Stop TB Partnership - Communiqué, No. 17

February 2002, issue of the Stop TB Communiqué

STOP TB COMMUNIQUE

Issue 17, February 2002

1. NEWS FROM THE STOP TB PARTNERSHIP SECRETARIAT

The Global Alliance for TB Drug Development and Chiron Corporation Agreed on License of PA-824 Compound for New Tuberculosis Therapeutics in a Groundbreaking Agreement for New Tuberculosis Treatment – Feb 1, 2002.

The 4th World Congress on Tuberculosis will be held in Washington, DC, on June 3-5: Co-sponsored by NIH, WHO (TDR and Stop TB), KNCV, CDC, and a number of other organizations. The Congress will evaluate the state of the global tuberculosis epidemic since the last TB World Congress held in 1992, review the status of TB research and identify research gaps. Topics covered will include fundamental, translational and operational research. Attendance should be of interest to global TB control officials, TB researchers, health systems services researchers, policymakers and funders, as well as infectious disease and pulmonary physicians.

The Program Committee invites the submission of abstracts for inclusion in the poster sessions. The committee will review all submitted awards. A small number of abstracts may be selected for "late breaker" oral presentations. Abstracts are due by March 1, and notification of acceptance will be sent out on or about April 1. For international travelers only, a limited amount of travel support may be available for those presenting posters or "late breaker" talks.

Detailed information about the meeting program and abstract submission can be found on the meeting website (http://www.niaid.nih.gov/dmid/tuberculosis/tbcongress/).

Follow-up of the Stop TB Partners' Forum, 22-23 October 2001, Washington, DC, USA:
- The final report from the Partners' Forum "Highlights: First Stop TB Partners' Forum" is now available in hard copy printed version. It has been distributed widely to all our Partners and is online as a pdf file on our documents page
- The Washington Commitment is also available in hard copy version in English, French, Spanish and Russian (Chinese and Arabic can be downloaded from the website) on our documents page
- A final evaluation of the STOP-TB eForum and the utility of electronic networking to those working in the field of TB control, is now available at: http://www.hdnet.org/home2.htm

Stop TB Image Library: We are pleased to announce that an Image Library Data Base is currently being built which will soon become available to the Stop TB partnership, through the website and via a CD-ROM.

We would very much welcome receiving your images to further build the Image Library. If you have TB images you can share, please contact us: stoptbinfo@who.int

More information will be available on the website. http://www.stoptb.org/

Global TB Drug Facility (GDF) http://www.globaldrugfacility.org

The recently established Direct Procurement Mechanism is now up and running, to enable countries and organizations committed to DOTS to use their own resources to procure quality TB drugs, through a reliable procurement agent, at prices that will result in considerable savings, thereby freeing up resources for the non-drug aspects of DOTS. For further information on Direct Procurement through the GDF kindly visit our website at:

/GDF/drugsupply/Direct_procurement_process.html

The third round of applications is now open and the secretariat is accepting applications from NGOs and countries for free grants of TB drugs. The closing date for receipt of applications is 1^st April and the Technical Review Committee of the GDF will meet in mid April 2002.

The GDF and MSH are jointly hosting a meeting on in-country drug management issues in June 2002. This meeting will build on the GDF country visits as well as country assessments, organised by KNCV and MSH which are taking place over the next 2 months to look at in-country TB drug management. The meeting is of utmost importance in the light of the GDF and the increased demand for TB drugs as countries scale up DOTS to meet the global targets, thus presenting new challenges to in-country drug management. The main objectives of the meeting are:

- To identify the major strengths and weaknesses in relation to in-country drug management of TB drugs.
- To develop a joint plan of action with countries and partners on what is needed to be done, and by whom, in relation to TB drug management.

Further information on the GDF is available from gdf@who.int

Stop TB Coordinating Board

The second meeting of the Stop TB Coordinating Board was held in Osaka, Japan, on 19-21 February 2002. The meeting was attended by 22 of the 27 member organizations of the Board and hosted by the Japanese government. The main objectives of the meeting were;

Review progress and formulate priorities for action of the Global Partnership to Stop TB in 2002

Review the operational and financing aspects of the Global Plan to Stop TB

Endorse the strategic plan for the Global TB Drug Facility

Endorse the strategic plan for advocacy & communications

In addition, there was substantial discussion on the relationship between Stop TB and the Global Fund to Fight AIDS, TB, and Malaria.

A complete report of the meeting will be available on the Stop TB website in due course.

Further information is available from the Stop TB Partnership Secretariat at stoptbinfo@who.int.

World TB Day 2002

World TB Day (WTBD) 2002 on 24 March 2002 is 16 working days away! World TB Day 2002 addresses the theme "Stop TB, Fight Poverty". It suggests that tackling TB, one of several illnesses that affect the poor, is one way of achieving greater global prosperity. Unlike previous years, a sustained campaign emphasizing this year’s theme is envisioned. Stop TB partners are encouraged to develop year-round activities and stress the targets for case detection and cures, as this indicates both that the global partnership has a plan and that massive expansion of DOTS is necessary to achieve the targets. To initiate your year-long campaign, a WTBD tool-kit is being prepared and will be available over the next weeks. This package includes facts-sheets, posters, sticker, CD Rom including video's and various documents.

We would like to hear of your events and plans mailto:stoptbinfo@who.int

The theme "Stop TB, fight poverty" will be further explored throughout 2002, with case-stories and evidence. Research papers, seminars and workshops will be developed. A STOP-TB eForum addressing Stop TB, Fight Poverty will be reinstated soon.

More information and background material can be found on the Stop TB Website:</events/world_tb_day/2002/default.asp>

Staff secondments

The Stop TB Partnership Secretariat is welcoming secondments from Stop TB partner organizations. The team in Geneva needs to be strengthened with expertise in communications & advocacy, information management and resource mobilization.

Further information is available from the Stop TB Partnership Secretariat at stoptbinfo@who.int.

WORKING GROUPS

/wg/default.asp

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

The workshop to develop collaborative TB and HIV/AIDS programme activities, co-ordinated by WHO/AFRO/TUB and WHO/HQ in collaboration with the USA Centers for Diseases Control and USAID, was held on 11-15 February 2002, in Nairobi, Kenya. The workshop was attended by some 90 participants including national TB and HIV/AIDS programme managers, development and technical agencies representatives and ProTEST co-ordinators from ongoing sites.

The key objective of the meeting was to strengthen the capacity of participating member States (Ethiopia, Kenya, Malawi, Mozambique, South Africa, Tanzania, Uganda and Zambia) to effectively manage the overlapping TB and HIV/AIDS epidemic through the development of country specific proposals and plans of work for phased implementation of collaborative TB & HIV/AIDS programme activities.

The workshop confirmed the tremendous motivation by the TB and HIV/AIDS communities to collaborate to plan and implement collaborative TB/HIV programme activities. As a conclusion of the workshop, country specific draft proposal were compiled and mentors were identified to assist country teams in finalising and implementing collaborative programme activities. Country proposal will be finalised and submitted to review panel by July 2002. Activity initiation at chosen sites are expected to commence by December 2002.

Further information available from Dr Wilfred Nkhoma, WHO Africa Regional Office, Harare, (nkhomaw@whoafr.org).

- DOTS Expansion Working Group /wg/DOTS_Expansion/default.asp

The Western Pacific Regional Office of WHO (WPRO) held its third Stop TB Technical Advisory Group (TAG) meeting and Inter-agency Coordination Committee (ICC) meeting in Osaka, Japan, from 17 to 19 February 2002. Programme managers from the 7 high burden countries (HBC) of the Region (Cambodia, China, Lao PDR, Mongolia, Papua New Guinea, Philippines and Viet Nam) and from the 7 intermediate burden countries or areas (Brunei, Hong Kong China, Japan, Republic of Korea, Macao China, Malaysia and Singapore), the nine TAG members and more than 10 partners’ organizations and agencies met to review the situation of tuberculosis in the region, assess progress made in DOTS implementation and discuss plans to further accelerate DOTS expansion.

This TAG meeting focused on the TB situation in intermediate burden countries of the region. With the exception of the Republic of Korea, these seven countries and areas are experiencing an increase or a plateau in case notification during the last decade. This situation is of concern, since detection rates are still high (except for Japan) in the range of 20 to 40 new smear positive cases per 100 000 population. This prompted the TAG in its last meeting to advise WPRO to undertake an analysis of the situation. An epidemiologist went to each country or area to review available data with programme managers and perform an epidemiological analysis to identify possible factors explaining the stagnation of the TB endemic. Increase in migration and ageing were the two main factors identified. The TAG recommended further in depth reviews of TB programmes in the intermediate burden countries to identify programmatic factors that could explain country specific reason for the stagnation in trends in TB notification.

WPRO's progress report for the period since the last TAG meeting shows very high commitment from WHO, good partnership with technical and financial actors, and important achievements. The proportion of newly detected patients enrolled in DOTS programmes increased from 67% in 2000 to 74% in 2001. All 7 high burden countries in the region have medium-term DOTS expansion plans, including costs estimates and national ICC. Philippines provides DOTS countrywide, China can count on a new WB/DFID project, increased access to DOTS has been achieved in Viet Nam for difficult to reach populations in rural areas, and in Cambodia for rural populations through the participation of health centres in the implementation of the DOTS strategy.

With this renewed commitment, DOTS expansion will be accelerated in the Region during the year 2002.

- DOTS Plus Working Group /wg/mdrtb/

CALL FOR NOMINATIONS TO MEMBERSHIP: GREEN LIGHT COMMITTEE (GLC) OF THE WORKING GROUP ON DOTS-PLUS FOR MULTIDRUG RESISTANT TB (MDR TB).

To address the issue of MDR-TB, WHO and its partners built upon the DOTS strategy and initiated DOTS-Plus, a strategy, under development and testing, designed to manage MDR-TB using second-line anti-TB drugs. In order to further develop the DOTS-Plus strategy, WHO created the Working Group on DOTS-Plus for MDR-TB. To promote the implementation of this strategy, WHO established the Green Light Committee (GLC) as a subgroup of the Working Group. The primary task of the GLC is to review applications for projects and determine whether these projects comply with the Guidelines for Establishing DOTS-PLUS Pilot Projects for the Management of Multidrug-Resistant Tuberculosis (MDR-TB) (http://www.who.int/gtb/policyrd/DOTSplus.htm). Projects can benefit from the pooled procurement process for preferentially priced second-line anti-TB drugs and technical assistance via the Working Group.

The Green Light Committee is an independent technical body that serves the DOTS Plus Working Group in an advisory capacity on programmatic, scientific, and clinical aspects of MDR TB. The institutional members and consultants participate entirely on a volunteer basis and receive no financial benefits for participation. Institutional members and consultants are required to adhere to strict rules of conflict of interest and confidentiality.

The GLC members

evaluate DOTS-Plus pilot projects in reference to the standards outlined in the Guidelines, including potential participation in pre-approval reviews.

make recommendations to WHO on specific instructions for projects interested in applying for review by the GLC;

promote technical assistance, by the agencies/institutions participating in the Working Group and other institutions to DOTS-Plus pilot projects approved and potentially to be approved.

contribute in monitoring GLC endorsed DOTS plus pilot projects;

meet at least once a year at WHO HQ, in Geneva, to review and propose revisions to the Instructions, the Guidelines, as well as to review GLC functions and procedures.

GLC members serve for a period of at least two years. The workload is approximately equivalent to 10% of full time work. Selection criteria for membership of the GLC include the following: 1. Extensive experience in DOTS implementation. 2. Knowledge and experience in clinical, laboratory and/or programmatic aspects of MDR-TB. 3. Participation in a national review of a TB programme outside the current country of residence. WHO requests applications from participants of the Working Group interested in serving on the GLC, and will evaluate such applications to determine the composition of the GLC. Final decision will be announced at the Working Group meeting in Tallinn (Estonia), 10-12 April, 2002. If you are interested in being nominated to be member of the GLC, please send your CV with a covering letter expressing why you feel suitable for being a GLC member accompanied by a letter of institutional support. Must be received at the below address by 15 March 2002.

World Health Organization, Communicable Diseases, Green Light Committee of the Working Group on DOTS-Plus for Multidrug-Resistant Tuberculosis (MDR TB), 20 Avenue Appia, CH-1211 Geneva 27, SWITZERLAND (Phone: +41 22 791 13034, Fax: +41 22 791 4268, E-mail: dotsplus@who.ch).

Global Alliance for TB Drug Development and Chiron Corporation Agreed on License of PA-824 Compound for New Tuberculosis Therapeutics in a Groundbreaking Agreement for New Tuberculosis Treatment – Feb 1, 2002. Under the terms of the agreement, the Global Alliance for TB Drug Development obtains the exclusive worldwide license of PA-824 and related compounds for the development of a new drug to treat tuberculosis. The parties have agreed that no royalties will be due under this agreement for drugs marketed in less developed economies, including impoverished countries with a high burden of tuberculosis. PA-824 is a novel lead compound related to nitroimidazoles, a family of compounds used to treat a range of infections. PA-824 has already demonstrated in vitro activity against both drug-sensitive and multi-drug resistant strains of TB. Early research into PA-824 has highlighted important properties that may have the potential to permit significant reduction in the duration of TB treatment from its present course of 6 to 9 months. The first scientific report on PA-824 came out in June 2000 in Nature and yielded much enthusiasm among the TB community.

International Symposium on Current Developments on Drug Discovery for Tuberculosis, January 14-17, 2002: The Global Alliance for TB Drug Development and WHO’s Special Programme for Research and Training in Tropical Diseases co-hosted with AstraZeneca an International Symposium on Current Developments on Drug Discovery for Tuberculosis. This symposium was organized by AstraZeneca India in Bengalore and was attended by many members of the working group. hhtp:/www.astrazenecaindia.com

Further information is available from joelle.tanguy@tballiance.org

2. CALENDAR OF EVENTS /events/archive.asp

The 4^th World Congress on Tuberculosis (TB) will be held at the Marriott Wardman Park Hotel in Washington, D.C, U.S.A. on June 3-5, 2002. This meeting will evaluate the state of the global TB epidemic since the last Tuberculosis World Congress in 1992, review the status of TB research and identify research gaps.

Topics covered will include fundamental, translational and operational research. This meeting is for global TB control officials, TB researchers, health systems services researchers, policymakers and funders, as well as infectious disease and pulmonary physicians. Abstract for poster presentation due: March 1, 2002

Hotel, abstract and meeting details: www.niaid.nih.gov/dmid/tuberculosis/tbcongress

7th Conference of the IUATLD North America Region

http://www.iuatld.org/html/r_middleeast.htm
Vancouver, Canada, February 28 - March 2

WORLD TB DAY
March 24 /events/world_tb_day/2002/default.asp

International Conference on Emerging Infectious Diseases

http://www.cdc.gov/iceid/
Atlanta, Georgia, USA, March 24-27

SGM Control of bacterial gene expression http://www.sgm.ac.uk/MTGPAGES/warwick02.htm
Warwick, UK, April 8-12

IUATLD Conference of the European Region http://www.iuatld.org/html/r_middleeast.htm
Bucarest, Roumania, April 17-20

12th European Congress of Clinical Microbiology and Infectious Diseases http://www.escmid.org/preview.html?meetings.html
Milan, Italy, April 24-27 (Abstract deadline November 28th)

55th World Health Assembly, Switzerland

http://www.who.int/gb/ Geneva, Switzerland, May 2001

American Society for Microbiology (ASM) 102nd General Meeting http://www.asmusa.org/mtgsrc/gm2002prelimprogtoppage.htm
Salt Lake City, Utah, USA, May 19-23

4^th World Congress on Tuberculosis

http://www.niaid.nih.gov/dmid/tuberculosis/tbcongress Washington, D.C., USA, 3-5 June

IUATLD Conference of the African Region
Durban, South Africa, June 10-14 (Programme to be announced)

ESM 23rd Annual Congress of the European Society of Mycobacteriology http://www.esm2002.com/
Dubrovnik, Croatia, June 23-27

June 2002: The annual meeting of the Global Alliance for TB Drug Development Stakeholders Association will take place in Washington DC, around the 4th World Congress on Tuberculosis. Further information is available from joelle.tanguy@tballiance.org.

1st FEMS Congress of European Microbiologists,
Ljubljana, Slovenia, June 29 - July 3 (Abstract deadline Dec 31st 2001)

6th International Meeting on Molecular Epidemiology and Evolutionary Genetics in Infectious Diseases
Paris, France, July 24-27

The World of Microbes

http://www.iums-paris-2002.com/
Paris, France, July 27 - August 1

3rd European Congress on Tropical Medicine and International Health http://www.kit.de/tropical2002/
Lisbon, Portugal, September 8-12

12th European Respiratory Society

http://www.ersnet.org/2/2/2_2.asp
Stockholm, Sweden, September 14-18 (Abstract deadline Feb 28th. incl. session on Cost-effectiveness of TB control)

42nd Interscience Conference on Antimicrobial Agents and Chemotherapy http://www.icaac.org/ICAAC.asp
San Diego, California, USA, September 27-30

IUATLD 33rd World Conference on Lung Health

http://www.iuatld2002.org/
Montreal, Canada, October 6-10

Fall 2002. The annual meeting of the R&D Coalition for TB will take place in the Fall in Penang, Malaysia. Further information is available from Bernard Fourie.

2003

13th European Congress of Clinical Microbiology and Infectious Diseases http://www.escmid.org/preview.html?meetings.html
Glasgow, Scotland, UK, May 10-13

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 Partnership 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.

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