1. 5th DEWG meeting Conclusions
Karam Shah: chair
Carmelia Basri: rapporteur
L. Blanc, M. Grzemska: secretariat
Paris 28th October 2004

2. DOTS Progresses the link with implementation

3. LAB: proposed actions to DEWG
Countries to increase resources for laboratories
Strengthening HR for laboratory work (Quantity, Quality)
Establish Quality Assurance system
High quality equipment and laboratory supplies
Collaboration NTP and Laboratory managers
Development of standardized training package
Strengthening the managerial capacity of NRL managers
(training of trainers)
Facilitate field evaluation of new diagnostic tools

4. DOTS is evolving Making explicit the Patient Centred approach
1993 WHA TB as a Global emergency
1994 Standardized framework for TB control
1996 DOTS is branded
2000/2002 An expanded DOTS framework
2005 ? Expanded DOTS and Standard of Care
Making explicit the Patient Centred approach

5. TB control strategy today
It is based on the "Expanded DOTS Framework for TB control" published in 2002
Political commitment
Diagnosis with bacteriology confirmation (microscopy , culture and DST)
Standardized treatment under proper case management conditions, including DOT
Uninterrupted drug supply to the patient
An adequate recording and reporting of cases and treatment outcomes.
Stop TB Department 7

6. Main directions to accelerate DOTS expansion and to reach all patients
Expanding and sustaining DOTS achievements within strengthened health systems
(1) DOTS, the public health strategy for TB control, and (2) the importance of individual patient care with DOTS
Improve diagnostic capacity and reliability
Engage all care providers, public and private, to increase access and use of standard of care, especially among the poorest
Community participation and social mobilization for TB care
Stop TB Department 14

7. Main directions to accelerate DOTS expansion and to reach all patients
Streamline TB/HIV activities and treatment of MDR-TB with DOTS programme activities.
Strengthen M&E for problem-solving and to measure achievements vis-à-vis WHA & MDG targets
Increase communication among Stop TB Partnership Working Groups
Stop TB Department 14

8. Link with GFATM, WB, bilateral and multilateral donors
Need to broaden scope of activities and include
- Laboratory strengthening
- Engage all health care providers: PPM-DOTS
- Human resources/Capacity building: ISAC
- Secure quality drug supply (GDF)
- Advocacy and communication, social mobilisation
- Building partnership and fund it
- DRS and MDR-TB
- TB/HIV
- Monitoring : internal and external, MDGs
MIP should now be convinced that DOTS expansion is a human right and a major public health priority.
What can MIP do?
MIP needs to support, promote and finance GDEP.
MIP partners need to help establish national/regional partnerships.
MIP should support integration of action by partners into GDEP.
MIP can ensure GDF is part of GDEP.
By virtue of our knowledge of plans, partners, and gaps, MIP can promote GDEP as a template for proper investment of funds and a means to strengthen international assistance.

9. Conclusion Planning the period 2006-2015 Global DOTS expansion plan
Regional plans and country plans
Think about the possible availability of new tool
Year 2001 : preparation
Year 2002 : implementation
Year 2003 : scaling up
Year 2004 : accelerating actions
Year 2005 : broadening the scope of interventions
MIP should now be convinced that DOTS expansion is a human right and a major public health priority.
What can MIP do?
MIP needs to support, promote and finance GDEP.
MIP partners need to help establish national/regional partnerships.
MIP should support integration of action by partners into GDEP.
MIP can ensure GDF is part of GDEP.
By virtue of our knowledge of plans, partners, and gaps, MIP can promote GDEP as a template for proper investment of funds and a means to strengthen international assistance.