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1
ERNA 2004
Scaling Up The Red Cross Red Crescent Response to Tuberculosis
in Europe Region (strengthening the HIV/AIDS component)
Krakow, 25-28 September, 2004
2
Tuberculosis A Global Emergency
8 - 9 million new TB cases every year
TB kills 5,000 people a day – 2 million each year
One third of the world’s population is infected with TB
3
STOP TB Partnership
DOTS strategy (Directly Observed Treatment, Short Course)
Global Targets:
cure rate up to - 85%
case Detection - 70%
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The 5 components of the internationally recommended TB control strategy
Political and financial commitment
Case detection by sputum smear microscopy and culture of TB suspects
Directly observed and standardized short-course anti-TB chemotherapy (DOTS)
Regular, uninterrupted supply of all essential anti-TB drugs
A standardized recording and reporting system
TB Register
World Health OrganizationRegional Office for Europe
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Stop TB Partnership2004 News2004 News
March 2004, new Delhi – MeetingMarch 2004, new Delhi – Meeting
Participants from the MovementParticipants from the Movement(Members of the Stop TB)(Members of the Stop TB)- American Red CrossAmerican Red Cross- Russian Red CrossRussian Red Cross- SecretariatSecretariat
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World Health OrganizationWorld Health Organization
Lessons learned
DOTS – the most cost effectiveLess progress in case detection targetLimited access to diagnostic (partly because of weak
social mobilization)Political commitment in some countries to be
increasedFocus on institutional capacity buildingPartnership to be expanded to private sector, civil
society, communitiesTB / HIVAdvocacy / social mobilization
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Achievements & Aims 2001–2005
By 2001: National plans and increased commitments
By 2002: Accelerating detection rates to 37%
By 2005: 70/85 TB control targets
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70
80
85
100
50 60 70 80 90 100
DOTS detection rate (%)DOTS detection rate (%)
Tre
atm
ent
succ
ess
(%)
Tre
atm
ent
succ
ess
(%) Cambodia
Oman
Sri Lanka
Guatemala
Peru
Morocco
Maldives
Viet NamCuba
Slovenia
Solomon Is
UruguayQatarMongolia
USA
Morocco
Tanzania
Venezuela
Djibouti
ChileNicaragua
TARGET ZONE
Bosnia & Hezegovina
Hong Kong
DR Congo
El Salvador
Fiji
French Polynesia
Italy
Kazakhstan
Kenya
Kyrgyzstan
LatviaLebanon
Malta
Marshall Is
Portugal
St Lucia
Samoa
South Africa
Tonga
Tunisia
Turks & Caicos Is
9
70
80
90
100
50 60 70 80 90 100 110 120
DOTS detection rate (%)
Tre
atm
en
t s
ucc
ess
(%)
40
50
60
70
80
90
100
0 10 20 30 40 50 60 70 80 90 100
DOTS detection rate (%)
Tre
atm
en
t s
uc
ce
ss
(%
)
Uganda
DRCongo
KenyaTanzania
Viet Nam
MyanmarBangladesh
India PhilippinesIndonesia
China
Ethiopia
Nigeria
RussiaSouth Africa
Thailand
Cambodia
Pakistan
Afghanistan
Brazil
Zimbabwe
Mozambique
Peru
TARGET ZONE
85 %
70 %
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Summary HIV/TB - 2000
Africa World
TB Cases 2.0 million 8.4 million
HIV infected 526,000 633,000
TB Deaths 535,000 1.88 million
HIV infected 203,000 246,000
Adult AIDS deaths
% due to TB
1.76 million
12%
2.29 million
11%
L Corbett et al. Arch. Int. Med. In press. 2002
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RC/RC in TB Control Programmes
Bulgaria Russia Ukraine Moldova Central Asia Armenia Azerbaijan (planned) Romania (planned) Macedonia (planned)
Georgia prisons (ICRC) Azerbaijan prisons
(ICRC) Armenia prisons (ICRC) Myanmar (GFATM) Americas (Agreement
between AmX and PAHO)
Africa – Integration TB and ART
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30 pilot projects in Russia and Central Asia
Number of defaulters decreased by 30%
Increased number of cured patients (from 65% to 73% in Pskov)
Positive impact on TB control
Motivation to complete the treatment
Less side effects due to improved nutrition (results of interviews of TB patients in CA)
70-90% of patients completed the treatment
Knowledge increase on the disease (by 30-80%)
Psychological support helped
RC/RC expertize in managing and implementing programme
Role of the RC/RC in health care structure
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Partnership: Role of the National Societies in TB working groups in
respective countries
Information sharing between different partners
New partnership: Federation - Lilly
Involvement in MDR – TB (Kazakhstan, Russia)
From TB guidelines to TB Policy
Decision of the health commission to prepare the TB Policy.
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Next Steps ?????TB will not go away tomorrow
Red Cross Red Crescent – one of the major players in
Effective interventions exist
RC/RC can reach more people Importance of increased partnership inside of the Movement
More focus on social mobilization and voluntary involvement in TB programmes
Working on new monitoring tools and quality analysis of programmes
TB / HIV
Identify areas of mutual benefit Better integration between TB and HIV programmes
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For consideration in group works
If this is the level we would like to achieve
National Society Contribution