Transcript Global Progress on Stop TB Partnership

The Second Stop TB
Partners’ Forum
Keynote address: Marcos Espinal
Executive Secretary
24 March 2004 – New Delhi, India
Overview
I.
Progress: Fulfilling Amsterdam and
Washington
II.
Preview: Plotting the way forward
III. Partners:
Everyone is necessary
24 March 2004
Review progress
through 2003
“The Global Stop TB Partnership is working”

Grown 50 fold: 280 members

Accelerated TB control progress
and funding
3%
7%
11%
4%

Become a model for international
public health partnerships

Reach out to new partners—e.g.
the private sector and civil society
50%
25%
NGO
Academic
24 March 2004
Government
For Profit
Internat.Org
Other
Achievements & Aims
2001–2005
“Global Firsts”
The Global Plan to Stop TB, the Global DOTS Expansion
Plan, the Global Drug Facility (GDF), the Green Light
Committee (GLC) and the link with the Global Fund to
Fight AIDS, TB and Malaria (GFATM)
By 2001: National plans and increased commitments
 By 2002: NIACCs, accelerating detection rates to 37%,
and a fully operational GDF
 By 2005: 70/85 TB control targets

24 March 2004
The Global Plan to
Stop TB

Working Group on DOTS
Expansion

– 180 countries implementing
DOTS

Working Group on TB/HIV
– Enabling environment for
commercial tool development

– Policy for TB/HIV
collaborative activies

Working Group on DOTSPlus for MDR-TB
– Treatment for MDR-TB in
more than 10 countries
Working Group on New
Diagnostics
Working Group on New TB
Drugs
– Pipeline of promising compounds

Working Group on New
Vaccines
– Two vaccine candidates entering
phase I clinical trials
24 March 2004
Progress
DOTS in 180 countries
DOTS coverage
non-DOTS
< 10% pop
10 - 90% pop
> 90% pop
low incidence, non-DOTS
No report
24 March 2004
It can be done—
Achieved and sustained in
6 countries for four years!
Treatment success (%)
100
Malta
TARGET ZONE
Cambodia
Viet Nam
Tonga
Solomon Is
Morocco
Bosnia & Hezegovina
80
70
Hong Kong
Tunisia
Samoa
Qata
Uruguay
r
Mongolia Marshall Is Nicaragua
Chile
Kyrgyzstan
Morocco
St Lucia
Kazakhstan
Venezuela
Guatemala
Djibouti
Kenya El Salvador
Slovenia
Sri Lanka
French Polynesia
Tanzania
South Africa
Italy
LebanonPortugal
USA
Latvia
DR Congo
50
Cuba
Peru
Fiji
85
Maldives
60
70
80
90
Oman
Turks & Caicos Is
100
DOTS detection rate (%)
24 March 2004
110
120
It can be done
in your country
100
100
TARGET ZONE
China
Cambodia
Treatment success (%)
90
Treatment success (%)
85 %
80
Bangladesh
90
Nigeria
Pakistan
Peru
Philippines
Tanzania
Kenya
Myanmar
DRCongo
Ethiopia
Thailand
Mozambique
Brazil
70
60
Viet Nam
Indonesia
Afghanistan
India
Zimbabwe
Russia
South Africa
80
Uganda
50
40
70
0
50
10
60 20
70
30
40
80
50
90
60
DOTS
detectionrate
rate (%
)
DOTS
detection
(%)
24 March 2004
100
70
70
%
110
80
90
120 100
Global Drug Facility
(GDF)
Creating a “model,” since 2001 it has:

Supplied TB drugs to 1.7 million DOTS patients

Committed drugs – 2.8 million patients in 58 countries

Raised and committed US$ 30 million in grants

Increased delivery-efficiency, slashed drug prices

Advanced combination treatments

Established direct procurement service and White List of
suppliers

Signed an agreement with Novartis through WHO to provide
free TB drugs for 500 000 patients over the next 5 years
24 March 2004
The Partnership’s
“Report Card”
First independent external evaluation:
– Scored “extremely high” marks
– Added value, new initiatives, increased funding
– Made progress against TB
– Supported new diagnostics, drugs and vaccines
– Operationalized GDF and GLC
– Increased political commitment to the Global Plan
We‘ve made a great start but ...
24 March 2004
The clock is ticking …
Case detection rate, smear-positive cases (%)
This is no time for complacency
80
WHO target 70%
70
accelerated progress:
target 2005
60
50
II. The WayForward
40
30
DOTS
begins
average rate of progress
1994-2000
20
10
0
1990
1995
2000
2005
Year
24 March 2004
2010
2015
II. Preview of the
future
Plotting the way forward
2005 (Global Targets: 70/85)
2015 (Millennium Development Goals:
halving prevalence and mortality)
24 March 2004
Accelerate progress
2005
Win the “case race”
ONE MILLION TB PATIENTS EXTRA
EVERY YEAR
24 March 2004
Accelerate progress
2005
Win the “case race”

Double DOTS detection from 37% to 70% by:
– ensuring diagnosis and cure of known TB cases according to
DOTS standards
– recruiting patients from non-DOTS participating clinics and
hospitals and from beyond the public health systems;
Inch up treatment cure rates from 82% to 85%
 Strengthen focus on countries and communities
 Focus on TB’s human face

24 March 2004
Intensify action
2005
Bold initiatives:

ISAC: Emergency ‘Intensified Support & Action
Countries’ accelerates efforts in lagging HBCs

PPM DOTS: The public-private and public-public Mix
DOTS casts the health care net wider

Global Plan Phase I: Finalize and secure funding
24 March 2004
Fill the resource gap
in the Global Plan
Funding and gaps for partnership activities, 2001–2005
10 US$ billions
Total gap:
US$ 3.8 billion
41% of global
plan cost
8
6
4
Gap
2
Current-External
0
Current-National
DOTS
Expansion
Adapting DOTS
R&D
Partnership
Total
24 March 2004
Why long-term
goals matter

TB will not go away tomorrow

TB is still a disease of the poor

Ill health and poverty are a vicious circle

Effective interventions exist; need to reach more people

Improve national TB control policies, institutions, investment

Coordinate partner-donor efforts
The LIVES and CASES prevented are the bottom line
24 March 2004
Long-term goals
2015
2nd Ad Hoc Committee recommendations :







Consolidate, sustain, advance achievements to date
Enhance political commitment
Address the health workforce crisis
Strengthen health systems, especially PHC delivery
Accelerate responses to the TB-HIV/AIDS emergency
Mobilize communities and the private sector
Invest in R&D to shape the future
24 March 2004
Long-term goals
2015
Global Plan To Stop TB II
Poverty Reduction Strategy Papers
Investments plans based on well-documented
needs and costing scenarios
24 March 2004
Energize partnerships
Partnerships play a strong role:

Countries: Strengthen / building partnerships

HIV/AIDS community: Make TB a major issue

Diverse partners: Define complementary roles

Donors: Cultivate investments, expand the base

Media: Raise awareness, increase advocacy & networks

Stakeholders: Broaden the range
24 March 2004
Develop new tools
To defeat the mutable TB microbe,
we must upscale efforts to develop:

New diagnostics: FIND, TDR,

New TB drugs: Global Alliance, Novartis Institute,
Glaxo Welcome

New vaccines: Aeras
24 March 2004
III. Partners:
To evolve dynamically and fulfil
the Amsterdam Declaration and
 the Washington Commitment

All of us here today must keep the New Delhi
Pledges
24 March 2004
Let us not fail
“We don’t need more
promises; we need to deliver
on those already made.”
- MDGs High-Level Forum,
January 2004
24 March 2004
Keep the pledges
The reward will be found most meaningfully
in the faces of those whose lives have been saved
and health restored through our unremitting efforts.
24 March 2004