The Stop TB Partnership

Transcription

1 The Stop TB Partnership Vision, principles, opportunities and challenges of successful National Stop TB Partnerships Dr Giuliano Gargioni National Consultative Meeting of Partners PARTNERSHIP FOR TUBERCULOSIS CARE AND CONTROL IN INDIA 30 th September New Delhi

2 Outline The global Stop TB Partnership What is it? Targets Strategies National Stop TB Partnerships What is a National Stop TB Partnership? Why establishing a partnership? Who could lead the process to establish a partnership? How does the partnering process work? How much would the partnering process cost? Examples of National Stop TB Partnerships

3 Stop TB Partnership A global social movement to Stop TB Need for multisectoral approach New opportunities to work in partnership (multiple actors) Vision: a TB-free world Mission: Ensure that every TB patient has access to effective diagnosis, treatment and cure Stop transmission of TB Reduce the inequitable social and economic toll of TB Develop and implement new preventive, diagnostic and therapeutic tools and strategies to stop TB

4 Governance and operational structure Global Partners Forum Global TB Drug Facility Coordinating Board Partnership Secretariat WHO Technical Advisory Group W O R K I N G G R O U P S DOTS Expansion TB/HIV MDR-TB New TB Vaccines New TB Diagnostics New TB Drugs Global Laboratory Initiative Advocacy Advisory Committee

5 Global TB Control Targets 2015 Goal 6: Combat HIV/AIDS, malaria and other diseases Target 8: to have halted by 2015 and begun to reverse the incidence Indicator 23: incidence, prevalence and deaths associated with TB Indicator 24: proportion of TB cases detected and cured under DOTS % reduction in TB prevalence and deaths by Elimination (<1 case per million population)

6 The Stop TB Strategy

7 The Global Plan to Stop TB Response to country needs for long-term planning Outlines financial requirements for sustainability A pathway towards the Partnership's targets for 2015 Underpinned by the WHO Stop TB Strategy

8 Treatment success on target (~85%), case detection stalling after years of expansion Estimated case detection (%) of sputum smear + cases DOTS Whole Country Target 70% 63% in Treatment success (%) among sputum smear+ cases Target 85% Africa: 47%; Europe 51%; East. Med: 60% Europe: 70%, Africa: 75%, Americas: 75%

9 TB prevalence and mortality 350 Prevalence (cases/100,000) 35 Mortality (deaths/100,000) Target = ,990 1,995 2,000 2,005 2,010 2, Target = ,990 1,995 2,000 2,005 2,010 2,015 Falling but need to fall faster to reach targets

10 Latest global TB estimates Global TB Control target on track, BUT All forms of TB Greatest number of cases in Asia; greatest rates per capita in Africa Multidrug-resistant TB (MDR-TB) Estimated number of cases 9.27 million (139 per 100,000) 511,000 Estimated number of deaths 1.77 million (27 per 100,000) ~150,000 Extensively drugresistant TB (XDR-TB) HIV - associated TB ~50,000 ~30, million (15%) 456,000

11 What is a National Stop TB Partnership? a voluntary alliance between organizations from different sectors of society (government, civil society and private sector) who commit to work collaboratively towards TB prevention, care and control in which all partners contribute from their core competencies (comparative advantage) share resources, risks and responsibilities and benefit by achieving their own, each other's and the overall partnership goal

12 Focus of a National Stop TB Partnership In close collaboration with the NTP, it aims at: strengthening TB prevention, care and control in a given country achieving the targets of the Global Plan to Stop TB with the technical support, if deemed helpful, of the Global Stop TB Partnership Secretariat Its main focuses are: Advocacy, communication, social mobilization Service delivery

13 Rationale The operational challenges of TB control and the social aspects of the disease demand a joint effort of institutions and civil society. While governments are responsible for ensuring services reach the people in need, different actors (civil society and private/business sector) are often involved in the delivery of service. Governments can recognize and support as part of the public system other actors that institutionally do not belong to the state ("public function of private initiative"). Higher institutions or levels of the society should support and promote what a lesser form of social organization can do, in order to contribute to the common good of its members (subsidiarity). Engagement of civil society is essential to design, implement and evaluate people-centred health services.

14 New opportunities 1. Coordination based on a common strategy and plan 2. Multi-sectoral participation: public, private, civil society (health sector and beyond) 3. Increased access to resources (local/global): financial, technical, human, knowledge, physical and network resources 4. Pro-active leadership (vs "business as usual" ) 5. Social capital available for other endeavors

15 Who could lead the process to establish a partnership? Initial partners: organizations working at country level (any of the below) that promote the partnering process. They could act as broker/facilitator of the partnering process or hire an external broker/facilitator for this task. Institutions: - Ministry of Health / NTP -WHO Advocates and service providers: - nongovernmental organizations - private sector - community based organizations - faith based organizations This is the CORE GROUP OF INTERESTED PARTIES

16 Prerequisites 1. The basics of TB control are in place: adequate technical competence of the NTP, internationally endorsed national policy for TB control, a national strategic plan for the Stop TB Strategy implementation. 2. A close coordination with the Ministry of Health (NTP) is ongoing. 3. The objectives of the national TB plan provide the basis to establish a collaboration with various partners. 4. Other ongoing forms of collaboration/coordination are identified, contacted and involved (build upon).

17 How does the partnering process work? Institutionalization: building structures and mechanisms to maintain commitment and ensure continuity Building a vision (Needs, challenges, resources, opportunities) Can obstacles be addressed? Review the partnership (process, outputs, outcomes). Corrective actions Identification and dialogue among potential partners (motivation, commitment) Process: 1 - Exploration 2 - Building 3 - Maintenance Monitoring & evaluation of effectiveness and impact - outputs and outcomes Mapping resources (identifying cash and non-cash resources) PARTNERSHIP BUILDING WORKSHOP Implementation (once resources are in place to work on specific deliverables) Partnering agreement Leadership Preparing a plan of activities with roles and resources Roles Mandates in specific areas Partnership management (core structure) Agreement on core principles, goals and objectives C O R E G R O U P FORMAL LAUNCH

18 Costing the partnering process - 1 Partnership exploration: the partnership building workshop/s on common vision, identification of relevant partners and mapping of resources Partnership building: basic documents establishment of a secretariat formal launch

19 Costing the partnering process - 2 Partnership maintenance: meetings of the governing bodies; implementation of the activities agreed in the operational plan; monitoring and evaluation of the activities; institutionalization of the National Stop TB Partnership.

20 Resource mobilization Through the following mechanisms: HR or in-kind or cash contributions from the partners; resource mobilization strategy at country level (e.g. targeting corporate/business sector or network of supporters); inclusion of partnering process and partnership operations in proposals submitted to Global Health Initiatives.

21 National Partnerships As of September 2009 Partnerships in High Burden Countries Partnerships in WHO Regions Afghanistan Bangladesh Brazil Cambodia China DR Congo Ethiopia India Indonesia Kenya Mozambique Myanmar Nigeria Pakistan Philippines Russian Federation South Africa Thailand Uganda UR Tanzania Vietnam Zimbabwe AFRO Angola (CUAMM) Francophonie Ghana Malawi Nigeria Swaziland Uganda EURO Italy Russian Federation UK (Results) Ukraine AMRO Brazil Canada Dominican Rep. Mexico Peru USA SEARO Bangladesh India Indonesia Myanmar EMRO EMReg.Partnership Afghanistan Djibouti Jordan Iran Morocco Pakistan Sudan Syria WPRO Japan Korea Philippines Viet Nam

22 National Partnership Highlights - 1 Brazil: good collaboration NTP/other partners In 2004 institutions of the civil society and the TB Programme of the Ministry of Health started the process to build Stop TB Brazil. Today it is a cohesive national movement to stop TB. Partners: Ministries, Multilateral/bilateral governmental agencies, Nongovernmental organizations, Professional associations/technical societies, Patient associations, Faith-based organizations, Corporate/business sector, Media. Swaziland: effective and improved access to TB care through different partners thanks to the partnership. Challenge of TB, TB/HIV and MDR/ XDR TB. NGOs, FBOs, CBOs and the private sector were providing uncoordinated services (no support from Govt). Now one national plan, access to funds, HRD. Partners: Ministries, Multilateral/bilateral governmental agencies, NGOs, Professional associations/technical societies, Patient associations, FBOs, CBOs, Private practitioners, Corporate/business sector, Media. Secretariat hosted by NTP.

23 National Partnership Highlights - 2 Uganda: external funds initially allowed the MoH to set up the partnership (now mobilization of national resources-gfatm) The support to partners has guaranteed a wider access to services for the patients. Partners: Ministries, Multilateral/bilateral governmental agencies, NGOs, Professional associations/technical societies, Patient associations, CBOs, Corporate/business sector. Secretariat hosted by WHO, working to register it as an NGO. Philippines: in 1994, the government started a partnership with a variety of groups both from civil society and the private sector. The Philippine Coalition Against Tuberculosis (NGO,PhilCAT). Today new challenges (MDRTB). Partners: Ministries, NGOs, Professional associations/technical societies, Patient associations, FBOs, CBOs, Private practitioners, Corporate/business sector.

24 Partnering and Social Mobilization Team Elisabetta Minelli National partnerships Young-Ae Chu Advocacy, communications and social mobilization Jennifer Dietrich Challenge Facility for Civil Society Hanan Twal Gloria Haselmann Giuliano Gargioni Community involvement