Facilities for TB Control in SAARC The National TB Control programmes of all SAARC Member Countries use the DOTS Strategy.

Facilities for TB Control

in SAARCThe National TB Control

programmes of all SAARC Member Countries

use the DOTS Strategy

DOT prolongs survival ofHIV-infected TB patients

Survived 56.7%

Died43.3%

SCC with DOTSCC without DOT

Survived85.4%

Died14.6%

93

10

84

100

30

100

90

Bangladesh Bhutan India Maldives Nepal Pakistan Sri Lanka

% o

f P

opu

lati

onPopulation covered by DOTS programme

(not

to s

cale

)

Bangladesh Total Population 125 millions

Population Covered by DOTS 114 millions

Percent of Population Covered by DOTS 90%

Estimated Number of New SS(+)ve.patients 137318

Number of New SS(+)ve Pts.treated (Jan.-Sept 99) 29219

Treatment Success in DOTS areas

~80%

Bhutan Total Population 0.6 millions

Population Covered by DOTS 0.6 millions

Percent of Population Covered by DOTS 100 %

Estimated Number of New SS(+)ve.patients 1275

Number of New SS(+)ve Pts.treated (1999) 315

Treatment Success in DOTS areas ~90%

India Total Population 1000 millions

Population Covered by DOTS 300 millions

Percent of Population Covered by DOTS 30%

Estimated Number of New SS(+)ve.patients 818210

Number of New SS(+)ve Pts.treated (1999) 522800

Treatment Success in DOTS areas ~85%

Maldives Total Population 0.27 millions

Population Covered by DOTS 0.27 millions

Percent of Population Covered by DOTS 100%

Estimated Number of New SS(+)ve.patients 107

Number of New SS(+)ve Pts.treated (1999) 176

Treatment Success in DOTS areas ~98%

Nepal

Total Population 23 millions

Population Covered by DOTS 20 millions

Percent of Population Covered by DOTS 85%

Estimated Number of New SS(+)ve.patients 20000

Number of New SS(+)ve Pts.treated 8000

Treatment Success in DOTS areas ~89%

DOTS and Community• DOTS committeeDOTS committee

• District development committeeDistrict development committee

• MunicipalityMunicipality

• Village development committeeVillage development committee

• NGOsNGOs

• MediaMedia

• Community VolunteersCommunity Volunteers

• Social WorkersSocial Workers

• Teachers and studentsTeachers and students

• TB patientsTB patients

DOTS committee, key to success

DOTS Committee:

• Group of motivated people: social workers, political leaders, civic leaders, health service providers, journalist, teachers, representatives of local organizations, I/NGOs, medical schools and colleges and TB patients.

DOTS and Medical colleges• Frequent meeting with them

• NTP DOTS orientation• Establish DOTS Centre

– BPKIHS– Nepalganj Medical College (2 DOTS centres)– Bharatpur Medical College– TU Teaching Hospital

• Such activities are being carried to other SAARC member countries, Bhutan, Bangaldesh, Sri Lanka, India, Pakistan, Maldives

Pakistan

Total Population 130 millions

Population Covered by DOTS 10.4 millions

Percent of Population Covered by DOTS 8%(in National Population)

Estimated Number of New SS(+)ve.patients 117,000

Treatment Success in DOTS areas ~85%

Sri Lanka Total Population 18 millions

Population Covered by DOTS 17 millions

Percent of Population Covered by DOTS 95%

Estimated Number of New SS(+)ve.patients 5019

Number of New SS(+)ve Pts.treated (1999) 3734

Treatment Success in DOTS areas

~75%

SAARC TB Centre (STC)1984 Second meeting of Foreign Ministers identified TB as priority area

1990 Fifth Summit of the head of states/governments decided to set-up STC in Nepal

1992 First Governing Board meeting held to formulate rules & regulations

1994 Staff recruited - STC started functioning

Governing BoardGoverning Board Highest policy making body

Composed of eight eminent experts in the field of

Tuberculosis - one each nominated by seven member countries

Director of STC is Member Secretary

One nominated member of SAARC Secretary General

participates in all meeting

Focal point of host country participate in each meeting

Meets once in a year or in emergency if required

Objectives of Objectives of SAARC Tuberculosis SAARC Tuberculosis

CentreCentreTo work for prevention and control of tuberculosis & HIV/AIDS in the region

by coordinating the efforts of National Tuberculosis Control

Programmes of SAARC member countries

Functions of STCFunctions of STC1. To act regional co-ordination centre for

tuberculosis control in SAARC region

2. Collection and dissemination of information

3. To establish net working arrangement among

National Tuberculosis Control Programme of

member countries

4. To initiate, undertake and co-ordinate the

research and training on TB control in the

region

5. To assist member countries for harmonization of policies and strategies

6. To assist member countries of maintain adequate supply of low cost anti-TB drugs

7. To monitor incidence, prevalence and emergence of drug resistance in the region

8. To promote action on issues relating to HIV related tuberculosis

9. To carryout other important works identified by the technical committee

Organogramme of SAARC TB CentreOrganogramme of SAARC TB Centre

Governing BoardGoverning Board

Director

Deputy Director

ICC DivisionResearch &

Training DivisionEpidemiology

DivisionBacteriology

Division

Achievements of STCAchievements of STCSeminars and Workshops Socio-cultural aspects of TB - Dec. 1993 TB programme managers of SAARC - Nov. 1994 TB programme through PHC approach - Apr. 1995 Preparation of Health Education materials - Oct. 1995 Pilot Demonstration areas of TB control - Jan. 1997 Production and Distribution of ATD -Jul. 1997 Formulation of guidelines for coordination in Govt. and

Pvt. Sector - Jun. 1997 Relating to research on TB/HIV in the region- Oct. 1997 SAARC-CIDA cooperation on TB/HIV - Mar.1999 Gender & Sociological Issues Related to TB-July 1999 SAARC Seminar for compilation and updating advocacy

and IEC material relating to TB-Sept.2000

Achievements of STCAchievements of STC T r a i n i n T r a i n i n gg Trainers’ training for NTP - Jul. 1994

Trainers, training for DTP managers - Jul. 1995

Training for regional TB programme coordinators

- Jul. 1996

Training for Lab. Technicians on TB bact. Apr. 96

Training for strengthening IEC activities on TB/HIV -

Feb. 1998

Trainers’ training for programme managers Jul- 1998

Training for TB coordinators - Dec. 1998

Trainers’ Training - Jun. 2000.

Achievements of STCAchievements of STCM e e t i n g

Consultative meeting on TB and AIDS - Oct.

1996

Meeting of TB experts for compilation of TB

control training manual - Jun. 1997

Ten meetings of Governing Board

Expert meeting for standardizing training

curriculum and workshop on operational Research

for TB control - Dec. 2000

Achievements of STCAchievements of STC

R e s e a r c h Member countries have identified focal

institute for research Research on TB bacillus, drug sensitivity

pattern in SAARC region is in progress Pilot demonstration site with suitable

strategy in TB control is being developed Initiation of SAACR-CANADA project

Activities organized for TB & HIV/AIDS control by SAARC TB Centre

SAARC Consultative Meeting on TB and HIV/AIDS, 23-25 Sept 1996, Kathmandu

Workshop Relating to Research on TB and HIV/AIDS in SAARC, 28-29 Oct. 1997, Kathmandu

Training Programme for Strengthening IEC activities with special emphasis on TB and HIV/AIDS, 10-23 Feb. 1998, New Delhi

Workshop on SAARC-CIDA Cooperation for TB and HIV/AIDS, 1-5 March 1999

Seminar for compilation and updating advocacy and IEC material relating to TB and HIV/AIDS, Oct. 2000

Cross Border Meeting for TB, HIV, Malaria and Kala-azar, March 2001

Achievement of STCCollection and Dissemination of the Information A resource centre (Library) for TB and HIV has been developed

Regional TB and HIV AIDS epidemiological data base

is being established.

Information network in Member Countries has been created

Directory of TB institutions and TB specialists has been

prepared

Regular collection and dissemination of information is being

done in the form of STC Newsletter, reports on workshops,

meetings & seminars and materials on training and research

Presentations of scientific papers in international and national

conferences

Achievements of STC

Scientific Sessions have been chaired and Technical Papers on TB and HIV have been presented in global lung congresses and IUATLD meetings held in Paris, Bangkok, Hong Kong and Dhaka

Regional situation and progress on TB control has been presented in WHO meetings held in Delhi, Bangkok and Myanmar

Dr. K. Styblo International Public Health Award, has been awarded for outstanding contribution - 1998

International Gold Star Award has been presented by International Friendship Society of India - 1999

Representation in International Conferences

Establishment of Resource Centre

A Regional Library for TB and HIV/AIDS has been established in SAARC TB Centre for Health Workers, Medical Students, Researchers and the interested people.

Focal Training Institutes for TB control in Focal Training Institutes for TB control in SAARC Member CountriesSAARC Member Countries

BangladeshBangladesh -- TB Control Training Centre, DhakaTB Control Training Centre, Dhaka

BhutanBhutan -- Division of Health Services, ThimphuDivision of Health Services, Thimphu

IndiaIndia -- National TB Institute, BangaloreNational TB Institute, Bangalore

MaldivesMaldives -- Chest Clinic, MaleChest Clinic, Male

NepalNepal -- National TB Centre, Thimi, National TB Centre, Thimi,

PakistanPakistan -- Ojha Institute of Chest Disease, KarachiOjha Institute of Chest Disease, Karachi

Sri LankaSri Lanka -- Respiratory Disease Control, ColomboRespiratory Disease Control, Colombo

Services to NTPs of Services to NTPs of Member Countries from STCMember Countries from STC

To provide platform for interaction and exchange of experiences

Collection, compilation and dissemination of information

Identification of problem areas in NTP Feedback suggestions with remedial

measures to member countries Training and Research for support of NTP

SAARC-WHO Memorandum of UnderstandingMoU between SAARC and WHO has been signed in

August 2000 STC has been identified as a collaborative Centre

for WHO activities in TB and HIV/AIDS SAARC-WHO meeting of potential

consultants in TB control- Jan. 2001 SAARC-WHO inter-country meeting on cross

border initiative in HIV/AIDS, TB, Malaria and Kala-azar - March 2001

Organizing WHO/ SEARO Training on TB Control Management from 1997 for

SAARC-CIDA project on TB and HIV/AIDS

SAARC and CIDA signed a MoU in July 1997

for cooperation to Control TB and HIV/AIDS.

The Project Document was prepared

in March 1999.

Member Countries have approved the Project

in Sept. 2000

The project has been initiated.

ConclusionsConclusionsBurden of TB & HIV/AIDS in SAARC region is enormousTB control is not only national but international issueCooperation is essentialSAARC TB Centre is in unique position to facilitate cooperationRegional approach is needed to fight against tuberculosis Strong and sustainable NTPs with 85% cure and 70% case detection is key of the successThere is a strong need of social mobilization and advocacy at each level in order to achieve objective of TB control