1. Tailored Review Proposal for Tuberculosis
NTCP

2. Background for Material Change
Bhutan is Gearing Towards Ending TB by 2035
National Guidelines for Management of TB/DR -TB guideline revised
Moving towards treating latent TB infection
JMM mission recommendations (2016)

3. Moving towards Active Case finding from Passive case finding
Enhancing Infection Control Measures
Targeted and focused intervention-More cases are concentrated in 8 districts- including districts bordering neighboring countries

4. High prevalence of MDR-TB-10% of all new TB cases, and 37% among retreatment cases.
Expanded prevention and care to high-risk populations.
Expand diagnosis and care for the treatment of RR-/MDR-TB as recommended by the WHO.
WHO 2013 recording and reporting tools updated

5. Epidemiology Update

6. Estimate of TB Burden, 2015
MDGs achieved in 2015

7. Estimated Vs Notified

8. TB Case Notifications (2009-2016)

9. TB Case notification by Dzongkhags (2016)
993 cases in 8 districts accounting to 87% of the notified cases (Wangdi,
S/jong, Sarpang, Chukha, Thimphu,
Samtse, Mongar and Paro)

10. Estimated Vs. Notified

11. Notification of MDR-TB Cases: 2005-2016

12. Gearing towards TB Elimination by 2030
National Strategic Plan II ( )
Gearing towards TB Elimination by
2030

13. Goal
To reduce TB and DR-TB burden until it no longer poses a public health problem in Bhutan

14. Objectives
To increase case notification rate of at least 90% among estimated TB and MDR-TB
To maintain treatment success rate of at least 90% among Drug susceptible TB and 75% among MDR-TB
To Improve TB/HIV co-infection case detection and ensure 100% registration
To strengthen programmatic management of TB at all levels.

15. Implementing Partners
Grant Recipients
Principal Recipient
Ministry of Health
Implementing Partners
University of Medical Sciences of Bhutan

16. Modules and Interventions selected
TB care and prevention
Case detection and Diagnosis
Treatment
MDR-TB
TB-HIV
TB-HIV Collaborative interventions
Resilient Sustainable Systems for Health (RSSH)
Health Management information system and M& E

17. Targets The milestones for End TB strategy for 2030, the
target year for the SDGs:
To reach 90% of people who need treatment and treat them successfully by 2030
To reduce TB deaths by 90% by 2030
To reduce TB incidence by 80% by (less than 20 cases per 100,000 population)

18. Total Funding Need and Funding Request
Total NSP is USD 9.68 Million ( )
Total NSP Need for Funding cycle is USD 4.26 Million ( )
Anticipated Domestic Resources Million
Anticipated other resources-USD 30,000

19. National Strategic Plan(funding requirement )
Module Y1 Y2 Y3
Key AP
15500
MDR-TB-C&D
390300
124850
218650
MDR-TB-Treat
228050
176550
207710
Others
17500
RSSH
525214
478564
460214
TB care & prevention-C&D
263850
311578
242268
TB care & prevention-Treat
142900
88350
98400
TB-HIV
32600
88860
86800
Total

20. Anticipated Domestic Resources
RGOB support
804,515
848,599
892,019
Module Y1 Y2 Y3
Key AP
8045
8486
8920
MDR-TB-C&D
120677
84860
89202
MDR-TB-Treat
201129
127290
133803
Others
16090
16972
17840
RSSH
254580
267606
TB care & prevention-C&D
241355
TB care & prevention-Treat
64361
67888
71362
TB-HIV
32181
33944
35681
Total

21. Financial Gap- for the funding cycle

22. Total Allocation for Tuberculosis 2019-2021
USD 1,074, (1.074Million)

23. Module wise budget forecast (%)

24. Module wise budget forecast

25. Sustainability Commitment from RGOB
First Line TB Drugs procured through RGOB support
Infrastructure and HR
Bhutan Health Trust Fund mechanism

26. Proposal Development ProcessSl
Activity
Date
Remarks 1
35th CCM endorsed for Tailored Made Proposal
7th June 2017
Completed 2
Retreat to develop Zero drat proposal with TWG members
3rd -9th
July 2017 3
Submitted Zero Draft to PDC,WHO and TWG members for comments
10/07/2017 4
Received comments from WHO, SEARO and GF
20/07/2017 and 21/07/17 5
Reviewed and Incorporated the comments from technical Experts
11/08/2017 6
Submitted the first draft to PDC, TWG and WHO
28/07/2017 7
17/08/2017 8
Submitted the 2nd Draft to PDC, TWGs, WHO and GF for further comments and feedbacks
18/08/2017 9
Received Comments and feedbacks from GF and WHO/PDC members
21/08/2017 10
Review of the comments
Ongoing 11
Meeting with TWGS members to further review before the submission of proposal
24th August 2017
To be held 12
Online Submission
28th August 2017
Will be done

27. Thank you