RETOOLING TASK FORCE

1
RETOOLING TASK FORCE
Meeting of the Global Laboratory Initiative 8-9
May 2008 Andy Ramsay
2
What is Retooling?

• The process of preparing for Adoption,
  Introduction and Implementation of new
  Diagnostics, Drugs and Vaccines in TB control

3
Rationale
Lessons learned

• Lesson learned from previous experience with
  other communicable diseases show significant
  delays between the availability of new tools and
  use at country levels

Challenge to the TB community
Coordinated action by the Stop TB community at
global and national levels for timely adoption
and introduction of new tools as they become
available
The Boards response
The Coordinating Board, Abuja, April 2006,
established the Retooling Task Force
4
Goals

• Plan for adoption and introduction of new tools
• Create framework for policy-makers and
  practitioners to accelerate introduction of new
  tools
• Clarify processes to move from trials to policy
  and implementation
• Engage stakeholders working in TB control
• Provide country voice into global product
  development
• Learn from other disease communities
• Fast-track effective new tools into WHO and
  national policies
• Link all working groups around the theme of
  retooling

5
Products

• RTF Phase I Setting the foundation
• Products
• New technologies for TB control a Framework on
  their Adoption, Introduction and Implementation
• Provide guidance on what actions are needed for
  adoption, access and proper use of tools as they
  become available
• Advocacy package
• Executive summary, FAQs, Overview on Retooling,
  Postcard
• Engaging Stakeholders for Retooling TB Control
• Simple tools for conducting stakeholder analyses
  and preparing stakeholders engagement plan

6
RTF Phase IIMoving to country level

• Retooling session in Cape Town
• Countries still lacking information on new tools
  in pipeline and recently endorsed by WHO
• Implementation / TA partners not prepared to
  support introduction of new tools
• Task Force response
• Updated pipelines for new diagnostics
• Broad inclusion criteria, posted on web
• Being translated into informational brochure for
  countries
• Checklist for introduction of liquid culture
• Recently field tested in Tanzania
• Summary of WHO policy process to endorse new
  tools
• Retooling activities included in guidelines for
  Global Fund applicants
• Retooling questions included in WHO global
  monitoring

7
Retooling in Tanzania

• Background
• Case detection rate 45
• MDR lt2 in new cases
• Introducing MGIT, Hain and widespread use of LED
• Moving from 3 to 2 smears for diagnosis
• No standard EQA system currently operational
• TB programme pathfinder within MOH
• Pushed lab services to periphery, innovator
• Priority
• Ensure that the introduction of new tools is
  catalytic and does not overburden the health
  system

8
Tanzania lessons Global and local needs for
retooling

• Technical assistance and information needed to
  support decision-making regarding tools for
  adoption
• Costing tools (fully loaded for yearly
  implementation), HR requirements, equipment
  specifications and maintenance, technology
  comparisons
• Analyse risks and benefits of implementing new
  tools
• Strategic planning
• Define programmatic objectives to be served by
  new tools
• Plan introduction to meet needs, anticipate
  obstacles
• Develop retooling strategy for each new tool,
  including associated EQA
• Guidance on prerequisites for introduction and
  how to use new tools in combination
• Proper sequencing of introduction, SOPs,
  supervision checklists, algorithms
• Guidance on full range of programmatic
  implications of new tools
• e.g. LED at district level - - need to revise EQA
  strategy to best incorporate
• Training and supervision requirements throughout
  system

9
Proposed Next StepsRetooling task force and GLI

• Retooling Task Force as resource for GLI, link to
  NTPs
• Finalize checklist for introducing liquid culture
  
• Include NTP-requested parameters in scientific
  blueprint for new diagnostics
• Update costing/budgeting tool to reflect full
  costs of introducing new tools
• Communicate global recommendations and diagnostic
  pipelines to NTPs
• Define programmatic objectives (i.e. diagnostic
  challenges) to be addressed by each new tool
• Communicate technical guidance on use of new
  tools (e.g. EQA, prerequisites, HR needs, costs,
  space requirements)
• Retooling strategy for each tool to support
  comparisons, decision-making
• Translate product technical information for NTP
  consumption / planning

10
For further information
Website www.stoptb.org/retooling
Email stoptbretooling_at_who.int