VIETNAM STOP TB PARTNERSHIP€¦ · 2012 TB Month with high political commitment GR R9 Phase 2 proposal development National TB Control Strategy to 2020, vision 2030 Engage business

Seoul, 22-23 November 2012

VIETNAM STOP TB PARTNERSHIP

1. Country TB epidemic

2. Priorities

3. Challenges, Contraints, Gaps

4. Partnership’s contribution

1. TB epidemiology

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PrevalenceNotification

High rate in the south High TB/HIV in HCM city, Mekong river delta Low TB in mountainous, highland areas

Ho Chi Minh City

Tay Ninh An

Giang

Ha Noi

Da Nang

Ranks 12th among 22 TB HBCs Ranks 14th among 27 high MDR-TB burden countries TB prevalence in Viet Nam remains high. 1st National Prevalence Survey (2006-2007) showed that the previous estimation was underestimated by 60%.

A significant number (~40%) of tuberculosis cases remains undiagnosed or unreported.

1. TB epidemiology

2. Priorities

Priorities after Prevalence Survey 2006-2007

Increase case detection is the key PPM – PAL to engage all health care providers Encourage using chest X-ray as screening tool High risk group (closed setting, HIV, diabetes, …) Pilot & expand PMDT Novel multi-modality of A - C - SM Mobilization for local resources

3. Challenges

Human resources – Stigma, low financial compensation, and perceived risk

affect recruitment; lack of sufficient staff results in over-work; in combination these result in high staff turn-over

– Need for training on new approaches and techniques Financial resources

– GVN budget: grossly insufficient, barely covering DOTS – Heavy dependence on external funding for PMDT,

TB/HIV, PPM, ACSM, high risk groups in context of rapidly decreasing funding

– New diagnostic tools: promising but expensive

Example of financial challenge

PMDT Targets driven by financial resources

Challenge Intervention Ss(-) & EPTB increase HIV/TB Relapse/failure/default cases & reTx after default increase

DOT / PMDT

High CNR + poor Tx outcomes in congregate settings

TB control in congregate settings

High Tx success rate, but high prevalence rate and ~40% incident cases untreated each year

+ PPM

Very low CNR among children less than 14 years Childhood TB control

Strengthening of recording/reporting

Programmatic challenges

Programmatic challenges

Challenges Response Reduced international financial support Advocacy Cross-cutting issues of MDRTB, TB/HIV, PPM, closed settings … requires broad engagement of non-NTP partners

Partnership

Diagnostic delay for susceptible and resistant TB, suboptimal treatment adherence

New diagnostic tools, decentralization, shorter regimen, addl community engagement

Access barriers in mountainous areas ACF, ACSM, community DOT

SLD management Drug supply & Forcasting

Shortage of HR More incentives ($, training)

Accessibiltity (Patient charge) + Health insurance

Funding levels & gaps, 2013-15

Financial Need (USD) 2013 2,014 2,015 Total

Objective 1: High quality DOTS 48,557,537 54,067,373 49,350,967 151,975,876

Objective 2: TB/HIV, MDR-TB, Closed settings 6,449,221 7,254,870 8,267,339 21,971,429

Objective 3: HSS 3,445,845 4,310,847 4,487,344 12,244,036

Objective 4: PPM 2,814,085 2,164,900 2,154,153 7,133,138

Objective 5: ACSM 4927475 4934582 4633739 14,495,796

Objective 6: Surveillance and research 393,000 1,577,764 435,000 2,405,764

Total (in US$s) 66,587,162 74,310,335 69,328,542 210,226,039

Funding levels & gaps, 2013-15

Financial Gap (USD) 2013 2014 2015 Total

Funding needs 2013-2015 66,587,162 74,310,335 69,328,542 210,226,039

Estimated fund

Central Gov’t budget 5,500,000 6,000,000 6,500,000 18,000,000

Provincial Gov’t Fund 4,741,607 5,435,115 6,152,621 16,329,343

Global Fund 10,503,688 10,616,383 11,495,842 32,615,913

TB CARE I (PEPFAR) 3,900,171 3,900,171 3,900,171 9,600,342

EXPAND TB In-kind n/a n/a

CDC (PEPFAR) 293,000 293,000 293,000 879,000

Total in US$ 24,938,466 26,244,669 28,341,634 79,524,769

Funding Gap, US $ 41,648,696 48,065,666 40,986,908 130,701,270

VSTP Establishment as an utmost important solution for NTP

Initial concept and reason for formation: 2008

First formal VSTP meeting: April 2010, followed by regular

quarterly meetings

Strong support from MOH and local partners, now over 39

Host organization and legal status:

Vietnam Association Against TB and Lung Diseases - VATLD

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COORDINATIN

G BOARD

MEETING OF

THE STOP TB

PARTNERSHIP

VSTP’s Partners

Partners # members National Lung Hospital / NTP

WHO – Vietnam Office

Women’s Union ~ 14 million

Farmers’ Union > 10 million

Red Cross > 10 million

Youth Union > 6 million

Veteran’s Association > 3.5 million Other NGO/CBO/Academic and bilateral/multilateral organizations: Vietnam Association Against Tuberculosis and Lung Diseases, CDC, USAID, KNCV, MCNV, PATH, URC, FHI, PSI, University of California San Francisco, Woolcock Medical Research Institute

Other VN government organizations: Ministry of Health, Ministry of Public Security, Ministry of Labour-Invalids and Social Affairs, Ministry of Education and Training, Viet Nam Administration of HIV/AIDS Control, National Institute for Hygiene and Epidemiology

Private sector: Ha Noi Association of Private Medical Practitioners, Hai Duong Association of Private Practitioners, Hung Thinh Pharmaceutical and Medical J.S. Company, METRO Cash & Carry Company

4. Partnership’s contribution

Technical & policy advisory role to NTP Information sharing and improved coordination & collaboration

Support to NTP in developing & implementing solutions for challenges Initiate priority focus to develop ACSM and PPM advisory networks among VSTP partners Financial and technical resource mobilization from local and international organizations Quarterly full partnership meetings, TWG meetings, ad hoc one-on-one meetings

4. Partnership’s contribution

GR R9 proposal development (~60 mil. $)

NTP 2007-2011 mid-term & end-term evaluations

National TB Control Strategy 2011-2015

2012 TB Month with high political commitment

GR R9 Phase 2 proposal development

National TB Control Strategy to 2020, vision 2030

Engage business sector in Tb control

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