, including the individuals who build and apply models; policy-makers, technical experts and other members of the TB community; international funding and technical partners; and individuals and organizations engaged in supporting TB policy-making.
In 2017, 3.6 million of the estimated 10 million people with TB worldwide were “missed” by national TB programmes (NTPs). Two thirds of them are thought to access TB treatment of questionable quality from public and private providers who are not engaged by the NTP. The quality of care provided in these settings is often not known or substandard. Closing these gaps and ensuring patient-centred care imply that quality-assured and affordable TB services must be made available wherever people choose to seek care.
Keywords: TB, funding, investment, services, treatment
The report – “Antibacterial agents in clinical development – an analysis of the antibacterial clinical development pipeline, including Mycobacterium tuberculosis” – shows a serious lack of new antibiotics under development to combat the growing threat of antimicrobial resistance. Most of the drugs currently in the clinical pipeline are modifications of existing classes of antibiotics and are only short-term solutions. The report found very few potential treatment options for those antibiotic-resistant infections identified by WHO as posing the greatest threat to health, including drug-resistant tuberculosis which kills around 250 000 people each year. In addition to multidrug-resistant tuberculosis, WHO has identified 12 classes of priority pathogens – some of them causing common infections such as pneumonia or urinary tract infections – that are increasingly resistant to existing antibiotics and urgently in need of new treatments.
This is the second SEAR TB Report as we take first steps into the post 2015 era of the SDGs. In 2015, there was an estimated 4.74 million incidence of TB in the SEA Region, including HIV+TB co-infection. The total number of new cases notified to National TB programmes in the Region were around 2.65 million in appear staggering despite a reasonably good performance. Three countries that are poised well to eliminating TB by 2030 are Maldives, Bhutan and Sri Lanka. Nepal too is doing well despite the twin challenges of its mountainous terrain and coping with a major natural disaster. Timor-Leste, though small in terms of absolute TB numbers, faces a major challenge in bringing down its incidence rate.
The two-day ministerial meeting held in Delhi was essentially aimed at raising the pitch on TB and garnering political commitment to end TB by 2030. From the above perspective the meeting was a resounding success considering that nine of 11 SEA Region health ministers attended the meeting promising to end TB with renewed momentum. Two countries had high level government representation. One of the core agendas of the meeting was framing the 'Call for Action' declaration and endorsing it by Member States. The 'Call for Action' declaration was signed by all SEA Region countries in an exemplary show of unity to 'bend the curve' and end TB.
The Global Plan provides an opportunity for greater alignment among efforts to fight both diseases. Taking inspiration from the UNAIDS target of providing treatment to 90% of people who know their HIV-positive status, the Global Plan calls for countries to find at least 90% of all people with TB in the population that require treatment (including those living with HIV) and place them on appropriate therapy (including TB treatment and preventive therapy for people living with HIV).
Tuberculosis (TB) remains the largest cause of death and suffering due to any communicable disease among the most productive groups in the World Health Organization’s South-East Asia Region (SEAR). Nearly half of global TB cases emerge in this Region, which is home to one fourth of the total population. It is estimated that TB and TB-HIV co-infection caused 3 deaths every 2 minutes in the Region in 2015. These deaths were entirely preventable with proper treatment of all TB patients, including those infected with drug-resistant strains.
The WHO End TB strategy and corresponding Regional Strategic Plan to end TB targets reductions to the extent of 90% in deaths, and 80% in TB incidence by 2030. This is in alignment with the Sustainable Development Goals (SDGs) to which all countries have committed.