Transcript BREAKOUT DISCUSSION (GROUP 4)

NINTH TECHNICAL ADVISORY GROUP AND NATIONAL TB PROGRAMME MANAGERS
MEETING FOR TB CONTROL IN THE WESTERN PACIFIC REGION
Manila, Philippines, 9-12 December 2014
Some updated information from
Consultation on Research for Tuberculosis
Elimination, Karolinska
Institutet, Stockholm, 24, 2014
A/Prof. Nguyen Viet Nhung, MD., PhD
Director, National Lung Hospital
Manager, National TB control Program
Viet Nam
Result of BREAKOUT DISCUSSION
Liz Corbett
Afranio Kritski
Viet Nhung Nguyen
Joseph Cavanaugh
Nadia Khelef
Ajaya M.V. Kumar
Tom H.M. Ottenhoff
(GROUP 4)
Melvin K. Spigelman
Alison Kraigsley
Abdul Ghaffar
Anna Scardigli
Tom Evans
Knut Lönnroth
DO BETTER AND DO MORE
Aspect
Global
Curent
- There are some models in several
situation
countries: Brazil, Viet Nam, India,
Indonesia, …
- Multi-country academic networks
- WHO Training package for TB
control, but not yet for TB
research training
Country (LMIC)
There are available TB research in all countries, but still:
- Lack of information about Research (Capacity, HR,
opportunity, …)
- Lack of effective models for Capacity building
- Lack of coordination of all existing, ongoing research in
countries (projects, institution, researchers, resources)
 overlap, no translation into practice, waste …
- There are various level of TB research: R&R, data
management, basic  implementation research
The needs There are Roadmap and OR priority
- Toolkit for evaluation: SWOT
analysis
- Guidance for create research
demand for the new strategy
- A new program, model for TB
research training
- TA for TB research
- Mapping key institutions
Solutions - Guideline / recommendation
- Framework for capacity building
for TB Research
- Model and piloting model
Country TB Research Agenda
- SWOT analysis on Tb research
- Prioritizing the gaps
- Planning to fill the gaps
- Mapping, inventory all available, ongoing project, HR,
partners
- True partnership for TB research
- Coodination and ownership: MoH, NTP, MoEdu, …
- NTP needs to be the core
- Identify the priority researches that should be focus of
the country (basic  implementation research)
- Establish strategic plan of TB research in the national
strategy for TB control as the whole (TB research
agenda)
- Create a leadership, partnership for implementing the
plan for better coordination and collaboration
EXPECTATION
Aspect
Global
1 year Establish a ad hoc WG & ToR based
in WHO
- Define needs for 1 year deliverables
- Identify key players (TB Programme,
TDR, Alliance, the Union, …)
- Guide for conducting in-country
mapping and situational analysis
- Develop participatory workshop
facilitator guides for NTP to support
comprehensive research strategy
generation
- Share training and research materials
- Repository for materials
- Hold workshop for exchange of ideas
and lessons learnt between key players
in TB and broader research capacity
building initiatives
- Best practice country examples to
share learning points and draw
guidance
Country (LMIC)
- Encourage in-country mapping and situational
analysis with needs assessment of TB activities and
NTP capacity to conduct research in all countries
- Develop clear plan for comprehensive National TB
Research Agenda and capacity building strategy (inc
OR, basic etc)
- Example Research Strategy plans from key
countries
- Pathfinders
- Viet Nam, Kenya, BRICS, Uganda, Malawi
- Invite applications from all countries
- Ask regional offices to nominate
- In-country regulatory review to define
functionalities, timelines and information for
international collaborators
- Initiate consideration of regional harmonization
plans
- Initiate consideration of regional research
networking plans
- Include critical assessment meetings in regional
meetings and International Union Conferences
Aspect
Global
5 years • Researchers toolkit,
databases, and data sharing
• Established global research
movement with regional
hubs
• Expansion of TB research
network in regions and
countries
10
years
Country (LMIC)
• All high burden countries have a Strategic
research and capacity building plan
• Regional networks established
• Individual and multicountry studies
providing results
• OR funds available from Global Fund are
fully utilized
• Funding sources diversified and increased,
including in-country investment
• Supportive research environment and
regulatory processes
Researchers toolkit, databases, • Capacity to evaluate TB epidemic and
and data sharing
control interventions
Scale up TB research network • Established leadership in comprehensive TB
in countries, regions and global research platform from (formerly) high
to know how to achieve the TB burden countries
control Goal.
• Clear examples of contribution of national
research to local control efforts
Messages to region and countries
1. Adapt the Global research movement in regions with
regional hubs
2. Establishment and expansion of TB research network in
regions and countries
3. Countries should develop a Comprehensive TB Research
Agenda integrated in the National Strategic Plan with
appropriate research capacity building
4. Countries should be involved and responsible in all kind of
research for TB Control
POST 2015 NATIONAL STRATEGY FOR TB CONTROL
PILLAR 3
Viet Nam – an example
Pillar 3 - an example: Viet Nam
Level
Framework
Funding
resources
Government /
MoH
National Strategy to 2020 with vision 2030: Optimize the
application of current and new technologies, approaches in TB
detection, diagnosis, treatment and prevention
Gov’t
National Program
National Strategic Plan for TB control 2015-2020
Objective 4 (of 4). To sustain and promote monitoring,
evaluation and surveillance of the TB epidemic and control
while applying new technologies and approaches in TB control
by routine data, surveys and researches.
- 16 projects in agenda 2015-2020 with
Gov’t and
partners
Partnership
National Lung Hospital / NTP: Core partner
TB and lung disease research coalition: MoH, MOST, Academy,
University, Institution.
International partners: KNCV, WHO, UCSF, Sydney University,
WMRI, LSHTM, …
Provincial
program and
other institution
-
R&R, case based, web based surveillance system
Research Project implementation: capacity building on
needs
Promoting younger researchers
GFATM,
AUSAID,
USAID,
CDC,
WHO,
Projects,
…
16 ITEMS IN THE AGENDA 2015 -2020 VTN NSP TB CONTROL
4.1. Further development and updating of both paper based and electronic R&R systems (VITIMES and
e-TB manager) to support the program measure indicators for IC, Childhood TB, PPM,
Community engagement, Pharmacovigilance and new drugs and regimens initiative, equipment
maintenance etc.
4.2. Develop and implement data quality assurance and security system for protection of electronic
records.
4.3. Identify new gaps from the feedback of M&E and supervision visits and strengthening health facilities
to fulfil the needs for PPM and PMDT scale up.
4.4. Strengthen research partnership with universities in Vietnam
4.5. Analysis of population access to TB services per province and population groups
4.6. Enhanced surveillance for risk group identification and follow-up of yield attributable to active and
passive case finding in each risk group
4.7. Operational research to underpin and support the stepwise introduction of new regimens for
TB and/or MDR, including pharmacovigilance
4.8. Continuation of the STREAM trial in HCMC, ACT3 in Ca Mau (Community based genExpert screening
for TB), TBTC in Ha Noi (clinical trials for TB drugs and regimens), GeneTB.
4.9. Operational research to support and evaluate new tools (mHealth, CAD4TB), in public and private
sector
4.10. Studies on elimination of TB in Vietnam, modeling of the epidemic in collaboration with the
London School of Hygiene & Tropical Medicine (LSHTM), piloting interventions in preparation of
scenario’s for TB “elimination”
4.11. National Prevalence survey of Tuberculosis (2015-2017)
4.12. 5th National Drug Resistant Survey (2015-2016)
4.13. Studies related to health financing (Vietnam transitioning towards full coverage of health
insurance, paying for TB diagnosis and treatment)
4.14. Study on fluoroquinolone and pyrazinamid resistance among new patients
4.15. Sentinel survey for TB in KAPs
4.16. Mortality and fatality of TB in sentinel areas
Christian Lienhardt