Promoting Adoption and Implementation of WHO recommendations INAT 12 November 2010 Summary guidance for National TB Programmes

Background Many new advances (solutions to programmatic constraints) Country enthusiasm for new tools & approaches Country assessment of bottlenecks to progress How to link gaps to solutions? Proposal: Simple tools that pulls together WHO recommendations for new approaches and tools; presents rationale for when to use / how to roll-out

New approaches and tools WHO Endorsed FDCs ACSM Community TB care Public Private Mix Three I’s BCG PAL Diagnostic approaches Front-loading, 3-to-2 smears, case definition Diagnostic technologies LED, LPA, liquid culture, rapid speciation, GeneXpert?

Problem-solving approach Primary Objective: Provide practical information to support decision-making regarding the introduction of new approaches and tools; and planning for introduction Secondary objectives: Facilitate strategic assessment of constaints to progress and consideration of approaches and tools that may offer solutions Identify potential technical assistance needs Introduce tracking of progress with introduction of new tools

Content For each approach/tool Problems the approach / tool can help to resolve Context in which the approach is relevant (e.g. level of health system, any prerequisites) Summary of the approach; technical overview Implementation considerations Training needs Cost How to integrate with other technologies, approaches (e.g. diagnostic algorithms) Other (e.g. power supply) Alternatives (e.g. for FDCs, consider blister packs; for liquid culture, various methods) Monitoring and evaluation considerations