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The ProTEST Projects:Achievements so far Philip Onyebujoh Stop TB, Communicable Diseases

The ProTEST Projects:Achievements so far Philip Onyebujoh Stop TB, Communicable Diseases World Health Organization Global TB/HIV Working group Meeting, Durban 14-16 June 2002. This presentation will cover…. Goals and objectives of the ProTEST Initiative

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The ProTEST Projects:Achievements so far Philip Onyebujoh Stop TB, Communicable Diseases

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  1. The ProTEST Projects:Achievements so far Philip Onyebujoh Stop TB, Communicable Diseases World Health Organization Global TB/HIV Working group Meeting, Durban 14-16 June 2002

  2. This presentation will cover…... • Goals and objectives of the ProTEST Initiative • Update of activities in each of the 3 countries piloting ProTEST • Key achievements and constraints by countries • Plans for Phased implementation activities (PIA) and next steps World Health Organization

  3. ProTEST Initiative Goals: To reduce the dual TB/HIV burdens 1.Reduce HIV transmission Good quality VCT 2. Reduce TB transmission Improved TB case finding 3. Reduce TB reactivation in HIV+ Preventive therapy for TB

  4. ProTEST Goals……. To reduce the dual TB/HIV burdens 4. Facilitate collaboration TB and HIV public and private stakeholders at district level 5. Improve comprehensive HIV/AIDS/STI/TB care & referral to ensure continuum of care

  5. Progress so far... • South Africa (1999-2002) • VCT clients: 31,456; 10,211 HIV + (shift from medical to self-referred) • IPTrecipients:1,810 out of 4,078 (44%) HIV+ clients (adherence; 13%-63%) • CPT recipients:1,218 out of 3,636 (34%) HIV+ clients (adherence: 5%-64%) • ICF: 77 (6%) out of 1,265 HIV+ clients (WC) World Health Organization

  6. Progress….Summary of achievements & constraints • Feasibility of TB/HIV programme collaboration • Rapid tests important in uptake of VCT • District Health committees critical for Programme collaboration • Rollout plans developed by district & Provincial co-ordinators: 5 year medium term plans for roll out • GFATM award to drive expansion plans • Adherence to IPT, CPT and TB case finding (ICF) still suboptimal • Capacity development by collaboration • Referral network important for joint activities World Health Organization

  7. Progress so far... • Malawi (1999-2002) • VCT clients: 28,827; 6,657(23%) HIV + (shift from medical to self-referred) • IPTrecipients:465(85% of IPT-screened HIV+ clients) (adherence: 29 %) • CPT recipients: 908clients (adherence:83% ? Incomplete cohort analysis) • ICF: 15 (8 sm+ve & 7 SM-ve) out of 10,135 clients seen at VCT sites World Health Organization

  8. Progress….Summary of achievements & constraints • Feasibility of joint TB and HIV programmes • Unmet demand for VCT (uptake) • Adherence to IPT&CPT suboptimal. • Improved District collaboration with ProTEST, NTP & other stakeholders (PMG) • Roll out plans developed by PMG • Impediments to rollout: • Donor reluctance to fund “HIV/AIDS” activities • continuous reorganisation of NACP • HSR and Sector-wide approach World Health Organization

  9. Progress so far • Zambia (1999-2002) • VCT clients: 12,697 (gp counselled) 7,221(57%) tested and 2019 (29%) HIV + • IPTrecipients:765 (52%) out of 1,468 clients (Adherence in Matero 17%) • CPT recipients: Not documented • ICF: 150 (7%) out of 2019 HIV+ clients World Health Organization

  10. Progress...Zambia…Achievements & Constraints • Good district collaboration services • Rollout plans by TB WG & CBoH • Promotion of TB committees & focal persons • Challenges to implementing good IPT and ICF strategies • Impediments to rollout • Suboptimal NTP: Attempts at improvement • Resource constraints: New GFATM+ CDC funds to assist rollout. World Health Organization

  11. Gaps • Impact of VCT on sexual behaviour • Cost/Cost effectiveness of interventions promoted • How to improve ICF and PT adherence • Is IPT and CPT cost effective • Impact of HAART on TB/HIV burden • Any other interventions • How to ensure & sustain programme collaboration World Health Organization

  12. Next steps: Phased implementation…. Implementation of TB/HIV interventions thro’ pilot sites & expanding step-by-step to national coverage • Proposals submitted for review and funding (? role of GFATM) • Implementation workshops held • Capacity development needs defined • Standard indicators piloted in choice district • M/E plans agreed between facilitators and country teams • Scheme of technical assistance for monitoring finalised World Health Organization

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