1. 0 ERNA 2004 Scaling Up The Red Cross Red Crescent Response to Tuberculosis in Europe Region (strengthening the HIV/AIDS component) Krakow, 25-28 September, 2004

2. 1 Tuberculosis A Global Emergency 8 - 9 million new TB cases every year TB kills 5,000 people a day – 2 million each year One third of the world’s population is infected with TB

3. 2 STOP TB Partnership  DOTS strategy (Directly Observed Treatment, Short Course)  Global Targets: cure rate up to - 85% case Detection - 70%

4. 3 The 5 components of the internationally recommended TB control strategy Political and financial commitment Case detection by sputum smear microscopy and culture of TB suspects Directly observed and standardized short-course anti-TB chemotherapy (DOTS) Regular, uninterrupted supply of all essential anti-TB drugs A standardized recording and reporting system TB Register World Health Organization Regional Office for Europe

5. 4 Stop TB Partnership 2004 News March 2004, new Delhi – Meeting Participants from the Movement (Members of the Stop TB) - American Red Cross - Russian Red Cross - Secretariat

6. 5 World Health Organization Lessons learned  DOTS – the most cost effective  Less progress in case detection target  Limited access to diagnostic (partly because of weak social mobilization)  Political commitment in some countries to be increased  Focus on institutional capacity building  Partnership to be expanded to private sector, civil society, communities  TB / HIV  Advocacy / social mobilization

7. 6 Achievements & Aims 2001–2005  By 2001: National plans and increased commitments  By 2002: Accelerating detection rates to 37%  By 2005: 70/85 TB control targets

8. 7 70 80 85 100 5060708090100 DOTS detection rate (%) Treatment success (%) Cambodia Oma n Sri Lanka Guatemala Peru Morocco Maldives Viet Nam Cuba Slovenia Solomon Is Uruguay Qata r Mongolia USA Morocco Tanzania Venezuela Djibouti Chile Nicaragua TARGET ZONE Bosnia & Hezegovina Hong Kong DR Congo El Salvador Fiji French Polynesia Italy Kazakhstan Kenya Kyrgyzstan Latvia Lebanon Malta Marshall Is Portugal St Lucia Samoa South Africa Tonga Tunisia Turks & Caicos Is

9. 8 70 80 90 100 5060708090100110120 DOTS detection rate (%) Treatment success (%) TARGET ZONE 85 % 70 %

10. 9 HIV/AIDS ALWAYS ON BOARD IN TUBERCULOSIS PROGRAMMES Is it so?

11. 10 Summary HIV/TB - 2000 L Corbett et al. Arch. Int. Med. In press. 2002

12. 11 RC/RC in TB Control Programmes  Bulgaria  Russia  Ukraine  Moldova  Central Asia  Armenia  Azerbaijan (planned)  Romania (planned)  Macedonia (planned)  Georgia prisons (ICRC)  Azerbaijan prisons (ICRC)  Armenia prisons (ICRC)  Myanmar (GFATM)  Americas (Agreement between AmX and PAHO)  Africa – Integration TB and ART

13. 12 30 pilot projects in Russia and Central Asia Number of defaulters decreased by 30% Increased number of cured patients (from 65% to 73% in Pskov) Positive impact on TB control Motivation to complete the treatment Less side effects due to improved nutrition (results of interviews of TB patients in CA) 70-90% of patients completed the treatment Knowledge increase on the disease (by 30-80%) Psychological support helped RC/RC expertize in managing and implementing programme Role of the RC/RC in health care structure

14. 13  Partnership:  Role of the National Societies in TB working groups in respective countries  Information sharing between different partners  New partnership: Federation - Lilly  Involvement in MDR – TB (Kazakhstan, Russia)  From TB guidelines to TB Policy  Decision of the health commission to prepare the TB Policy.

15. 14 Next Steps ?????  TB will not go away tomorrow  Red Cross Red Crescent – one of the major players in  Effective interventions exist  RC/RC can reach more people Importance of increased partnership inside of the Movement More focus on social mobilization and voluntary involvement in TB programmes Working on new monitoring tools and quality analysis of programmes  TB / HIV  Identify areas of mutual benefit  Better integration between TB and HIV programmes

16. 15 For consideration in group works  If this is the level of what we do

17. 16 For consideration in group works  If this is the level of the needs (MOH)

18. 17 For consideration in group works  If this is the level we would like to achieve National Society Contribution

19. 18 For consideration in group works  How do we get there ? In 20 years

20. 19 For consideration in group works  Scaling up Strategy ? In 20 years In 2 yearsIn 5 years

21. 20 For consideration in group works 2 ideas (suggestions) for each issue: -Ways to increase voluntary involvement, community mobilization in TB Programmes -Ways to integrate TB / HIV -Way to increase partnership