PPM Subgroup Meeting: Lille Increasing the effectiveness of the Stop TB Partnership in engaging all care providers A White Paper of the PPM Subgroup
Requests of the Subgroup Read the document Endorse the document as a whole Adopt/adapt the objectives and strategies for the guidance of the subgroup. Agree with the next steps recommendations
Rationale Most persons ultimately shown to have TB first seek and receive care from non-tb program providers Public sector DOTS continues to be successful, but universal access to effective services for TB can be achieved only by systematic engagement of all providers. It is essential to develop linkages that enable private clinicians to fulfill their public health responsibilities in providing tuberculosis services. Public sector programs should dedicate sufficient resources, both human and financial, to the implementation of PPM activities.
Rationale TB care is increasingly complicated, often requiring specialized expertise. Tb control programs are often not in a position to implement preventive measures such as treatment of latent infection and infection control. Private sector involvement is either implicit or explicit in the activities of all the Stop TB Partnership working groups.
Objectives To contribute to the goal of universal access to high quality diagnostic, treatment, and prevention services through appropriate engagement of care providers, healthcare facilities and laboratories: To strengthen health systems through promotion of effective engagement of all providers: To promote best practices for implementation and scaleup for engagement of all providers by providing guidance and tools for global, regional, country-specific policies, strategies and plans: To ensure that the current and/or potential role of nonprogram providers is taken into account in the activities of all components of the Stop TB partnership:
Next Steps Seek full working group status as the Working Group to Engage all Providers with representation on the Partnership Coordinating Board. Revise the Core Group terms of reference as follows: oversight and coordination of the activities of the working group coordination of the activities of the working group with those of other Partnership working groups oversee the preparation of a strategic plan and annual work plans to implement the strategic plan coordinate any revisions of the Global Plan to Stop TB as they relate to the engagement of private sector providers serve as the liaison between the Partnership and the Stop TB Department s activities in engaging all providers
The Indonesia PPM Model 2.Public/Private Hospital Services - Approach: Hospital Accreditation, Implementation TB DOTS as Minimum Standard requirement for accreditation of Hospitals - Leading: Directorates of Referral Health Services -TA: KNCV 1.Basic DOTS Services At Puskesmas -Approach: Surveillance System Strengthening and MIFA, Improving quality of care, increasing coverage of TBHIV, reaching un-reach pop at remote are (DTPK), increasing referral to Quality DOTS Services -Leading: NTP -TA: WHO, FHI and other partners 3.Quality DOTS services by Private Practitioners and Specialist - Approach: Implementation of ISTC for all TB care and treatment from all care providers, increasing professional responsibility to cure TB patients, rewarding through cumulative credits mechanism for licensing/certification -Leading: IMA -TA: ATS, 4.Qualified TB Diagnostic -Approach: Strengthening lab network and Quality Assurance (public and private) DST, Culture and Microscopic -Leading: Directorate of Medical Support - TA: KNCV and JATA 6.Community System Strengthening -Function as advocator raise fund and commitment, - Increase public awareness, function as public watch to ensure deliveries of quality services, -increasing awareness of right and responsibility of the patients (patient's charter). -Social Mobilization, suspect identification, increasing demand creation, intensifying the services of TB in slum areas and prison -Leading: NGO, FBO, CSO -TA: FHI, other partners 5.Quality of anti TB Drug Dispensing and rational Use of Drug -Approach: law enforcement, establishment of networking and monitoring system, WHO prequalification -Leading: Indonesian Pharmacist Association, DG of Pharmaceutical Services, Indonesian FDA -TA: USP and MSH
The Indonesia PPM Model Strong national and local Services at primary level TB control programs Hospitals Setting standards Maintaining surveillance Evaluating results Laboratories Private providers and academic institutions Rational pharmaceutical policies Providing accessible public health services High quality Community diagnostic services Treatment supervision support Contact investigation/evaluation
Requests of the Subgroup Read the document Endorse the document as a whole Adopt/adapt the objectives and strategies for the guidance of the subgroup. Agree with the next steps recommendations
Composition of Partnership Board 4 representatives from high burden countries, 3 representatives, one from each of WHO, the World Bank and the GFATM 1 representative of another international organization, 6 regional representatives, assuring the inclusion of representatives from non-high burden countries, 7 Working Group Chairpersons representing DOTS Expansion, MDR-TB, TB-HIV, Diagnostics, TB Drug Development, New Vaccines and ACSM 5 representatives of financial donors, 1 representative of Foundations, 3 representatives of NGOs and technical agencies (Union and CDC) 2 representatives of communities affected by TB, The Chair of the WHO STAG, 1 representative of the corporate business sector
Partnership Working Groups Working groups are essential components of the partnership that contribute significantly to the achievement of partnership aims. There are currently seven such groups - DOTS Expansion, TB-HIV, MDR-TB, New TB Drugs, TB Diagnostics, New TB Vaccines, and Global Laboratory Initiative. Role and mission To implement research, advocacy and/or operational activities in pursuit of the group's specific area of interest and of the aims of the partnership. To collaborate with other elements of the partnership so as to create synergy and value added to actions taken in pursuit of the aims of the partnership.