The Stop TB Communiqué is issued monthly by email to global partners in order to share information on progress in the global partnership movement to stop TB. Partners are invited to submit news items, progress updates, comments and suggestions to reynoldsk@who.org. Stop TB Secretariat, World Health Organization, 20 avenue Appia, CH-1211 Geneva 27. Visit the Stop TB website at www.stoptb.org. The site is sponsored by the American Lung Association www.lungusa.org. Stop TB is a partnership hosted by the World Health Organization www.who.int.
Throughout the Stop TB Communiqué, "DOTS" is used as a brand name in its broadest sense as an umbrella term for all DOTS-based strategies, including DOTS-Plus for MDR-TB and expanded strategies to address TB/HIV.
1. NEWS FROM THE SECRETARIAT
The Director-General of WHO has appointed Dr J.W. Lee, formerly Special Representative of the Director-General, as Director of Stop TB with immediate effect. The Stop TB initiative will now have two components: the Stop TB Secretariat and the WHO normative and technical functions. The Stop TB Secretariat will be headed by an Executive Secretary, Dr Jacob Kumaresan. The WHO normative and technical responsibilities in TB will be coordinated by Dr Mario Raviglione.
Stop TB would like to thank Dr Kochi for his immense contribution to TB control over the past decade. We wish Dr Kochi well in his new position as Director of HIV/AIDS Care and Support.
The final draft of the proposed governance of Stop TB has been circulated to partners following completion of the consultation phase. The final document will be available by 20 January 2001, and will be available on the Stop TB website at that time. An interim Stop TB Coordinating Board, which will address the issue of the future management framework, will be convened for early 2001.
Stop TB would like to thank Kevin Lyonette for his help in steering the governance process.
The Stop TB Secretariat continues to seek support for staff secondments from global partners. Such commitments will enable the Stop TB Secretariat to support partners' actions towards operationalizing the Amsterdam Declaration to Stop TB.
For further details please contact the Stop TB Secretariat at stoptbinfo@who.int.
Following the successful meeting of partners at the First Meeting of the Stop TB Working Group on DOTS Expansion held in Cairo from 20-22 November 2000, work on the GDF has progressed rapidly. Participants in Cairo agreed on a "two track" approach to developing the GDF. The Stop TB Secretariat was given responsibility to rapidly develop and operationalize a "fast track" GDF using funds already committed by a generous donor. The first supply of drugs to countries through the "fast track" GDF will commence by summer 2001.
The "fast track" GDF will send out application forms to WHO Regional Offices by early January 2001, and a Technical Review Committee will be established. Applications should be received by Stop TB by the end of February 2001. The Technical Review Committee will review and prioritize applications, and countries eligible for this first round of support will be announced on World TB Day, 24 March 2001.
The "second track" for the GDF will develop more slowly in order to ensure that the final form of the GDF will effectively and efficiently ensure access to quality TB drugs in an appropriate manner. A Core Technical Working Group (CTG) for the GDF was formed in Cairo comprising 13 representatives from Member countries, donors, technical agencies, and industry. The CTG has held three teleconferences following the Cairo meeting, and the group will finalize the GDF prospectus and propose a governance mechanism for the GDF by the end of January 2001.
For further information please contact the Stop TB Secretariat at www.stoptb.org.
Advance materials for World TB Day 2001 have been distributed and are available on the Stop TB website at www.stoptb.org. These include the following products: a World TB Day folder; a one-page rationale on the global theme, "DOTS: TB Cure for All" (available in English, French, and Spanish); a report of global activities Highlights of activities in countries World TB Day 24 March 2000 "Forging new partnerships to stop TB; a planning guide, Guidelines for Social Mobilization: Planning World TB Day; and a documents order form.
DOTS Expansion
WHO, on behalf of the Stop TB Initiative, organized a major planning meeting in Cairo, Egypt from 20–22 November 2000 to establish a rational, coordinated Global DOTS Expansion Plan (GDEP) focusing on the 22 high TB burden countries. The meeting convened the NTP managers from the 22 high TB burden countries, the international technical and financial partners of Stop TB, and the entire WHO TB network. It allowed the development of a first draft of the GDEP following presentations by country representatives of their medium-term plans, financial and other needs, and gaps to be filled in order to achieve the WHO targets for TB control. The resulting global plan focuses on three areas: (1) support to countries to develop/implement/expand/sustain five-year plans of action; (2) establishment of country-based partnerships with national and international groups supporting the NTP in addressing existing needs; and (3) creation of regional coalitions of agencies to facilitate the widest possible coverage by DOTS in all countries.
WHO will facilitate and convene the newly established "Working Group on DOTS Expansion", one of the current Stop TB partnership working groups. The "Cairo" direction will now guide the work of Stop TB in order to achieve rapid progress towards the global targets of detecting at least 70% of infectious cases and successfully treating 85% of them. Next steps include development of the following: (i) a timeframe to develop regional strategic plans with partners; (ii) a regional short-term plan of action to address the immediate need for technical support for the 22 high TB burden countries to prepare national medium-term development plans for DOTS expansion; and (iii) a report outlining, for each of the 22 high TB burden countries, epidemiological situation, control situation, medium-term plans of action, financial situation and budget, gaps to be filled, and a list of agencies and institutions that have agreed to provide support. Such a report would facilitate identification by potential investors of areas to be supported and will constitute a sound basis - being derived directly from transparent country information - for monitoring progress towards full DOTS coverage.
TB/HIV
WHO and UNAIDS held an informal consultation with Stop TB partners and National TB Programme managers from high TB prevalence countries, including some of those most badly affected by TB/HIV, as part of the First Meeting of the Stop TB Working Group on DOTS Expansion. It was agreed to establish a TB/HIV Working Group coordinated by WHO under the auspices of the Stop TB Initiative. The goal of the Working Group is to promote the ability of health systems to deliver the interventions that will lead to a reduction in the burden of TB in high HIV prevalence populations.
The Terms of Reference for the TB/HIV Working Group were agreed as follows: (i) to use field experience of tackling TB/HIV in order to inform the development of the new WHO/UNAIDS strategy; (ii) to promote implementation of the new strategy (as part of DOTS expansion), taking into account the comparative advantages of each Stop TB partner. Close collaboration will be necessary with the Working Group on DOTS Expansion, also to be coordinated by WHO under the auspices of the Stop TB Initiative; (iii) to share experiences among Stop TB partners on progress in implementing the TB/HIV strategy and to disseminate lessons learned (contributing to the cycle of experience informing policy and strategy); (iv) to promote collaboration between TB and HIV/AIDS programmes in order to maximize synergies in supporting the health service response to TB/HIV.
The first meeting of the TB/HIV Working Group is expected to take place in March 2001 (exact dates and venue to be confirmed).
DOTS-Plus/MDR-TB
The Working Group on DOTS-Plus/MDR-TB will meet in Lima, Peru from 25-27 January 2001. The objectives of the meeting are to report on the following: (i) progress of the working group; (ii) progress of projects at country level; (iii) research priorities for MDR-TB; (iv) progress on work on access to second-line drugs for MDR-TB. The meeting will help WHO to formulate its future international policy on the management of MDR-TB in resource-limited settings. Policy guidelines will be issued by WHO in two to three years' time after the data from pilot projects around the world are evaluated in terms of efficacy, feasibility, and cost-effectiveness.
2. NEWS FROM PARTNERS
Stop TB welcomes the Infectious Diseases Society of America (IDSA) TB Committee and the TB Network association to the global partnership movement to Stop TB.
IDSA is a professional organization of more than 5000 infectious diseases physicians, scientists, and other infectious diseases experts. The mission of IDSA is to promote and recognize excellence in patient care, education, research, public health, and the prevention of infectious diseases. IDSA is now playing a prominent role with regard to TB-related issues in the US and is a co-sponsor along with ATS and CDC of the TB Treatment statement that is undergoing revision as well as the TB Control statement which will be revised next year. IDSA would like to expand its activities in the TB field to the international arena given the global impact of the disease. A number of its members are involved in international projects (public health, research) including the field of TB. Further information www.idsociety.org.
The TB Network association is a voluntary organization based in the UK that provides support and information for anyone affected by, or infected with, TB. The TB Network in collaboration with the Foundation of Nursing Studies will hold a National Conference on "Social Aspects and the People's Participation in Tuberculosis Cure and Prevention to mark World TB Day on 23 March 2001. Further information is available from www.tbnetwork.co.uk.
3. UPCOMING EVENTS
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