THE GLOBAL PLAN TO STOP TB,

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• THE GLOBAL PLAN TO STOP TB,
• 2006-2015
• Marcos Espinal
• Executive Secretary
• Stop TB Partnership
• Joint Meeting of the DOTS Expansion, TB/HIV and
  DOTS-Plus Working Groups
• 18 October, 2005
• Paris

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Presentation on Global Plan to Stop TB

• Outline of development of Global Plan
• what is the Global Plan?
• why do we need a Global Plan?
• the process of developing the Plan
• regional scenarios and Working Group plans
• expected impact
• next steps

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The Global Plan

• the Stop TB Partnership's plan for TB control
  over the decade 2006-2015, in working towards the
  goal to eliminate TB as a global public health
  problem by 2050
• a convincing argument for the resources needed
  for action, underpinned by rigorous
  epidemiological analysis with robust budget
  justifications

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The Global Plan (contd.)

• What activities are necessary (aimed towards
  reaching the Stop TB Partnership's targets for
  2015)?
• At what cost?
• With what impact (implementation WGs)?

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MDG 6 target 8

• "to have halted by 2015, and begun to reverse the
  incidence" of TB

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The Stop TB Partnership's targets

• by 2005
• at least 70 of people with infectious TB will
  be diagnosed and at least 85 cured
• by 2015
• the global burden of TB disease (prevalence and
  deaths) will be reduced by 50 relative to 1990
  levels
• (reducing prevalence to 155/100,000 and deaths
  to 14/100,000 per year by 2015)
• by 2050
• the global incidence of TB disease will be less
  than 1 case per million population

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Why do we need a Global Plan to Stop TB?

• As a vision of what we can achieveAs a roadmap
  to achieve targetsAs a tool for advocacy and
  fundraisingTo support long-term national
  planningTo stimulate research and development

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Process for developing the Global Plan to Stop TB

• Process is
• coordinated by Stop TB Partnership secretariat
• informed by feedback from first Global Plan
• guided by the Steering Committee
• driven by need to achieve 2015 targets in each
  region
• dependent on contributions of the 7 Stop TB
  Partnership WG
• (DOTS Expansion, DOTS-Plus, TB/HIV, drugs,
  diagnostics, vaccines, and advocacy,
  communications social mobilisation) and of the
  Secretariat
• based for implementation Working Groups on
  developing projections of the expected impact and
  costs of interventions needed to achieve 2015
  targets

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Global Plan has two key dimensions

• Strategic plans of Working Groups and of
  Secretariat
• Regional scenarios

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Benefits for each WG of development of strategic
plan

• Process
• engages stakeholders
• clarifies activities in line with strategic
  direction
• aids prioritisation
• identifies resource needs
• Product
• sets out activities (with timelines) linked to
  targets
• enables monitoring of progress towards goal
• helps resource mobilisation

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Nine epidemiological regions of the world
AFR high HIV
AFR low HIV
Central Europe
Eastern Europe
Established Market Economy
EMR
LAC
SEAR
WPR
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Implementation of DOTS, DOTS-plus and TB-HIV

• DOTS enhanced
• Expand DOTS, improve quality and effectiveness
• Community care, public-private or public-public
  mix (PPM), PAL
• New labs for culture and drug susceptibility
  testing (DST)
• DOTS-plus
• DST (new and retreatment)
• Treatment (new) or retreatment (previous) MDR-TB
• TB-HIV
• Active search for TB among HIV-infected, with TB
  treatment or isoniazid preventive therapy (IPT)
• HIV testing for TB patients, with antiretroviral
  therapy (ART) and/or cotrimoxazole (CPT) TB
  treatment
• Advocacy, communication, social mobilization

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Development of regional scenarios

• Step 1. Defining and costing intervention
  packages
• e.g. DOTS expansion (complete DOTS coverage,
  improved quality of DOTS, PPM DOTS, community
  DOTS, PAL, culture services, DST and new
  diagnostics).
• Step 2. Estimating the magnitude and pace of
  scaling up of activities
• Step 3. Estimating TB control outcomes and impact
  
• Step 4. Estimating the cost of DOTS expansion,
  DOTS-Plus, TB/HIV and diagnostics

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Summary of planned achievements of R D WGs
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Summary of main messages (1)

• Over the ten years of this Plan, about 50 million
  people will be treated for TB under the Global
  Strategy to Stop TB, including about 800,000
  MDR-TB patients, and about 3 million TB/HIV
  patients will be enrolled on ART.
• Some 14 million lives will be saved from
  2006-2015.
• The first new TB drug for 40 years will be
  introduced in 2010, with a new short TB regimen
  (1-2 months) shortly after.
• By 2010 "point of care" diagnostics will enable
  rapid, sensitive and inexpensive detection of
  active TB. By 2012, a diagnostic toolbox will
  accurately identify people with latent TB
  infection and those at high risk of progression
  to disease.

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Summary of main messages (2)

• Full funding (US 55 billion) for implementation
  of the Plan would result in achievement of
• the MDG "to have halted by 2015, and begun to
  reverse the incidence" of TB
• the Partnerships 2015 targets to halve
  prevalence and death rates from a 1990 baseline
  globally, with enormous progress in all regions
• the 2015 targets most likely later than 2015 in
• E Europe and even later in Africa

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Conclusion together let's Stop TB!

• Next steps
• 1. Global Plan launch at the World Economic Forum
  at Davos, 29 January 2006
• 2. Use the Global Plan
• a) to mobilise funds
• to continue current levels of funding
• to fill the US 35 billion funding gap
• (depends on the commitment of national
  governments and all those who fund TB control,
  and on fulfilling this commitment)
• b) to inform the development of regional plans to
  Stop TB
• c) to assess progress in implementation of the WG
  and secretariat strategic plans
• 3. Measure impact