TB/HIV COLLABORATION IN GHANA

1. TB/HIV COLLABORATION IN GHANA Dr. Nii Nortey Hanson – Nortey National TB Control Programme Accra

2. STATISTICS • In Accra Metro for the 2nd Quarter of 2006, a total of 138 patients were diagnosed with TB. • 71% tested for HIV and 51% were positive. • Of this 66% were started on Co-trimoxazole and were eligible for ART.

3. RATIONALE • Recognition that TB is the most important opportunistic infection in HIV and causes increased morbidity and mortality. • Also increases the progression of HIV infection to clinical AIDS - HIV is fanning the TB epidemic in Ghana.

4. PURPOSE • To decrease the morbidity and mortality of TB and HIV in Ghana. • To enhance the activities of the NTP & NACP in providing quality care, prevention and support at all service delivery points in Ghana for people living with, or at risk of TB & HIV.

5. Background Information • Mechanism for collaborative HIV/TB activities initiated in early 2005 at the national level - National HIV/TB Coordinating Body • Goal: To take advantage of the natural synergies and complimentarity of the two programs to develop collaborative programme • Various stakeholders meetings called to collect information and generate consensus to develop policy • Roles and responsibilities for HIV/TB collaborative activities by NACP and NTP defined

6. Implementation TB/HIV collaboration is to be achieved by effective implementation of • Recommended DOTS strategy for TB control • Improved HIV prevention and care • Additional collaborative TB/HIV activities e.g. routine offer of HIV testing to all patients attending clinics in Ghana

7. MODE OF IMPLEMENTATION • The NTP is well established in all districts (Ghana has 100% DOTS coverage) and has strengths that can be synergistic with the national scale up of HAART. • The NACP & HAART program are relatively new and both patients and health workers will benefit from closer collaboration. • Increased efficiencies and elimination of overlap will help reduce costs.

8. NOTE WELL • Duplication of efforts minimized and care taken to coordinate budgets • A focal person for joint HIV/TB collaboration has been identified. • Office established at the Central TB Unit to coordinate and ensure joint TB/HIV activities. • Policy document prepared and completed NO NEW PROGRAMME SET UP

9. Strategies • Strengthening the health system to respond to the TB/HIV dual epidemic • Decreasing the burden of TB among PLWHIV and • Decreasing the burden of HIV in TB patients.

10. Strategic activities to be rolled out in phases • Scale up will be synchronised with the roll out of the NACP HAART services • The TB/HIV collaborative strategies will be implemented by the NACP and NTP, the Teaching Hospitals, NGOs, CBOs, FBOs and the private sector

11. Health System strengthening in response to TB/HIV • Coordination of TB/HIV activities at all levels • Joint TB/HIV planning • Partnership Development and coordination (National, Community, Public-Private) • Resource mobilization and deployment • Joint Advocacy, Communication and Social Mobilization • Operational Research to enhance TB/HIV collaboration • Health and Infrastructure Development • Building Partnerships with communities, PLWHIV and NGOs • Surveillance • Supervision, Monitoring and Evaluation (M&E)

12. Decrease the burden of TB in PLWHIV • Prevention of TB Infection in PLWHIV • Intensified TB Case Finding in PLWHIV with early diagnosis and treatment of HIV associated TB • Prevention of TB Disease in PLWHIV

13. Decrease the burden of HIV in people living with TB • Prevention of HIV in TB Patients • Provision of Antiretroviral Treatment for TB patients during TB treatment • HIV Care and Support for HIV-positive TB patients during and after TB treatment • Prevention of Opportunistic Infections in PLWHIV with TB

14. THANK YOU