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TB Track Evidence-based recommendations

TB Track Evidence-based recommendations. Structure Evidence (“What we learned?”) Recommendations (“What we can do?”) Relevant research topics (“How research can help?”) Discussion areas General International National Academic. General areas – 1. Evidence on ICIUM04

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TB Track Evidence-based recommendations

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  1. TB TrackEvidence-based recommendations • Structure • Evidence (“What we learned?”) • Recommendations (“What we can do?”) • Relevant research topics (“How research can help?”) • Discussion areas • General • International • National • Academic

  2. General areas – 1 • Evidence on ICIUM04 • ICIUM04 is very informative & inspiring • Excellent opportunity to mingle with drug management people • We are all happy: very high utility level • Recommendations • ICIUM, with Thai government, hold ICIUM conference regularly together with AIDS, Tuberculosis & Malaria (ATM) communities

  3. General areas – 2 • Evidence on Research results presented • High quality and relevant research presented • In particular, young researchers did wonderful work! • Researchers have some difficulties in publishing • Recommendations • ICIUM, with academic societies and national governments, support the researchers, particularly young researchers, to publish research results. • Support should include both technical and financial

  4. International area – 1 • Evidence on Global TB Drug Facility (GDF) • Global TB Drug Facility works well. • Many countries expanding DOTS with supply of high-quality TB drugs from GDF • Recommendations • WHO, GFATM continue to promote GDF • ICIUM give more attention to GDF • Research areas • Pharmaco-political analysis on GDF

  5. International area – 2 • Evidence on Drug management in TB • Drug management in TB is generally weak • Shortage of drug management experts in TB • Recommendations • TB/WHO & ICIUM make strong link & collaboration • ICIUM would be involved more in GFATM & “3 by 5”\ • GDF & ICIUM continue to organize training courses • Research areas • Joint operational research activities by TB & ICIUM • Effectiveness & cost-effectiveness of fixed dose combination • Drug management cycle: part. storage & distribution

  6. International area – 3 • Evidence on Drug management in TB • Weakness is reflection of not-so-high priority of general drug management • Essential drug is not a “sexy” topic • Recommendations • WHO, with help of ICIUM, make essential drug program (EDM) as international high-priority • ICIUM would be involved more in GFATM & “3 by 5” • Research areas • Political analysis of essential drug in global health

  7. National area – 1 • Evidence on DOTS • DOTS works well: 82% effectiveness globally • Countries, with complex situations, expanded DOTS • DOTS Plus can also work in complex situations • Recommendations • WHO, GFATM continue to promote DOTS, especially in the context of health sector reform • ICIUM give more attention to DOTS & DOTS Plus as means of rational use of anti-TB drugs • Research areas • Expansion of DOTS (& DOTS Plus) in difficult areas and hard-to-reach populations

  8. National area – 2 • Evidence on DOT (Direct observation of treatment) • Lack of scientific evidence on DOT effectiveness: There are empirical evidence exists though. • DOT needs supporting mechanisms • Incentives, social support, community based services (including “community pharmacists”), private-public mix • Recommendations • Government, with WHO, ICIUM, academic community, study on effectiveness of different types of DOT • Research areas • Effectiveness of different types of DOT, and incentives

  9. National area – 3 • Evidence on National drug management in TB • TB Drug management cycle is generally weak • A lot of pitfalls: particularly quality of drugs and training of health personnel • Recommendations • Develop link between TB & drug management, including training of pharmacists on DOTS/DOT • NTP, with MOH, continue to strengthen drug management, including anti-TB drug resistance survey/surveillance • Research areas • Management of TB drugs in the field (quality, health personnel..) • Anti-TB drug resistance survey/surveillance

  10. Academic areas – 1 • Evidence on Research results presented • High quality and relevant research presented • In particular, young researchers did wonderful work! • Researchers have some difficulties in publishing • Recommendations • ICIUM, with academic societies and national governments, support the researchers, particularly young researchers, to publish research results. • Make link with TB control programs • Research questions from program side

  11. Academic areas – 2 • Evidence on TB-drug management research • Many unsolved issues on TB drug management • DOTS, as functioning services (including surveillance) is a good research field • Recommendations • Academic society, with Stop TB, WHO and ICIUM, give more attention on TB-drug related research • Make link with TB control programs • Research areas • Rational use of anti-TB drugs: DOTS, DOT, DOTS Plus, incentive, drug quality, training, community involvement..

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