July 2001, issue of the Stop TB Communiqué

STOP TB COMMUNIQUE

Issue 11, July 2001

1. NEWS FROM THE STOP TB PARTNERSHIP SECRETARIAT

• Stop TB Partners' Forum

The First Stop TB Partners' Forum will be held in Washington, DC from 22 to 23 October 2001. The meeting, which will be hosted by the World Bank, has five stated objectives: (i) to report on progress since the Amsterdam Conference on Tuberculosis and Sustainable Development (March 2000) /stop_tb_initiative/amsterdam_conference/default.asp; (ii) to further accelerate efforts to operationalize the Amsterdam Declaration to Stop TB /stop_tb_initiative/amsterdam_conference/default.asp#declaration; (iii) to address the urgent issue of TB and HIV/AIDS /wg/TB_HIV/Index.html; (iv) to launch the Global Plan to Stop TB (see next item below); and (v) to formally endorse the supporting mechanisms for the Stop TB partnership. Expected outcomes include consensus on the way forward for the global partnership; reinforced commitment to implement the Amsterdam Declaration in order to reach global targets for TB control by 2005; and strengthened partnership activities to stop TB.

Further information is available from the Stop TB Partnership Secretariat at mailto:stoptbadvocacy@who.int.

• Global Plan to Stop TB

A global TB investment plan has been in development for the past year, describing the action and resources needed to substantially accelerate action to Stop TB in three specific areas: (i) expanding DOTS to reach the global targets by 2005; (ii) adapting DOTS to meet the challenges of TB-HIV and MDR-TB; and (iii) improving DOTS by developing new diagnostics, drugs and vaccines. This plan has been developed jointly by Partners in Health http://www.pih.org/ and the Stop TB Partnership Secretariat mailto:stoptbadvocacy@who.int with funding from the Soros Foundation, and assistance from a wide range of contributing authors and an editorial committee.

With the rapid development and growth of the Stop TB Partnership, the Stop TB Coordinating Board identified the urgent need for a strategic plan for the partnership that would describe the different roles of the partners, and mechanisms for coordinated action. The global TB investment plan and the strategic plan are therefore now being integrated as a Global Plan to Stop TB, which will be presented at the Stop TB Partners' Forum in October 2001.

A preparatory meeting was held in Atlanta in May 2001, and a small writing committee formed, to consolidate a series of workplans prepared by Stop TB working groups /wg/default.asp. The first draft is approaching finalization, and will be posted on the Stop TB website www.stoptb.org for comments by the end of July.

• Global TB Drug Facility (GDF) and interim GDF pilot projects /GDF/Index.htm

Second Round Applications

The first round application form and notes were significantly revised as a result of feedback from partners, applicant countries, and the Technical Review Committee (TRC). The revised second round application form was sent via WHO regional offices in mid-May to the eligible countries that had not yet applied (57) with a closing date in mid-July.

• To date, the Secretariat has received 18 applications for this round.
• The second round TRC meeting is scheduled to take place from 25 to 26 July to discuss these applications.

Using the same tender from the first round, countries approved in the second round will receive drugs by September 2001.

Further information is available from the Stop TB Partnership Secretariat at mailto:stoptbadvocacy@who.int.

• WORKING GROUPS /wg/default.asp

DOTS Expansion /wg/DOTS_Expansion/default.asp

In preparation for the second meeting of the Working Group on DOTS expansion to be held in Paris in October 2001, the working group secretariat is producing an update of the situation of DOTS expansion in the high TB burden countries and in other countries, surveying NTP managers. WHO regional offices and other technical agencies working in the field will be asked to participate in the exercise and to provide information on the support given to countries. This will provide the necessary information to develop a comprehensive Global DOTS Expansion Plan.

The WHO Regional Office for the Western Pacific (WPRO) held its second Technical Advisory Group (TAG) meeting from 4 to 6 June 2001. TAG comprises representatives from the largest countries in WPRO and the major technical agencies working in the region. In 1999, 36% of the estimated number of new smear-positive cases were enrolled in DOTS programmes in the region, as compared to 23% globally. The meeting included a review of the situation of DOTS expansion in the 7 highest burden countries in the region (Cambodia, China, Lao PDR, Mongolia, Papua New Guinea, Philippines, and Viet Nam). All 7 countries have developed or will have developed by the end of 2001 a 5-year plan for DOTS expansion or for sustaining DOTS. Financial needs were also assessed and discussed with NTP managers and with financial partners. Based on discussions, figures are currently being finalized.

PRESS

"PREMIER TARLEV ASKS HEALTH MINISTRY TO WORK OUT SPECIAL PROGRAM AGAINST TUBERCULOSIS

Chisinau-27.06.2001/11:58:21/(BASA-general) Moldova's Premier Vasile Tarlev asked the Health Ministry at a cabinet meeting on Wednesday to work out a special program to fight tuberculosis in the penitentiary institutions in next five years.

Tarlev mentioned that the prisoners suffering from tuberculosis needed a special treatment, or a "national catastrophe" would happen when they get free. The tuberculosis morbidity rate in the penitentiary institutions is 42-fold higher than in the country on the whole. The premier suggested that this program could be financed by an international organisation.

The government also approved on Wednesday a national program of prophylaxis of tuberculosis for the period 2001-2005. The new program sees "a complete treatment of 85 percent of the patients suffer from TB and trackdown of 70 percent of the TB carriers." The program is based on an international strategy stipulating the implementation of the DOTS project, which stand for the short-term strictly supervised treatment.

… Moldova has more than 12,000 patients suffering from tuberculosis. Each 375th person in Moldova suffers from TB."

Global Working Group on TB among HIV-infected people /wg/TB_HIV/

The Global Working Group on TB among HIV-infected people represents a global partnership of many organizations and agencies, coordinated by WHO, working towards decreasing the burden of TB among HIV-infected people. This update reflects the activities of the Global Working Group and of WHO as the coordinating agency.

Update on the Global Working Group

Dr Gijs Elzinga, the chairperson of the Working Group, indicated in closing the first meeting of the Working Group in Geneva from 9 to 11 April 2001, that the partners need to describe their planned activities relevant to the strategic objectives of the Working Group. By describing their proposed activities as part of a coordinated Working Group workplan, partners have the opportunity to set out their commitment to work in partnership and to make the Working Group "a Group that Works", rather than an annual "talk shop". The workplan has been circulated widely, with a request for partners to indicate their proposed activities (in a common format for the workplans of the different Working Groups under the auspices of the Global Stop TB Partnership).

WHO update

The WHO advisory group on TB - the Strategic and Technical Advisory Group (STAG) - met in Geneva from 4 to 6 July 2001. Among other issues, STAG considered the WHO Stop TB Department's activities on TB among HIV-infected people. The main outcomes were as follows:

1) STAG endorsed (with some modifications) the technical framework to guide national strategies for effective TB control among HIV-infected people.

2) STAG approved the plan to develop guidelines for establishing phased implementation of collaborative TB and HIV/AIDS programme activities. WHO is convening the Scientific Panel of the Working Group in September 2001 to develop these guidelines, which will reflect the early experience gained from ongoing ProTEST projects in Malawi, South Africa, and Zambia.

3) STAG encouraged WHO in its planned work in the following ways to support countries to establish phased implementation of collaborative TB and HIV/AIDS programme activities:

i) through the Working Group to coordinate partners' activities;

ii) through collaboration with WHO regional offices;

iii) through implementation of planned Stop TB Department activities, e.g. promoting phased implementation through protocol development workshops.

4) STAG strongly endorsed the previous Working Group recommendation to submit a proposal to the WHO Executive Board for a policy resolution endorsed by the World Health Assembly in 2002 on collaboration between national tuberculosis and HIV/AIDS programmes.

Global Alliance for TB Drug Development http://www.tballiance.org/home.cfm

StopTBdrugWG@tballiance.org was set up as the central e-mail contact point for the TB drugs working group led by the Global Alliance for TB Drug Development. All interested parties are invited to contact this address. The working group is in the process of structuring its operations, reviewing its membership list, building on the work developed since the Cape town meeting in February 2000, and planning activities as laid out in the Terms of References.

The first Gordon Research Conference on tuberculosis drug development was held at Colby-Sawyer College in New London, New Hampshire on June 24-29, 2000, chaired by Dr. Clif Barry of the National Institutes of Health (NIH) and Dr. Ken Duncan of GlaxoSmithKline (GSK), both members of the Global Alliance for TB Drug Development Scientific Advisory Committee. The Alliance sponsored the participation of LDC researchers and investigators. For a full report, consult http://www.tballiance.org/news.cfm?rm=news

The Global Alliance has a new look for its website. www.tballiance.org. While the address remains unchanged, the site has been fully redesigned to provide in-depth review of the TB epidemic and the need for new TB drugs, including the science and economics of TB drugs development and, of course, the Global Alliance for TB Drug development. The Alliance is grateful to the Research Triangle Institute for its key role in the development of this new site.

Further information is available from Joelle Tanguy at joelle.tanguy@tballiance.org