Regional Situation What went right, and What went wrong

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Regional SituationWhat went right, andWhat
went wrong?
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What went right

• Network of dedicated TB family
• Lebanon
• Dear family, the last two days, I receive your
  respective messages. I would like to thank you
  all , one by one, for your support and your
  friendship. You give me a big push to continue
• Somalia
• You will be glad to know that this is the
  fastest reply in the history of the data
  collection in WHO. Thank you VERY MUCH
• Many, many more

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What went right
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What went right

• Foundation of TB control
• Lab Supra-national Ref Lab (Egypt)
• Drug management GDF
• ENRS nationwide in Egypt, Jordan, Syria
• Surveillance DQ-online (web-based)
• HIV/TB Regional strategy
• PAL scaling up in Morocco, Jordan, Syria
• ACSM Regional workshop in Pakistan
• OR SGS (delay report)

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What went right

• DOTS expansion Treatment outcomes

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What went right

• 2 million TB patients treated (1996-2005)

????
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HOWEVER.
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70/85 NOT ACHIEVED?
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70/85 NOT ACHIEVED?
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70/85 NOT ACHIEVED?

• 38/82, not 70/85
• In 2005, we miss 184,000 SS, and 378,000 all
  forms
• ? Missing cases

Dr 38/82WHO EMRO
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Why are TB cases undetected? (Chris Dyes Onion)
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What went wrong?

• Complacency?
• Happy with DOTS coverage with gt80 TSR?
• Happy with priority?

82!
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What went wrong?
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What went wrong?

• Suspect
• 5/22 reported
• Laboratory
• 8/22 EQA
• Contact
• No policy no reporting

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What went wrong?

• ACSM
• Very limited
• PPM
• No idea on size of patients outside NTP

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What went wrong?

• Recording reporting
• Missing components
• Estimates
• Surveys
• Limited
• PPD only
• Data analysis
• Limited

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Going Over the Magic MountainTB control in the
next 10 years
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Average of annual changes in notification rate of
all cases in EMR, 2000-2005
What is this?
CDR lt 40
CDR 40 - 70
CDR gt 70
Thanks to Mehran
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Average of annual changes in notification rate of
SS cases in EMR, 2000-2005
What is this?
CDR lt 40
CDR 40 - 70
CDR gt 70
Thanks to Mehran
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Where we are in 2005
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To be continued to Exercise 1