Second Africa TB Regional Conference on Management of TB Medicines

Africa TB Conference 2012, Zanzibar December 5-7, 2012

Summary of First Africa Regional Conference on Tuberculosis (TB) Pharmaceutical Management

Niranjan Konduri Zanzibar, Tanzania 5 December 2012

Global/Regional/Country documents emphasize on various dimensions of access to anti-tuberculosis medicines

PURPOSE • To share ideas and experiences about challenges and

interventions to improving TB medicine and supply management, use, and safety

25 countries represented in 1st Africa TB Conference, Johannesburg (2011)

Countries: Angola, Botswana, Burkina Faso, Central African Republic, Cote D'Ivoire, DRC, Ethiopia, Ghana, Guinea, Kenya, Lesotho, Madagascar, Mali, Mauritania, Mozambique, Namibia, Nigeria, Rwanda, South Africa, South Sudan, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe Source: http://bighugelabs.com/map.php (new map of South Sudan not available)

Notes – 1) Total participants = 87 – not counting MSH staff 2) NGOs include both international and in-country entities

Africa TB Conference (2011) - Participants

Topics discussed (1)

• Panel 1: Regional Perspective on current strengths and challenges in TB diagnosis and treatment in Africa

• Panel 2: Financing and Procurement of TB Commodities

• Panel 3: Impact of current and new TB diagnostic tools on pharmaceutical management

Topics discussed (2)

• Panel 4: Strengthening pharmaceutical human resources for TB control

• Panel 5: Strengthening management information systems for TB

• Panel 6: Pharmacovigilance for TB medicines

Topics discussed (3)

• Panel 7: Building public private partnerships to reduce spread of DR TB

• Panel 8: New regimens to overcome pharmaceutical management challenges

• Panel 9: TB/HIV management and service integration

Key barriers for scale-up of MDR-TB Programs (as discussed in July 2011)

• Lack of political commitment • Inadequate diagnostics capacity • Inadequate logistics and supply management systems • Limited availability of second-line medicines • Inadequate human resource capacity and management • Lack of national frameworks for involvement of private

sector • More expensive second-line TB medicines and long

duration of treatment for MDR/XDR-TB

Main solutions for the African region (as summarized by participants in July 2011 ) • To improve program performance by improving

DOTS, medicine supply, laboratory services, information system for decision making, rational use and medicine safety, and human resources capacity

• Donors and partners should continue to strengthen capacity of countries through mentorship

• Countries need to take ownership of their programs

Break-Out Groups

• Group 1: Strategies for Introduction of new TB technologies: A systems approach

• Group 2: Public-private mix for TB care and control • Group 3: Using TB information system for effective

decision making • Group 4: Rational medicine use and patient safety

Recommendations for Action

Examples of Global Level Response

March-2012 May - 2012

“Conclusions and Next Steps” (from July 2011 Recommendations for Action)

• “The conference’s goal was to agree on recommendations and plan for the region’s way forward.”

“Now it is up to the respective country programs to apply information shared at national level and decide on the most appropriate plan of action for their context. Suitable partners can then be approached to support country plans.”

Zanzibar (2012) - Participants Donor, 3

MOH, 4

NGO, 22 NTP, 22

Other, 5

Zanzibar (2012) – African countries represented

• DR Congo • Ethiopia • Kenya • Malawi • Mali • Mozambique • Nigeria

• Rwanda • South Africa • South Sudan • Swaziland • Tanzania • Uganda • Zambia • Zimbabwe

Note – new map of South Sudan not available