1. USAID/Mexico Tuberculosis Program LAC PHN SOTA, March 2001

2. Tuberculosis PAHO Health in the Americas, 1998

3. % TB Cases in LAC Presence Countries PAHO Health in the Americas, 1998

4. Infectious Diseases - Funding Compared to Need % LAC TB Cases compared to %2000-2001 TB funding

5. USAID/Mexico Tuberculosis Strategy SO: A sustainable and effective institutional capacity developed to diagnose, control and monitor tuberculosis in target areas IR1 Improved national and local political and administrative commitment to a tuberculosis control program IR2 Increased use of laboratory-based diagnosis to identify tuberculosis cases IR3 Improved directly observed therapy meeting strict case definitions IR4 Improved mechanisms for monitoring program activities

6. Staffing and Other Support  USAID/Mexico: 1 full time USPSC, 1/2 FSN administrative assistant  SSA: 1 Tech. Project Coordinator, 1 Admin. Project Coord., 6 supervisors  USAID/W: LAC and Global Bureau technical backup, future global projects  USAID/ES: Technical, administrative, and legal support

7. USAID/Mexico Tuberculosis Strategy: Partners  Official Counterparts: Secretaría de Salud and USAID  Mexico partners: CVE, Mexico National TB Prev. and Control Program (including IMSS, IMSS-Solidaridad, and ISSSTE), INDRE, State Secretarías de Salud, NGOs  US partners: TATB, CDC, NGOs, Gorgas Institute, State Health Departments  Other donors: PAHO, Comité Nacional de Lucha contra la Tuberculosis

8. DIEZ CONTRA LA TUBERCULOSIS TEN AGAINST TB Baja California, Sonora, Chihuahua, Coahuila, Nuevo León and Tamaulipas California, Arizona, New Mexico, Texas

9. Common Objectives

10. Tuberculosis Strategic Objective Grant Agreement  Signed August 21, 2000 by Mexico’s Secretary of Health and the US Ambassador to Mexico  Stipulates planned contribution of US and Mexican Governments through 2004  Obligates first tranche of funding ($3.7 million)  Outlines program objectives, activities, performance indicators, and standard provisions

11. Priority Areas Baja California, Sonora, Chihuahua, Coahuila, Nuevo León and Tamaulipas Chiapas, Jalisco, Veracruz, Michoacán, Guerrero, Oaxaca and San Luis Potosí

12. Phase I Activities 1) Development of educational campaign 2) Promotion of interinstitutional collaboration 3) Strengthening laboratory network 4) Operations research: eval. of program operation; sensitization of personnel and public; detection, diagnosis and treatment; specimen handling; studies of cases, contacts and deaths; information systems. 5) Development of National Tuberculosis Management Information System and Evaluation of Border Epidemiological surveillance systems 6) Management and operation of Program at national level 7) Supervision and impact evaluation

13. 1) Priority municipalities 2) Laboratories performing sputum smear microscopy 3) Patients with respiratory symptoms to be identified 4) Expected cases of pulmonary tuberculosis 5) Contacts to be examined 6) Sputum smears to be processed 165 304 311,880 15,594 62,376 1’029,204 Tuberculosis Program in the 13 Priority States

14. 100 75 50 25 2000 2001 2002 2003 2004 Year PromotionPromotion TrainingTraining SupervisionSupervision Control Funding/Activities SSA/USAID States Infrastructure Diagnosis % Evaluation

15. U.S.-Mexico Binational Tuberculosis Card  43% of TB cases in the US are among the foreign-born (7553/ 17,531); and among the foreign-born, 23% of the cases are among the Mexican-born (1753/7553)  The U.S. Border States lead the nation in cases and incidence of TB  The six Mexican border states have TB case rates much higher than the U.S. border states

16. U.S.-Mexico Binational Tuberculosis Card  Collaboration between Mexico and the United States: –Ten Against TB –TB Net –Cure TB –The Binational Juntos Project –Migrant Health Core Group –USAID TB Program