1. WHO global policy development process for TB/HIV
STOP TB Partnership and WHO
3rd Global TB/HIV Working Group Meeting June 4-6, Montreux, Switzerland.
WHO global policy development process for TB/HIV
Paul Nunn
GLOBAL PARTNERSHIP TO STOP TB

2. Vision
Patient focussed, collaborative action of TB and HIV/AIDS programmes at all levels
Effective use of all existing tools
Global strategies to implement, and rapidly scale up, TB/HIV care and prevention

3. Generic policy development process
TB/HIV policy development
Additional global level products for rapid scale up and implementation

4. Functions of WHO - Article 2
To act as the directing and co-ordinating authority on…health..
to establish and maintain effective collaboration with appropriate organisations
to stimulate work to eradicate epidemic diseases
to promote and conduct research
to make recommendations ...

5. WHO as Community

6. Information as raw material of policy

7. Information sources Ministries of health Development agencies
Research institutes
Non-governmental organisations
Community-based organisations
Civil society
Individuals

8. How do we turn data into policy?
Analysis of data
Creation of debate

9. The flow of debate

10. How do we turn data into policy?
Analysis of data
Creation of debate
Consultation
Meetings
and internet communications
Consensus development
Writing, publication and dissemination

11. Current TB /HIV policy stream
Strategic
framework
Interim Policy
Guidelines

12. Additional products for TB/HIV policy
Guidelines for HIV surveillance among TB patients
Guidelines for ARV treatment for TB patients
Policy options for reducing recurrence of TB among HIV + TB patients

13. Additional tools
Monitoring and evaluation systems for joint TB/HIV activities
Cost-effectiveness analyses of individual or packaged components
Training materials
Community-based care approaches to joint TB/HIV activities

14. Policy development process
Identify need
Identify writer
Form writing group from the WG members (TB and HIV)
Prepare drafts and consult widely
Develop consensus
Endorsement process
Core Group of the TB/HIV Working Group
WHO TB and HIV oversight groups

15. “Too much love can kill you just as sure as none at all”
Brian May/Queen

16. TB/HIV Draft Interim Policy - I
Not a separate TB/HIV programme
Establish national joint TB/HIV coordinating committee
Strengthen core activities
TB: DOTS
HIV: Prevention and care
General Health Services:
Refer TB and HIV suspects to specialised services

17. TB/HIV Draft Interim Policy - II
Establish joint TB/HIV activities
Entry point in TB services
Surveillance for HIV
VCT for TB patients
Cotrimoxazole for HIV + TB patients
ARV treatment for TB patients
Entry point in VCT
ICF for HIV clients
INH preventive therapy for individuals
?Programmatic INH preventive therapy

18. TB/HIV Draft Interim Policy - III
Conditions for establishing joint TB/HIV activities
Generalised HIV epidemics
Some concentrated HIV epidemics
Adequate DOTS performance (?default+failure+TO<15% )
Adequate HIV prevention and care
(?Indicator)
Adequate human resources
Adequate coverage of TB, HIV and GHS