Facilities for TB Control

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Facilities for TB Control in SAARC
The National TB Control programmes of all SAARC
Member Countries use the DOTS Strategy
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DOT prolongs survival of HIV-infected TB patients
SCC with DOT
SCC without DOT
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Bangladesh

• Total Population 125 millions
• Population Covered by DOTS 114 millions
• Percent of Population Covered by DOTS 90
• Estimated Number of New SS()ve.patients
  137318
• Number of New SS()ve Pts.treated (Jan.-Sept
  99) 29219
• Treatment Success in DOTS areas 80

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Bhutan

• Total Population 0.6 millions
• Population Covered by DOTS 0.6 millions
• Percent of Population Covered by DOTS 100
  
• Estimated Number of New SS()ve.patients
  1275
• Number of New SS()ve Pts.treated (1999)
  315
• Treatment Success in DOTS areas 90

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India

• Total Population 1000 millions
• Population Covered by DOTS 300 millions
• Percent of Population Covered by DOTS 30
• Estimated Number of New SS()ve.patients
  818210
• Number of New SS()ve Pts.treated (1999) 522800
• Treatment Success in DOTS areas 85

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Maldives

• Total Population 0.27 millions
• Population Covered by DOTS 0.27 millions
• Percent of Population Covered by DOTS 100
• Estimated Number of New SS()ve.patients
  107
• Number of New SS()ve Pts.treated (1999) 176
• Treatment Success in DOTS areas 98

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Nepal

• Total Population 23 millions
• Population Covered by DOTS 20 millions
• Percent of Population Covered by DOTS 85
• Estimated Number of New SS()ve.patients
  20000
• Number of New SS()ve Pts.treated 8000
• Treatment Success in DOTS areas 89

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DOTS and Community

• DOTS committee
• District development committee
• Municipality
• Village development committee
• NGOs
• Media
• Community Volunteers
• Social Workers
• Teachers and students
• TB patients

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DOTS committee, key to success

• DOTS Committee
• Group of motivated people social workers,
  political leaders, civic leaders, health service
  providers, journalist, teachers, representatives
  of local organizations, I/NGOs, medical schools
  and colleges and TB patients.

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DOTS and Medical colleges

• Frequent meeting with them
• NTP DOTS orientation
• Establish DOTS Centre
• BPKIHS
• Nepalganj Medical College (2 DOTS centres)
• Bharatpur Medical College
• TU Teaching Hospital
• Such activities are being carried to other SAARC
  member countries, Bhutan, Bangaldesh, Sri Lanka,
  India, Pakistan, Maldives

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Pakistan

• Total Population 130 millions
• Population Covered by DOTS 10.4 millions
• Percent of Population Covered by DOTS 8(in
  National Population)
• Estimated Number of New SS()ve.patients
  117,000
• Treatment Success in DOTS areas 85

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Sri Lanka

• Total Population 18 millions
• Population Covered by DOTS 17 millions
• Percent of Population Covered by DOTS
  95
• Estimated Number of New SS()ve.patients
  5019
• Number of New SS()ve Pts.treated (1999)
  3734
• Treatment Success in DOTS areas 75

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SAARC TB Centre (STC)
1984 Second meeting of Foreign Ministers
identified TB as priority area 1990 Fifth
Summit of the head of states/governments decided
to set-up STC in Nepal 1992 First Governing
Board meeting held to formulate rules
regulations 1994 Staff recruited - STC started
functioning
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Governing Board

• Highest policy making body
• Composed of eight eminent experts in the field
  of Tuberculosis - one each nominated by seven
  member countries
• Director of STC is Member Secretary
• One nominated member of SAARC Secretary General
  participates in all meeting
• Focal point of host country participate in each
  meeting
• Meets once in a year or in emergency if required

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Objectives of SAARC Tuberculosis Centre
To work for prevention and control of
tuberculosis HIV/AIDS in the region by
coordinating the efforts of National
Tuberculosis Control Programmes of SAARC member
countries
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Functions of STC
1. To act regional co-ordination centre for
tuberculosis control in SAARC
region 2. Collection and dissemination of
information 3. To establish net working
arrangement among National Tuberculosis Control
Programme of member countries 4. To initiate,
undertake and co-ordinate the research and
training on TB control in the region
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5. To assist member countries for
harmonization of policies and
strategies 6. To assist member countries of
maintain adequate supply of low cost anti-TB
drugs 7. To monitor incidence, prevalence and
emergence of drug resistance in the
region 8. To promote action on issues relating to
HIV related tuberculosis 9. To carryout other
important works identified by the technical
committee
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Organogramme of SAARC TB Centre
Governing Board
Director
Deputy Director
Research Training Division
Epidemiology Division
Bacteriology Division
ICC Division
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Achievements of STC
Seminars and Workshops

• Socio-cultural aspects of TB - Dec. 1993
• TB programme managers of SAARC - Nov. 1994
• TB programme through PHC approach - Apr. 1995
• Preparation of Health Education materials - Oct.
  1995
• Pilot Demonstration areas of TB control - Jan.
  1997
• Production and Distribution of ATD -Jul. 1997
• Formulation of guidelines for coordination in
  Govt. and Pvt. Sector - Jun. 1997
• Relating to research on TB/HIV in the region-
  Oct. 1997
• SAARC-CIDA cooperation on TB/HIV - Mar.1999
• Gender Sociological Issues Related to TB-July
  1999
• SAARC Seminar for compilation and updating
  advocacy and IEC material relating to
  TB-Sept.2000

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Achievements of STC
T r a i n i n g

• Trainers training for NTP - Jul. 1994
• Trainers, training for DTP managers - Jul. 1995
• Training for regional TB programme coordinators
• - Jul. 1996
• Training for Lab. Technicians on TB bact. Apr.
  96
• Training for strengthening IEC activities on
  TB/HIV - Feb. 1998
• Trainers training for programme managers Jul-
  1998
• Training for TB coordinators - Dec. 1998
• Trainers Training - Jun. 2000.

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Achievements of STC
M e e t i n g

• Consultative meeting on TB and AIDS - Oct. 1996
• Meeting of TB experts for compilation of TB
  control training manual - Jun. 1997
• Ten meetings of Governing Board
• Expert meeting for standardizing training
  curriculum and workshop on operational Research
  for TB control - Dec. 2000

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Achievements of STC
R e s e a r c h

• Member countries have identified focal institute
  for research
• Research on TB bacillus, drug sensitivity pattern
  in SAARC region is in progress
• Pilot demonstration site with suitable strategy
  in TB control is being developed
• Initiation of SAACR-CANADA project

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Activities organized for TB HIV/AIDS control by
SAARC TB Centre

• SAARC Consultative Meeting on TB and HIV/AIDS,
  23-25 Sept 1996, Kathmandu
• Workshop Relating to Research on TB and HIV/AIDS
  in SAARC, 28-29 Oct. 1997, Kathmandu
• Training Programme for Strengthening IEC
  activities with special emphasis on TB and
  HIV/AIDS, 10-23 Feb. 1998, New Delhi
• Workshop on SAARC-CIDA Cooperation for TB and
  HIV/AIDS, 1-5 March 1999
• Seminar for compilation and updating advocacy and
  IEC material relating to TB and HIV/AIDS, Oct.
  2000
• Cross Border Meeting for TB, HIV, Malaria and
  Kala-azar, March 2001

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Achievement of STC
Collection and Dissemination of the Information

• A resource centre (Library) for TB and HIV has
  been developed
• Regional TB and HIV AIDS epidemiological data
  base is being established.
• Information network in Member Countries has been
  created
• Directory of TB institutions and TB specialists
  has been prepared
• Regular collection and dissemination of
  information is being done in the form of STC
  Newsletter, reports on workshops, meetings
  seminars and materials on training and research
• Presentations of scientific papers in
  international and national conferences

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Achievements of STC
Representation in International Conferences

• Scientific Sessions have been chaired and
  Technical Papers on TB and HIV have been
  presented in global lung congresses and IUATLD
  meetings held in Paris, Bangkok, Hong Kong and
  Dhaka
• Regional situation and progress on TB control has
  been presented in WHO meetings held in Delhi,
  Bangkok and Myanmar
• Dr. K. Styblo International Public Health Award,
  has been awarded for outstanding contribution -
  1998
• International Gold Star Award has been presented
  by International Friendship Society of India -
  1999

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Establishment of Resource Centre
A Regional Library for TB and HIV/AIDS has been
established in SAARC TB Centre for Health
Workers, Medical Students, Researchers and the
interested people.
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Focal Training Institutes for TB control in
SAARC Member Countries
Bangladesh - TB Control Training Centre,
Dhaka Bhutan - Division of Health Services,
Thimphu India - National TB Institute,
Bangalore Maldives - Chest Clinic,
Male Nepal - National TB Centre, Thimi,
Pakistan - Ojha Institute of Chest Disease,
Karachi Sri Lanka - Respiratory Disease Control,
Colombo
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Services to NTPs of Member Countries from STC

• To provide platform for interaction and
  exchange of experiences
• Collection, compilation and dissemination of
  information
• Identification of problem areas in NTP
• Feedback suggestions with remedial measures
  to member countries
• Training and Research for support of NTP

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SAARC-WHO Memorandum of Understanding

• MoU between SAARC and WHO has been signed in
  August 2000
• STC has been identified as a collaborative Centre
  for WHO activities in TB and HIV/AIDS
• SAARC-WHO meeting of potential consultants
  in TB control- Jan. 2001
• SAARC-WHO inter-country meeting on cross border
  initiative in HIV/AIDS, TB, Malaria and Kala-azar
  - March 2001
• Organizing WHO/ SEARO Training on TB Control
  Management from 1997 for

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SAARC-CIDA project on TB and HIV/AIDS

• SAARC and CIDA signed a MoU in July 1997 for
  cooperation to Control TB and HIV/AIDS.
• The Project Document was prepared
  in March 1999.
• Member Countries have approved the Project in
  Sept. 2000
• The project has been initiated.

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Conclusions
Burden of TB HIV/AIDS in SAARC region is
enormous TB control is not only national but
international issue Cooperation is
essential SAARC TB Centre is in unique position
to facilitate
cooperation Regional approach is needed
to fight against tuberculosis Strong and
sustainable NTPs with 85 cure and 70 case
detection is key of the success There is a strong
need of social mobilization and advocacy at each
level in order to achieve objective of TB
control
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Thank you