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MAKING GLOBAL HEALTH NEWS GENEVA, 17-18 MAY 2009

MAKING GLOBAL HEALTH NEWS GENEVA, 17-18 MAY 2009. 62nd WORLD HEALTH ASSEMBLY 2009 Overview of key topics and resolutions MDR & XDR TB. Ernesto Jaramillo Medical Officer Stop TB Department. Drug-resistant TB: definitions.

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MAKING GLOBAL HEALTH NEWS GENEVA, 17-18 MAY 2009

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  1. MAKING GLOBAL HEALTH NEWS GENEVA, 17-18 MAY 2009 62nd WORLD HEALTH ASSEMBLY 2009 Overview of key topics and resolutions MDR & XDR TB Ernesto Jaramillo Medical Officer Stop TB Department

  2. Drug-resistant TB: definitions • Multidrug-resistant TB (MDR-TB) is a form of TB caused by bacilli that are resistant to, at least, isoniazid and rifampicin. • Extensively resistant TB (XDR-TB) is MDR-TB PLUS resistance to any fluoroquinolones, AND any one of the second-line injectable drugs (amikacin, kanamycin, capreomycin) • Management of M/XDR-TB is a complex public health intervention

  3. Latest global TB estimates - 2007 Estimated number of cases Estimated number of deaths All forms of TB Greatest number of cases in Asia; greatest rates per capita in Africa 9.27 million (139 per 100,000) 1.77 million (27 per 100,000) Multidrug-resistant TB (MDR-TB) 511,000 ~150,000 Extensively drug-resistant TB (XDR-TB) ~30,000 ~50,000 HIV-associated TB 1.4 million (15%) 456,000

  4. 500,000 new MDR-TB cases estimated annually <5% of MDR-TB cases have access to diagnosis; <3% have access to treatment under WHO standards The problem Sources: Global TB Report, 2008 and IV Global DRS Report, 2008

  5. The challenge… • Universal access to diagnosis and treatment by 2015 • 60 billion US$ necessary to control TB in endemic countries • 11 billion US$ necessary to develop new tools, and • Political commitment to make it happen The Global Plan 2006-2015 defines direction and costs

  6. Ministerial Meeting of high M/XDR-TB burden Countries Beijing, China, 1-3 April 2009 • Representatives from 27 + 5+ governments, donors, affected communities, and technical agencies • recognized the global M/XDR-TB emergency • committed to urgently accelerate efforts to achieve universal access to prevention, diagnosis and treatment by 2015 • committed to develop/pursue national plans • endorsed the "Beijing call for action" • http://www.who.int/entity/tb_beijingmeeting/media/en_call_for_action.pdf

  7. Ministerial Meeting of high M/XDR-TB burden Countries Beijing, China, 1-3 April 2009 Main outcomes "Urgency and innovation" • Change and/or develop policies and identify innovative health system solutions • Research for, and developing of, new tools • Mobilize resources, domestic and external • Engage civil society and affected communities • Engage actors in- and outside health sector • Tackle all identified bottlenecks

  8. Ministerial Meeting of high M/XDR-TB burden Countries Beijing, China, 1-3 April 2009 Main outcomes - Policy decisions at the highest level • Pursue universal health coverage as a must to remove financial barriers • "Turn the tap off" – basic TB control and links with HIV programme are essential in many settings • Address health workforce crisis • Urgently develop "integrated" laboratory networks • Only use quality-assured drugs • Restrict use of drugs to accredited care providers • Implement infection control policies everywhere • Sustain and substantially increase investments

  9. MAKING GLOBAL HEALTH NEWS GENEVA, 17-18 MAY 2009 62nd WORLD HEALTH ASSEMBLY 2009 Overview of key topics and resolutions MDR & XDR TB Ernesto Jaramillo jaramilloe@who.int Medical Officer Stop TB Department

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