Ending Drug-Resistant Tuberculosis in Central Asia

Speeches Shim

The Ending Drug-Resistant Tuberculosis in Central Asia activity is based on a comprehensive multi-component approach to provide support to the National Tuberculosis Programs (NTPs) of Kazakhstan, the Kyrgyz Republic, Tajikistan, Turkmenistan, and Uzbekistan in significantly scaling up the prevention, detection, and treatment of drug-resistant tuberculosis (DR-TB).

Our Work

The overall goal of this activity is to improve the prevention, detection, and treatment of DR-TB in Kazakhstan, the Kyrgyz Republic, Tajikistan, Turkmenistan, and Uzbekistan. The activity supports the NTPs to implement TB control interventions that contribute to reaching targets set forth in the United Nations High Level Meeting of the General Assembly to Fight TB in September 2018, the United States Government Global TB Strategy 2015-2019 and updated National Action Plan for Combating Multidrug-Resistant Tuberculosis (MDR-TB) to respond to the global challenges of MDR-TB 2020 - 2025, and WHO End TB Strategy. The activity focuses on high-level policy engagement with national governments and provides technical assistance with the introduction and scale up of new approaches for DR-TB treatment and care.

Activity Highlights

The main challenge in TB control in Central Asian countries is a high burden of multidrug-rifampicin-resistant tuberculosis (MDR/RR-TB). To address these challenges, the activity:

  • Assists in development and update of the National TB Strategic Plans and strengthening regulatory frameworks.
  • Supports introduction, implementation, and scale-up of latest WHO-recommended Guidelines for TB and DR-TB prevention and programmatic management of TB preventive treatment to enhance contact tracing, identification and testing of individuals at high risk, increased access to quality DR-TB diagnostics, ensure access to quality treatment and care for all TB patients. 
  • Updates National Clinical Protocols on DR-TB management, provides training of trainers (ToT) to instruct TB doctors at all levels on operationalizing new clinical protocols.
  • Stimulates and supports introduction of newly recommended modified fully oral shorter treatment regimens for DR-TB under operational research conditions by facilitating evidence-based decision making and advocating for patient-centered approach.
  • Assists the NTPs on strengthening surveillance and monitoring and evaluation (M&E) systems for effective TB case management.

Key Accomplishments

The Regional Initiative to introduce modified shorter treatment regimens (mSTR) under operational research (OR) conditions has been initiated in 14 countries in the WHO European Region, including countries in Central Asia. Under this initiative, Kazakhstan, Turkmenistan, Tajikistan, and Uzbekistan were supported in adapting the WHO generic operational research protocol to country conditions and submitting for approval by local Ethics Review Committees and WHO Ethics Review Committee. Enrollment of patients is ongoing, with over 100 patients enrolled so far.

Kazakhstan:

  • Assistance was provided with development of the National TB Strategic Plan 2021-2025. 
  • National Guideline on TB Preventative Therapy development has started, two international experts have been selected to support guideline development.
  • ToT on programmatic management of DR-TB was conducted for 41 national trainers in collaboration with WHO EURO and WHO Collaborating Center in Belarus.

Tajikistan:

  • A technical working group established to develop National Plan for Transition to new WHO Treatment Guidelines on MDR/RR-TB, experts were contracted.
  • Assistance and on-the-job training were provided for implementation of the National TB electronic database through M&E visits with the Ministry of Health and NTP staff.

Turkmenistan

  • National clinical protocol on treatment of DR-TB was updated based on WHO recent recommendations, 10 TB specialists from the national level were trained.
  • Development of the National Guideline on TB Control in Prisons was initiated, 15 medical staff of penitentiary system were trained on TB control in prisons.
  • National Guidelines on M&E were developed by elaborating key interventions and indicators to ensure effective workflow and creation of quality TB data, 13 key NTP M&E staff and supervisors were trained.

Uzbekistan: 

  • Assistance was provided on development of the National TB Strategic Plan for 2021-2025.
  • A series of laboratory trainings organized to ensure early diagnosis of all forms of TB, universal access to drug susceptibility test and strengthening laboratory network. In total, 15 laboratory specialists and 48 TB clinicians were trained in three regions.
  • Development of the National Clinical Protocol on case management of pulmonary TB and training modules to support countrywide introductions initiated. 
  • National Clinical Protocol on latent TB infection case management was updated to align with latest WHO recommendations.  
  • A technical working group under the Ministry of Health leadership was assembled to develop patient-centered model and protocols to support TB patients.
  • Adoption of the District Health Information Software 2 TB tracker was facilitated as the most advanced strategic tool for guiding national health authorities in management and implementation of appropriate TB activities.

PROJECT AREA

Kazakhstan, the Kyrgyz Republic, Tajikistan, Turkmenistan, and Uzbekistan

PROJECT DURATION: October 2019 – September 2022                                                     

IMPLEMENTING AGENCY: World Health Organization (WHO)

CONTACT

Sholpan Makhmudova, Agreement Officer’s Representative,

USAID/Central Asia

Email: smakhmudova@usaid.gov                                                                       

IMPLEMENTING PARTNER CONTACTS:

Ogtay Gozalov, Medical Officer

WHO Regional Office for Europe

Email: gozalovo@who.in

Last updated: March 17, 2021

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