1. COUNTRY ACTION: SUSTAINABLE INVESTMENT STOP TB PARTNERSHIP FORUM STOP TB PARTNERSHIP FORUM 24TH-26TH MARCH 2004 24TH-26TH MARCH 2004 BY BY MRS NENADI USMAN MRS NENADI USMAN HONOURABLE MINISTER OF STATE FOR FINANCE, FEDERAL REPUBLIC OF NIGERIA HONOURABLE MINISTER OF STATE FOR FINANCE, FEDERAL REPUBLIC OF NIGERIA

2. Introduction Significant advances were made in the 20 th Century like eradication of smallpox and the reduction of the incidence of childhood immunizable and preventable diseases. Significant advances were made in the 20 th Century like eradication of smallpox and the reduction of the incidence of childhood immunizable and preventable diseases. Still there is high burden of infectious diseases, under-nutrition and complications of childbirth. Still there is high burden of infectious diseases, under-nutrition and complications of childbirth. Re-emergence of TB and the emergence of infectious diseases like HIV/AIDS Re-emergence of TB and the emergence of infectious diseases like HIV/AIDS

3. Introduction cont. Introduction cont. The problems have prompted global concerns: The problems have prompted global concerns: - WHO declared TB a global emergency in 1993 - WHO declared TB a global emergency in 1993 -Amsterdam Ministerial Conference to Stop TB in 2000 -WHA Declaration of global targets (70% detection & 85% cure of infectious TB) -WHA Declaration of global targets (70% detection & 85% cure of infectious TB) - The millennium Development Goals. Nigeria has contributed to this history by hosting the African Summit on HIV/AIDS, TB and other infectious diseases. Nigeria has contributed to this history by hosting the African Summit on HIV/AIDS, TB and other infectious diseases. Since TB affects the most productive age group with the consequences on the economy, investment in TB control is not just an option but a necessary means of spurring economic growth and social development. Since TB affects the most productive age group with the consequences on the economy, investment in TB control is not just an option but a necessary means of spurring economic growth and social development.

4. The Key Areas The Key Areas Improving public sector resource allocation and increase coverage and quality of DOTS service provision Improving public sector resource allocation and increase coverage and quality of DOTS service provision Mobilizing private sector in the DOTS expansion strategy implementation Mobilizing private sector in the DOTS expansion strategy implementation Securing additional resources from new global mechanisms such as the Global fund to Fight AIDS, Tuberculosis and Malaria (GFATM) Securing additional resources from new global mechanisms such as the Global fund to Fight AIDS, Tuberculosis and Malaria (GFATM) Providing gender sensitive and equitable access to essential medicines and technology in collaboration with the Stop TB partnership (Global Drug Facility) Providing gender sensitive and equitable access to essential medicines and technology in collaboration with the Stop TB partnership (Global Drug Facility) Improve the institutional and human resource capacity of the entire health systems within the context of the National Reform Agenda. Improve the institutional and human resource capacity of the entire health systems within the context of the National Reform Agenda.

5. Key Areas Cont. Sustainable action to reduce poverty through the National Poverty Eradication Programme Sustainable action to reduce poverty through the National Poverty Eradication Programme Tracking progress and achievement through a reliable Health Information System. Tracking progress and achievement through a reliable Health Information System. Development and implementation of strategies to respond to the Multi-Drug Resistance Tuberculosis (MDR). Development and implementation of strategies to respond to the Multi-Drug Resistance Tuberculosis (MDR).

6. Progress Expansion of in-country TB control partnership Expansion of in-country TB control partnership All the 36 States and FCT are implementing the DOTS strategy All the 36 States and FCT are implementing the DOTS strategy The case notification has increased by 33% The case notification has increased by 33% Treatment success of 79.7% has been recorded for all detected smear positive cases as at 2001 Treatment success of 79.7% has been recorded for all detected smear positive cases as at 2001 The supervision of the programme has improved. The supervision of the programme has improved.

7. WHY WE NEED SUSTAINABLE INVESTMENT FOR DOTS Linkage between ill- health and poverty Disease burden due to TB Need to reach the TB target of 2005 and MDGs by 2015

8. GETTING SUSTAINABLE INVESTEMENTS FOR DOTS - sources A) EXTERNAL Global drug facility GDF Global fund for AIDS TB and Malaria Multilateral and bilateral donors Foundations, voluntary ORGS, NGOS Private donors etc

9. B) NATIONAL Adequate budgetary allocation to health at all levels eg. Nigeria’s NEEDS, SEEDS AND LEEDS Private sector Communities, etc

10. MAKING EFFECTIVE AND EFFICIENT USE OF THE INVESTMENT Improve the institutional and human resource capacity of the entire health systems within the context of the national reform agenda. Improve the institutional and human resource capacity of the entire health systems within the context of the national reform agenda. Improve diagnostic capacity Build capacity of health workers to detect and treat Strengthen monitoring systems

11. Strengthen drug procurement system to ensure ready supply of TB drugs Invest in vaccine research and production Invest in advocacy and communications Invest in poverty reduction projects /programs

12. CONCLUSION CONCLUSION Priority support from all our Development Partners as TB, HIV/AIDS and Malaria are growing threats to our survival and economic development. Priority support from all our Development Partners as TB, HIV/AIDS and Malaria are growing threats to our survival and economic development. Debt reduction or cancellation to make resources available for the health and development programmes. Debt reduction or cancellation to make resources available for the health and development programmes.

13. Thank you Thank you