Stop TB Partnership Communiqué
Issue No.27
December 2002

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News from the Stop TB Partnership Secretariat (web site)

Merry Christmas and a Happy New Year from the Partnership!

Please take time over the festive season to reflect over the millions of lives lost due to TB.

2003 will be a year of acceleration towards achieving the 2005 Global WHO Targets of 70% Case Detection and 85% Cure.

Third Taskforce meeting on TB Control for Africa, Harare, 11-13 December 2002:

Outcomes:

  • The high proportion of TB HIV/TB dual infections is a likely precursor for an even higher number of new cases of clinical tuberculosis in the coming years. 
  • The lack of adequate staff, and financial resources linked with a crumbling health infra-structure make the fight against tuberculosis in this region an imposing challenge. 
  • Current case detection and cure rates are very low and it is unlikely that our efforts will make a great impact on the overall spread of tuberculosis in the countries of the region. 

Recommendations:

  • The meeting recommended a wider approach to reach out to the communities to detect new cases and to link with other health initiatives to provide better treatment and cure.
  • The establishment of a regional partnership was recommended as the first step. Such partnership would serve as a catalyst as a multi-sector coalition with the purpose to fight tuberculosis using a much wider variety of approaches and tools than before.
  • The proposal for the establishment of an African Regional Partnership is expected to be submitted to the STB Coordinating Board during its next meeting.
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TB among prisoners in the Baltic States:

The meeting in St. Petersburg, Russian Federation (25 – 27 November 2002), was a follow up from the meeting in 2000, when the problems of tuberculosis among prisoners was extensively discussed. The St. Petersburg meeting presented remarkable progress within such a relatively short time-frame:

  • The impact of the reforms in the penal code in the Russian Federation
  • The number of inmates reduced, especially in the pre-trial detention centres

Most progress was in addition partly the result of special project support, while it was uncertain how these projects could be sustained after the completion of the project cycle. The WHO pilot project in the 26 oblasts of the Russian Federation initiated important improvements in the prisons such as:

  • Standardization of treatment regimen for first line drugs
  • Higher budget allocation for prisons
  • Better collaboration with the civilian public health service and 
  • Improvement of living conditions. 

In spite of this progress, considerable challenges are present:

  • Diagnostic capabilities and screening routines (especially bacteriology).
  • Infra-structures of prisons must be further improved (ventilation, isolation)
  • Cure rates are generally low (65% and less are reported)
  • Standardization of first line treatment regimen (incompatibility of regimens enhance the development of drug resistance)
  • Reporting and surveillance of tuberculosis from prisons are inaccurate
  • HIV in prisons is high for intra-venous drug users (especially in Latvia and Estonia)
  • MDR TB in prisons continues to cause concern
  • Collaboration with civilian public health service (about half of the released prisoners with TB are lost to follow-up)
  • International collaborations and financial support are time-bound projects with unfortunate short time-frames.
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TB and Poverty:

The theme for World TB Day 2002 was "Stop TB, fight poverty". The relationship was extensively explored and the evidence rigorously tested. During two meetings in 2002, new findings and experiences were presented. As a result of the last meeting (Satellite Symposium in October 2002 in Montreal) it was agreed that next steps towards practical interventions for a better pro-poor approach in tuberculosis control were needed. A Network for Action is currently being constructed by a wide variety of expertise and experience.

Three areas of work can be distinguished and earmarked with specific objectives:

  1. Research
  2. Dissemination of findings
  3. Implementation of pro-poor approaches or initiatives

A core group of professionals from established institutions with extensive experience (WHO, Stop TB Working Groups, Liverpool School Tropical Medicine and others), will develop a proposal for the setting of such a network. The network is expected to be more than just a forum for exchanging ideas but will serve as a catalyst and initiator for innovation to realise better equity in tuberculosis control. The final proposal will be submitted to the Coordinating Board for support during their next meeting.

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News from the Stop TB Working Groups (web site)

DOTS Plus

Working Group on DOTS-Plus for MDR-TB, Seoul, Republic of Korea, 24-26 April 200

Further details on the venue and agenda of this meeting as well as travel and accommodation information, will be announced in January. 

Job announcement: Closing date 15th January 2003

DOTS-Plus position available in the Tuberculosis Strategy & Operations (TBS) unit in the Stop TB department. Please click here for detailed information regarding the Terms of Reference and application procedure.

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News from the Global Drug Facility (GDF) (web site)

GDF Applications/Review Update:

The current situation with regards to applications and review is as follows:

Activity

To date
Rounds of applications and review 5
Number of applications received 60
Number of countries approved for support 39
Drug orders placed 25
Number of patient treatments approved (inc. buffer stocks) 1,800,000
Number of countries which have received drug deliveries 14

Applications and Review Update:

  • The secretariat is organising country visits to all 4th/5th round countries as well as monitoring visits to all 1st and 2nd round countries.
  • The secretariat will begin accepting applications for the sixth round of review in December 2002 (closing date of early February 2003). Copies of the GDF application forms are available on the GDF website at www.globaldrugfacility.org in English, French, Russian and Spanish. NGO application forms are also available.
  • The secretariat is currently creating a database of consultants to take part in GDF country and monitoring missions.

GDF Procurement/Supply Update:

  • A list of the currencies accepted by the GDF Procurement Agent, as convertible currencies, that can be accepted as payment from clients against the GDF Direct Procurement mechanism are posted on the GDF website: /GDF/drugsupply/Direct_procurement_process.html
  • 1 country has now successfully negotiated to buy drugs through the GDF at low cost, with 2 others negotiating final contracts. These countries are referred to as Direct Procurement clients.
  • A Request for Proposals (RFP) will be issued by the STOP TB Partnership to procurement agents who have expressed interest in becoming the procurement agent for the GDF and who have met the minimum requirements. This is will occur in December 2002.

External Evaluation:

The GDF was housed in WHO for an initial two period. In order to determine the future and governance of the GDF, an external evaluation of GDF operations will take place in January 2002. Bids have been received and are currently under consideration by the adjudication committee.

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Calendar of Events (web site)

For more information on upcoming events, please click on the above link:

January 2003:

  • 4th International Symposium on Perspectives in Clinical Microbiology and Infections,
    Italy, Venice, January 12-15
  • World Economic Forum,
    Switzerland, Davos,  January 23-28
  • Monitoring Mission to the NTP,
    Indonesia, Jakarta, January 27 - February 7
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    'Stop TB' - a global movement to accelerate social and political action to stop the spread of tuberculosis around the world. For further information please contact the Stop TB Secretariat at: stoptbinfo@who.int