Report of the 2nd ad hoc Committee on the TB epidemic Jaap F. Broekmans STOP TB Partner’s Forum

Report of the 2nd ad hoc Committee

on the TB epidemic

Jaap F. Broekmans

STOP TB Partner’s Forum

NEW DELHI

22 - 26 June 2004

2nd 2nd ad hoc Cad hoc Committee on the TB epidemicommittee on the TB epidemic

1998 1st ad hoc Committee, London

2000 Ministerial Conference for 20 HBCs, Amsterdam

2001 Global Plan to Stop TB

2003 2nd ad hoc Committee, Montreux

2005 WHA targets

2010 G8 Okinawa targets

2015 Millennium Development Goals

Objectives of 2nd Objectives of 2nd ad hoc Cad hoc Committeeommittee

(1) review status of TB epidemic and of TB control efforts

(2) review progress in implementing the 1st ad hoc Committee recommendations (London, 1998)

(3) analyse constraints in HBCs (DEWG)

(4) make recommendations in defining a mid-term strategic direction for the DOTS expansion movement

Time perspective of 2nd ad hoc Committee recommendations

WHA targets

MillenniumDevelopmentGoals

2003 2005 2015

Mid-term strategic direction(about 5 years)

2010

OkinawaG8 targets

Process of developing and endorsing2nd ad hoc Committee report

2nd ad hoc Committeesecretariat

Consultations

1st draft (constraints identified by DEWG)

challenges identified

report finalised

recommendations

DEWG

STB Cd Bd

Sept 03Mar 03 June 03June – Aug 03 Dec 03

Partners’ forum(New Delhi)

report endorsed

Apr 03

STAGSTB Cd Bd

MDGs

Oct 03

2nd ad hoc committee

Main recommendationsMain recommendations

(1) Consolidate, sustain and advance achievements

(2) Enhance political commitment

(3) Address the health workforce crisis

(4) Strengthen health systems, particularly primary care delivery

(5) Accelerate response to the HIV/AIDS emergency

(6) Mobilise communities and the private sector

(7) Invest in research and development to shape the future

(1) Consolidate, sustain and advance achievements The Stop TB Partnership should

(1) demonstrate the effectiveness and added value of the Partnership, GDF, GLC and its collaboration with the GFATM;

(2) involve a wider range of stakeholders at all levels;

(3) use existing mechanisms at national level, e.g. NICCs, Sector-Wide committees, CCMs;

(4) strengthen its relationship with the GFATM;

(5) seek enhanced and sustained donor support for GDF;

(6) advocate for support for TB activities based on success stories of TB as pathfinder for health system reform.

(2) Enhance political commitment

The Stop TB Partnership should

(1) explore complementary “top-down” (e.g. lobbying by high- level missions, political mapping and analysis) and “bottom-up” approaches (social mobilisation and communications);

(2) seek financial support from a broader donor base;

(3) argue the case for increased donor budget commensurate with global TB burden, e.g. GFATM;

(4) adopt the 2015 MDGs relevant to TB as impact targets while retaining WHA 2005 targets as process targets.

(3) Address the health workforce crisis The Stop TB Partnership should collaborate with governments and international bodies to:

(1) develop policies to remove administrative barriers to creating and filling posts;

(2) develop policies to promote terms and conditions of service attractive to employees;

(3) promote assessment of human resource needs;

(4) support human resource planning and training;

(5) explore strategies for mobilising human resources from the full

range of primary care providers, especially community groups.

(4) Strengthen health systems, particularly primary care deliveryThe Stop TB Partnership should(1) promote reflection of TB control needs in design and implementation of health reform strategies;

(2) ensure that TB programmes contribute to broader health system strengthening;

(3) foster NTP stewardship capacity;

(4) explore strategies for harnessing the contribution of the full range of health care providers;

(5) encourage partners in Global TB Monitoring and Surveillance Project to intensify collaboration with other programmes and improvements in accuracy of estimates of progress towards targets.

(6)

(5) Accelerate response to the HIV/AIDS emergency The Stop TB Partnership should

(1) urgently step up collaboration with HIV/AIDS partnerships to implement strategy of expanded scope to control HIV-related TB;

(2) support countries in delivering TB care as part of the HIV/AIDS care package;

(3) support countries in making progress towards the “3 by 5” goal, by promoting HIV testing among TB patients and referral for ART;

(4) support ART programmes in making use of lessons learned from TB programmes in applying public health principles to large scale diagnosis and treatment of a chronic communicable disease.

(7) Invest in research and development to shape the future

The Stop TB Partnership should

(1) ensure a framework to support interaction between the WGs on

new tools and the WGs on implementation;

(2) work with the research community on advocacy for new tools, funding and preparation of trial sites;

(3) promote operational research;

(4) develop and articulate arguments in favour of increased research capacity building to encourage OECD countries to increase funding for this.

Main implications for Stop TB PartnershipMain implications for Stop TB Partnership

(1) Speed of progress in reaching WHA 2005 targets now

depends on collaboration with other programmes and other constituencies.

(2) Need to reach out to other programmes within the health sector, in addressing the key health system issues, e.g. human resources, general health infrastructure, primary care providers, health system reform.

(3) Need to reach out to other sectors beyond health, in enhancing political commitment, expanding the resource base, and mobilising communities.