2020 TB TREATMENT

116. Continue to support countries to prioritize the identification, diagnosis, and scale-up of TB preventive treatment, including children living with HIV, including via the Union Sub Saharan Africa Centre of Excellence for Child and Adolescent TB as well as in countries where we are working with National TB programmes.

117. Support the scale-up of access to priority formulations and diagnostics and to take steps to facilitate their wider roll-out including by performing operational research via The Union’s Centre of Operational research, and ensuring The Union’s existing paediatric publications and training tools are up to date and disseminated widely in a number of languages to promote the highest standard of care for all children with or at risk of TB.

118. Advocate for the rights of all children, including those living with HIV, to receive TB care and treatment and promote a human-rights based approach to TB; to urge governments to ensure that all children have access to the latest formulations and models of care for TB prevention and care; and to work together to reduce stigma and discrimination that stops children from accessing care that they need.

Updates

Commitment 116:

 

June 2022

The Sub-Saharan Africa Regional Child and Adolescent Tuberculosis Center for Excellence (COE)

  • In 2019, The Union in collaboration with CDC established a virtual regional Centre of Excellence (COE) for child and adolescent TB, coordinated and based in The Union Uganda Country Office. The primary focus for the COE is the sub-Saharan Africa, a region with a high burden of child and adolescent TB, HIV, and TB-related mortality. The establishment of this virtual platform followed a regional stakeholder meeting, convened by The Union in collaboration with CDC in Kampala, Uganda, in August 2019.  The founding member countries of the Sub-Saharan Africa Regional Child and Adolescent TB COE are Eswatini, Ethiopia, Kenya, Malawi, Mozambique, Tanzania Uganda, Zambia, and Zimbabwe. The COE working with its member countries is focused on strengthening policy, governance, and training as well as providing a platform for sharing best practices and technical knowledge for solving common challenges for child and adolescent TB service provision. The overall goal of the COE is to pursue the bold vision of the Childhood TB Roadmap over five years of The Union Cooperative Agreement “Partnering with the International Union Against Tuberculosis and Lung Disease to Foster Sustainable and Effective Systems to Strengthen the Delivery of Quality Tuberculosis (TB) Services in Resource-Limited Countries” by capacitating national leadership, bridging the policy-practice gap, and fostering partnerships across the region to improve and expand interventions to end child and adolescent TB. Purpose : The Union, in collaboration with CDC-GTB, will provide the COE member countries with support in capacity building and evidence base for NTPs to implement, support, and strengthen the prevention, detection and management of TB in children and adolescents to achieve the targets set by the WHO End TB Strategy and the UNHLM-TB.

 

CONTRIBUTING TO THE ELIMINATION OF TUBERCULOSIS IN AFRICA (CETA) project

  • In 2019, The Union launched the CETA project which aims to Contribute to the Elimination of Tuberculosis in Africa by 2035. The kick-off meeting took place virtually on 30 July 2020, with the eight NTP managers and several partners (including Alliance Côte d'Ivoire, DRAF TB, Global Fund, WHO Global TB Programme, WHO TDR).  The project supports national tuberculosis programmes in eight countries (Benin, Burkina Faso, Cameroon, Guinea, Central African Republic, Niger, Senegal, and Togo) with TB screening and prevention, improving healthcare delivery, and strengthening the governance of these NTPs. The project works to create a network of African experts who support each other and have ongoing access to the expertise of The Union, through workshops, courses, conferences, and online resources to continue to improve the care offered to people with or at risk of TB. This project is financed by The Agence Française de Développement.

  • The first approach of CETA project aims to improve TB screening and prevention with a particular focus on improving access to care for vulnerable populations, such as people living with HIV and children under 5 years. Using contact investigation to help with the early detection of active TB, allowing those diagnosed to be treated quickly, and anyone in close contact to be given preventive therapy to stop the spread of the disease. 

  • CI was implemented in 150 Basic Management Units identified across the eight countries of the project. Four hundred and fifteen nurses and healthcare worker were trained. Children under 5 and person living with HIV (PLHIV) are the two contact target populations. They were evaluated during home and clinic visits using standardized questionnaire, clinical examination and according to each country additional tests. Contacts with active TB received TB treatment and other preventive therapy (TPT). Data were collected each quarter using standardised forms. Meetings were organized with partners to share the preliminary results and to advocate for the scaling up.

  • From October 2020 to December 2021, 9 044 home visits were performed. Ninety-three percent of children under 5 living at home [(13 356/14 297)*100] received TPT (12 980) or TB treatment (376). Ninety-eight percent of PLHIV living at home [(283/376)*100)] received TPT (254) or TB Treatment (29). The ratio of children < 5 years and PLHIV per index case were respectively 1,6 and 0.013. The advocacy permits the scale up of CI in 6 countries throughout the Global Fund funding. For two countries, Togo and CAR advocacy are still ongoing. 

  • These results indicate that CI is feasible in programmatic condition within NTP of African countries. Lessons learned through this implementation are currently used for the scale-up phase. The scaling up financed by the Global Fund reflects the good collaboration between NTPs and international partners. 

October 2021

  • In collaboration with CDC/GTB, The Union, through this virtual platform, continues to provide regional support for Sub-Saharan Africa in capacity building and evidence base for National TB programmes to implement, support, and strengthen the prevention, detection, and management of TB in children and adolescents. Over the next several months (2021/2022), the COE will leverage its platform and engagement with member countries through a virtual training series to support countries to adapt and/or develop national capacity-building strategies for child and adolescent TB in anticipation of updated child and adolescent TB guidance from WHO. The virtual training series will take a phased approach, through which countries will: 

    • Session 1:   Have an introduction to the updated concept note and strategies of COE’s virtual development of Country Training Capacity and Approaches for child and adolescent TB, including the session outline. 

    • Session 2:   Share findings from countries’ review of their national training strategies, current training materials/resources, staff training needs for child and adolescent TB and existing partners supporting implementation of child and adolescent TB capacity-building efforts.

    • Session 3:   Become familiar with best practices for adapting and/or developing a national capacity building strategy for child and adolescent TB, incorporating best practices for adult learning;

    • Session 4:   Share best practices and lessons learned for similar capacity-building strategies in the African region for TB, as well as other programs; and 

    • Session 5:   Present their proposed national capacity-building strategy for child and adolescent TB, identify resource needs and discuss resource mobilization.  

 

April 2021

  • Held a Sub Saharan Africa Centre of Excellence for Child and Adolescent TB webinar on “Optimizing diagnosis of TB in children: Balancing clinical and laboratory-based methods to close the detection gap.” Attended by representatives from 8 sub Saharan African countries.

Commitment 17:

June 2021

  • Working with EGPAF and Unitaid developed the "Child and adolescent TB training course for healthcare workers."

 

Commitment 18:

April 2021