Over 130 participants from countries, partners and civil society came together on 20-21 October at the second Strategic Initiative meeting on ‘Finding the Missing People with TB’. The meeting focused on progress achieved in the first year of implementation of the ambitious initiative of the Global Fund to find and treat an additional 1.5 million missing cases of TB by the end of 2019. Organized jointly by WHO with the Global Fund, Stop TB Partnership and USAID in the Hague on the sidelines of the 49th Union Conference on Lung Health, the meeting brought together national TB programme managers and staff from the 13 countries, in-country TB technical partners, the Global Fund, Stop TB Partnership, USAID, KNCV, KIT, and other key international partners, as well as representatives from WHO HQ, regional and country offices.
The Global Fund Strategic Initiative ‘Finding missing people with TB’ aims to support 13 priority countries to close gaps in care, especially in key populations and vulnerable groups, and to roll-out patient-centered community and innovative approaches.
During the meeting countries presented their progress, successes and challenges on finding missing cases. Six relevant theme-specific panel discussions were held to explore and exchange lessons learnt, these included: i) reaching missing people through expanded private sector engagement; ii) community engagement/active case finding/paediatric TB and contact tracing; iii) facility based screening, including TB/HIV; iv) data/private public hospitals; v) MDR-TB; and vi) laboratory expansion.
The country-led discussions were very constructive and informative and at the end country participants commented on how much they had learnt from each other.
For example, South Africa led the way in implementing WHO diagnostic guidelines; screening around 4% of the population annually using X-pert and planning further gains through improving the screening quality in clinics. Quality improvements in clinic services leading to increasing case finding was also a feature of the Tanzania and Kenya experience.
India, Pakistan and Bangladesh have seen a large increase in notifications from the private sector through private sector engagement, which may include support with notification through call centres, mobile devices, incentives, mandatory notification, and patient financial support to avoid catastrophic costs.
Indonesia is focusing on improving its monitoring and evaluation system after a prevalence survey and an inventory study revealed up to 40% of patients were being treated but not notified; and is seeing a large increase in case finding this year.
Most countries are on track to meet their case finding targets and the Global Fund grants strategic focus on case finding is incentivizing this.
A further meeting is planned at the next Union Conference on Lung Health in Hyderabad, India in November 2019 to further review the implementation progress and share lessons learnt.