Global Drug Resistant TB Initiative (GDI) Charles L. Daley, M.D. National Jewish Health Chair, GDI Core Group Diagnosis Treatment
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Global Drug Resistant TB Initiative (GDI)
Charles L. Daley, M.D.
National Jewish Health
Chair, GDI Core Group
Diagnosis Treatment
Disclosures
• Chair, Data Monitoring Committee for delamanid trials in adults (Otsuka)
• Member, Data Monitoring Committee for delamanid trials in children (Otsuka)
Outline
• Transition from GLC to GDI
• What is the GDI?
• Strategic priorities of the GDI
• Progress to date
• Future plans
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Global
DRS
project
launched
Green Light
Committee
established
The first WHO
MDR-TB
guidelines
100,000 (104,537)
patients approved
by GLC for treatment.
New framework
for the PMDT
WHO Working
Group on DOTS-
Plus for MDR-TB
The 1st DOTS-
Plus project
launched
Ministerial
meeting in
Beijing: "Call for
Action" 62nd WHA
resolution on
MDR-TB
Green Light Committee to New Framework for PMDT
Green Light Committee(GLC) Initiative
Objectives:
• Contribute to the progress towards meeting global tuberculosis control targets and prevent development of almost incurable forms of TB (XDR-TB)
• Increase access to quality-assured, affordable second-line drugs for the treatment of drug-resistant TB (DR-TB) among well-performing TB control programs in developing countries
Rationale for the New Global Framework
• Very few MDR-TB patients on treatment
Only 11% of people with MDR receiving any treatment
Less than 3% of people receiving care of known quality
• Revision of the global framework was urgently required
‘Shift from a controlling to a supporting mode’ Three Task Forces:
I. Provision of technical assistance
II. Availability of quality assured second-line TB drugs (SLDs)
III. Monitoring and evaluation, and the governance structure for MDR-TB management scale-up
Decentralization Establishment of Regional GLCs
6 rGLCs
1 gGLC
Global GLC Committee (gGLC)
Global level strategic gGLC with dual role of advising Stop TB Partners and WHO.
1. a sub-group of the MDR-TB working group of the Stop TB Partnership and
2. an advisory committee to WHO and Partners
• Members appointed in individual capacity
• All relevant technical areas, constituencies and regions are represented
Regional GLC Committee (rGLC)
Regional advisory committee with dual role of advising Stop TB Partners and WHO Regional Offices to guide countries on scale-up
1. Phased decentralization to regions
2. All relevant technical areas and constituencies represented
3. Composition should reflect the different needs of the respective region
Transition from GLC to GDI
• Joint meeting of the Global GLC and MDR-TB Core Group
– 18-19 April 2013
• MDR-TB Stakeholders meeting
– 27-28 October 2013
• First Core Group meeting in
– 1-2 May 2014
• Second Core Group meeting
– 27 October 2013
GDI - Global Drug-resistant TB Initiative
GDI mission
• To serve as a multi-institutional, multi-disciplinary
platform organizing and coordinating the efforts of
stakeholders to assist countries to build capacity
for PMDT in the public and private sectors
• Ultimate aim: Universal access to care and
appropriate treatment for all DR−TB patients
Selection of GDI Core Group
• Call for applications for membership in Core Group (CG) in December 2013
• 87 applications were received
• Selection Committee
– Aamir Khan (Chair of ex-MDR TB WG)
– Lucy Chesire (Civil Society)
– Lee Reichman (regional GLC)
– Karin Weyer ( WHO)
• Aimed for a broad, constituency-based CG balanced by region, gender, skills base
GDI Core Group Members (1)
Member Constituency Represented Organization
Amy Bloom Donor/funding agency USAID
Chen-Yuan Chiang Technical agencies/implementation partners assisting NTPs or high burden DR-TB countries
The Union
Daniela Cirillo Technical agencies/implementation partners assisting NTPs or high burden DR-TB countries
St. Rafaele Hospital, Italy
Charles Daley (chair)
Academic institutions, institutions of high scientific and technical standing having attained international recognition in the area of DR-TB management
National Jewish Health, USA
Dalene von Delft Civil society, patients and affected communities
TB Proof
GDI Core Group Members (2)
Member Constituency Represented Organization
Agnes Gebhard (vice-chair)
Non-governmental sector partners KNCV
Saira Khowaja Private for profit sector Interactive Research and Development
Kuldeep Sachdeva National TB programmes of high DR-TB burden countries
NTP, India
KJ Seung Technical agencies /implementation partners assisting NTPs or high burden DR-TB countries
Partners in Health
Gini Williams National/international/scientific/professional medical and nursing associations
International Council of Nurses
Carrie Tudor Infection Prevention and Control Infection Control sub-Group
GDI Core Group Members (3)
Regional Green Light Committee (rGLC) Chairs
Hind Satti rGLC - AFR
Raimond Armengol rGLC - AMR
Essam Emoghazy rGLC - EMR
Andrey Olegorich Maryandyshev rGLC - EUR
Rohit Sarin rGLC - SEAR
Lee B. Reichman rGLC – WPR
Observers
Tom Shinnick Global Laboratory Initiative
Joel Keravac Global Drug Facility
GDI - Global Drug-resistant TB Initiative
GDI - Global Drug-resistant TB Initiative
Facilitate integration and coordination of efforts to align diagnostic services for patients with access to high-quality care
Develop targeted advocacy strategies and resource mobilization for DR-TB management scale-up
Build global consensus on the management of DR-TB for patient-centred care delivery ("care for cure")
Promote strategies to facilitate patient access to high-quality DR-TB care through a long-term, in-country capacity building approach
Facilitate effective knowledge sharing among partners and harmonise coordination with existing technical assistance mechanisms
Support prioritization of research to generate evidence for PMDT
Strategic Priorities
Three TASK Forces
TASK Force Lead Collaborators Activities
Support prioritization of research to generate evidence for PMDT
Agnes Gebhard Chen Yuan Chiang
Carole Mitnick, Susan van den Hof, RESIST TB, Arnaud Trebucq
1. DR-TB research agenda 2. Overview of ongoing research activities 3. Develop a generic protocol for shorter treatment regimens
Build global consensus on the management of DR-TB for patient-centred care delivery ("care for cure")
Gini Williams
WPR rGLC Philippine NTP Philippine Nurses Association
Held training course in Quezon City, PI 17-21 November, 2014 with nurses from 10 countries
Develop targeted advocacy strategies and resource mobilization for DR-TB management scale-up
Dalene von Delft
Visual Epidemiology, Stop TB Partnership, GDI, TB Proof, and WHO
The Human Spirit Project
GDI - Global Drug-resistant TB Initiative
Facilitate integration and coordination of efforts to align diagnostic services for patients with access to high-quality care
• Develop tool to standardize the evaluation of the diagnostic and treatment GAP at country level
• Pilot the tool in 5 high burden MDR-TB countries • Use tool to evaluate all high burden countries • Develop country specific interventions to close the gap
• Goal: Get all detected MDR-TB cases on QA regimens
Communication
GDI Website GDI Newsletter
Other Activities
• Organize and provide minutes for monthly teleconferences
• Maintain GDI Listserve, now with > 300 members
• Oversaw administrative and contractual distribution of funding for 3 GDI Task Forces
• Organized a webinar on QuanTB in coordination with GDF
• Partcipated in external evaluation of GLC agreement between GF and WHO
• Drafted proposed budget for FY 2014 USAID funding for GDI
• Coordinated preparation for GDI/GLI Joint meeting
• Co-ordinated with Sentinel Project for DR-TB training on pediatric TB and DR-TB in China
• Oversaw management of DR-TB training modules
Thank you!
Acknowledgements:
Stop TB Partnership
Global TB Program, WHO
GDI Secretariat
Fraser Wares
Medea Gegia
Karen Weyer
Vineet Bhatia (until 2015)
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