Needs for global XDRTB response and potential sources

1
Needs for global XDR-TB response and potential
sources

• Advocacy, Communication and Social Mobilization
• Global Advocacy for Resource Mobilization
• Core Group meeting
• 29 October 2006, Paris

2
What is XDR-TB

• XDR-TB (extensively drug resistant TB) means
  resistance to at least rifampicin and isoniazid,
  a fluoroquinolone and one or more of the
  following injectable drugs kanamycin, amikacin,
  capreomycin
• First reported in March 2006 by WHO and CDC as a
  serious, emerging threat to public health and TB
  and HIV/AIDS control

3
The threats of XDR-TB

• Raise concerns of epidemics of TB with severely
  restricted treatment options
• Present in all regions but distribution unknown
• Occurs in outbreaks among people living with
  HIV/AIDS
• High case fatality rate - 98 in Tugela Ferry,
  South Africa, meadian survival time 16 days
• Cure rates in well-equipped and organised
  settings of 18-54, predominantly among
  HIV-negative patients
• Not a single strain, thus indicates systemic
  failures in health sector and/or in TB control
• Diagnostic capacity to detect XDR-TB only in a
  few countries
• Threatens progress towards MDGs and against
  milestones in the Global Plan to Stop TB,
  2006-2015

4
Chronology of XDR-TB events

• MMWR March 24 2006
• May 2006 PARTNERS and MDR-TB Working Grop
  meeting Atlanta
• August 2006 - Toronto AIDS Conference Tugela
  Ferry outbreak
• September 2006 - Johannesburg Expert Consultation
  on XDR-TB and 7-point action plan
• Global XDR-TB Task Force meeting, WHO, 9-10
  October 2006
• XDR-TB response workshop for Southern African
  countries, Pretoria, South Africa, 17-18 October
  2006

5
Plan of action for XDR-TB response in 2007 8
priority areas identified

• Strengthening of basic TB and HIV/AIDS control
  programmes
• Management of XDR-TB suspects
• Laboratory strengthening
• Infection control and protection of health care
  workers
• XDR-TB surveillance
• ACSM
• Resource mobilization
• Research and development

6
Preliminary costing for XDR-TB response in 2007
7
Breakdown of draft costing needs for 2007

• 12 million US at global level out of which 8
  million are for technical assistance and human
  resource development
• 23 million US are for strengthening XDR-TB
  response in Southern Africa countries
• 26 million US for second-line drugs
• 2 million US for rapid diagnostic tests

8
Resource mobilization strategies

• Build upon Green Light Committee resource
  mobilization plan and overall Global Plan
  resource mobilization approaches
• Initial discussions held mainly with US partners
  (USAID, PEPFAR, CDC technical support and staff)
  and GFATM regarding reprogramming with PRs, FIND,
  GFATM, Bill Melinda Gates Foundation
• Briefings proposed with Irish Aid, DfID, World
  Bank and EU
• Some donors likely can only spend for country
  costs donors targeting to be done

9
Next steps

• Awaiting XDR-TB response plans from Southern
  African countries
• Further development of activity costing
• Discussions with partners (XDR-TB Task Force
  within ASCM WG, other WGs and other new partners)
• Press and advocacy events
• Development of specific proposals following donor
  discussions