Regional GLC For Africa. Presented by Dr Norbert Ndjeka Member of AFRO rglc Committee

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Regional GLC For Africa Presented by Dr Norbert Ndjeka Member of AFRO rglc Committee

Year Before 2009 Activity History GLC : GDF, WHO, Technical partners, 2009 Revision of the MDR-TB global framework agreement on the need of a new model of coordination and support to countries More advocacy and support the control of MDR-TB Increase access to quality assured SLD, more and better extensive technical assistance over short and long term MoU with the Global Fund for countries contributions 2011 Decision of establishment of rglcs at regional level and hosted by WHO 2013 Establishment of the rglc for AFRO and first Meeting in Brazzaville 2014 Evaluation of the rglc Support March 2015 March 2015 Briefing meeting on revision of the MoU between the GF and WHO for the rglcs 2 nd Meeting of AFR rglc, revision of the terms of reference of the rglc for AFRO

rglc for the Africa Region Function as an advisory committee to the WHO Regional Office for Africa for WHO s Member states as well as donors and partners Secretariat hosted by the WHO African Regional Office in Brazzaville

Composition of the rglc in the African region Chair :Dr Hind Satti Members : Pr Oumou B. Sow Dr Norbert Ndjeka Dr A. Trébucq Dr M.Subroto Ms Rose Pray Dr Lovett Lawson Dr Beatrice Kirubi Mrs Alaine Umubyeyi Nyaruhirina

Objectives Main objectives Monitor the implementation of programmatic management of drug resistant TB programmes in Africa Specific objectives Provide technical advice to the WHO on findings and recommendations from country missions Analyse the quality of contribution of the rglc technical support to countries and advice Validate the mission plan for GLC missions in 2015 Update list of consultants for PMDT

TOR of GLC mission To assess implementation of the programme and evaluate current achievements; To assess the need and readiness for implementation of the MDR-TB program in the country; To review recently developed PMDT guideline and provide recommendations for improvement in line with international standards; To collect and analyze data on patients on treatment and specific regimens; To provide recommendations for NTP to move forward for implementation of MDR-TB program in line with the country context.

TOR of GLC mission Coordination between the NTP, implementing and potential partners, SNL, second-line drugprocurement agency and WHO; Case finding strategies; Treatment strategies, administration and follow-up; Management system for second-line TB drugs; Infection control strategies; Information system and data management; Field visit

AFRO rglc Activities and Findings in 2014

Countries visited IST West Africa Countries Senegal Togo Benin Côte d Ivoire Central Africa Chad (2) Congo (2) Sao Tomé and Principe South and East Africa Bostwana Eritea Kenya Malawi Mauritius and Seychelles Mozambique Swaziland Tanzania Uganda

Main findings/challenges in countries Unknown burden: poor / non existent surveillance systems for DR-TB Laboratory strengthening Human resource challenges, including low health worker awareness and skills to effectively manage DR-TB cases Poor quality of services Existence and quality of PMDT Extension Plan Second line drug over-projections Procurement of Partial consignments of SLD by countries Challenges of infection control

Human Resource Capacity Strengthening Ouidah Course in Benin 21 participants from 13 countries : Angola, Bénin, Burkina Faso, Cameroun, Congo, Côte d Ivoire, Guinea, Mali, Mauritania, CAR, Senegal, Tchad and Togo Durban Training course for PMDT Consultants 18 new consultants have been trained with a proposition of mentorship missions KEMRI Cancelled in 2014 because of Ebola

Access to second line drugs 35 request received in 2014 Country Quantification of the country needs Elaboration of the request GDF Reception of the request Transmission to rglc TO and GF rglc secretariat Protocol of treatment Quantities Number of patients in coherence with the national plan Additional questions for countries if needed Validation of the request

Next Step (1) Communication to WRs and NTPs regarding TOR of rglc, rglc membership and focal points for various areas AFRO rglc sub regional focal persons identified. WA- Dr Oumou supported by Andre (ndongosiemea@who.int) CA Anauld Trebucque supported by Dr Wembanyama (wembanyamh@who.int) SA - Dr Ndjeka supported by Dr Kefas (samsonk@who.int) EA - Dr Subroto supported by Dr Nkhoma (nkhomaw@who.int)

Next Step (2) Update the mission plan in the region and share it with countries April: Ghana, CAR May: Guinea, Guinee Bissau, Liberia, Mali, Senegal, Côte d Ivoire, DRC, Benin, Congo, Angola June: Burkina, Niger, Gabon, Nigeria, Cameroun, Bostwana, Comores Consultants training (Francophone). Promote and support introduction of new drugs.

rglc Members meeting in Dakar, Senegal 21 st March 2015

Thank you for your attention