The results of implementation of the “Stop TB in Ukraine” Program for 2011
During the 10 months of implementation of the “Stop TB in Ukraine” Program, the Rinat Akhmetov’s Foundation for Development of Ukraine in cooperation with the sub-recipients developed a management and coordination platform, analyzed and identified the key systemic issues related to TB control and suggested the relevant action.
The main achievements of the “Stop TB in Ukraine” Program include:
1. Development for the first time of a quality National program to combat tuberculosis for 2012-2016.
In order to develop the Program the Foundation not only took into account the past experience, but also provided for a broad involvement of national experts and public organizations, implementation of innovations and recommendations after the evaluation of the previous Program to combat tuberculosis. The Foundation also ensures the compliance of the new Program with international requirements and activities envisaged by the “Stop TB in Ukraine” Program with the support of the Global Fund to Fight AIDS, Tuberculosis and Malaria. Now the possibility to adopt the operational plan for implementation of the National Program based on the objectives-indicators-financing principle is discussed.
2. The Memorandums of Cooperation were signed with the Ministry of Health and the National Institute of Phthisiology and Pulmonology named after F.G. Yanovsky.
As a result, the schemes of treatment of patients with antibiotic-resistant forms of TB were approved. In addition, the Working Groups were established to develop the regulations on the standards of treatment of tuberculosis, procurement management, HIV/TB case management, the specifications for the purchase of equipment and supplies for microbiology TB laboratories were prepared.
3. The tripartite Memoranda with Oblast Councils and State Administrations were signed in 11 regions of Ukraine.
The representatives from different regions became the full participants of implementation of the “Stop TB in Ukraine” Program and the main customers of services.
Also the cooperation with regions was established through the regional coordinators - main TB specialists and deputy chief doctors of the oblast hospitals. Owing to this collaboration there is a possibility to quickly monitor and resolve problematic issues related to supporting treatment case management, redistribution of drugs etc.
4. There is positive dynamics in the situation with the purchase of the second-line anti-TB drugs under the Programme.
The Foundation plans to purchase the second-line drugs, and in view of the funds saving it now agrees with the Global Fund the possibility to increase the number of patients to 400 instead of the planned 120.
The Global Fund strongly requires to register the purchased drugs in Ukraine, as well as to ensure the compliance of the quality of drugs with the WHO requirements. Given that the two foreign manufacturers did not register their products in Ukraine, the Foundation signed a Memorandum with the Ukrainian manufacturer and provided technical assistance in translating the dossier to English. As a result, in the first quarter of 2012 one drug (capreomycin) will be reclassified, providing for the quick and relatively inexpensive procurement in the future.
5. The diagnosis of tuberculosis has improved.
The Foundation developed a National plan of optimization of the laboratory network that will provide for the optimal load of the laboratories and the efficient use of resources.
In the four regions the plans for the reorganization of the laboratory network have been prepared.
Other activities aimed at improving the diagnosis of tuberculosis include:
- revision of the regulatory framework.
- purchase of the new diagnostic equipment, the tender has been announced. At the same time it is planned to introduce the molecular methods of TB diagnosis;
- training of personnel aiming at strengthening the laboratory capacity;
- introduction of the system of external quality assessment of laboratories.
6. The plan of introduction of the register of patients with tuberculosis is developed.
It is expected that the Order on the introduction of the register of patients with tuberculosis will be signed in February 2012. The Foundation provided for coordination and oversight on this issue and is thankful for cooperation to MSH, PATH and the All-Ukrainian Center for Tuberculosis Control of the Ministry of Health of Ukraine.
Also, the Foundation for Development of Ukraine initiated a revision of the current rating indicators of the health status of population, the activity and resource provision of health care facilities with regard to the diagnosis and treatment of tuberculosis.
7. The process of integration of the international training standards in the system of public pre-and post-graduate health education on tuberculosis has been initiated.
The Foundation initiated the set up of the Working Group at the Ministry of Health, provided for the revision and standardization of the training modules.
8. The information campaign to combat tuberculosis was arranged.
In December 2011 the data on KAPB (knowledge, attitudes, practices, behavior) survey of tuberculosis were obtained. The results form the basis of the National information campaign, which started in January 2012, and the basis of the National ACSM (advocacy, communication and social mobilization) strategy).
9. On November 16-18, 2011 the All-Ukrainian scientific-practical conference on the fight and control of tuberculosis in Ukraine was held.
The conference brought together 260 experts on TB and related areas, including the 137 specialists from the regions.
In general, it is expected that the implementation of the Program will allow Ukraine to achieve in 5 years the necessary goals, namely - to identify 70% and cure 80% of TB cases.
The Program indicators and their implementation at the end of the third quarter (September 30), 2011:
- New smear-positive TB cases registered during the reporting period - 7772
- The rate of default of treatment of new smear positive cases – 8,28%
- The number of health and social service providers trained in TB case management and/or patient support – 331
- The number of health and social service providers trained in joint TB/HIV case management and/or awareness raising and prevention of TB/HIV – 85
- The number of TB patients covered with HIV/AIDS prevention services – 2149
- The number of people trained in the coordination and/or development of strategic plans – 27.