TIME FOR CHANGE :
New Approaches for Managing Drug-Resistant TB in Regions with High HIV Rates
New Approaches for Managing Drug-Resistant TB in Regions with High HIV Rates
What: AIDS and Rights Alliance for Southern Africa (ARASA), Médecins Sans Frontières (MSF), Open Society Institute (OSI), Partners in Health (PIH) and Treatment Action Campaign (TAC) are organizing a satellite meeting during the 38th World Conference on Lung Health to highlight the challenges of diagnosing and treating drug-resistant tuberculosis in southern Africa and other regions with high HIV rates. The satellite will underline the urgent imperative to explore novel approaches in such settings.
When: Friday, 9 November 2007; 13:00 – 15:30 (sandwiches provided)
Where: Arabella Sheraton Hotel, Convention Square, Lower Long Street, Cape Town.
Why: Tuberculosis (TB) is the leading cause of death among people with HIV/AIDS in sub-Saharan Africa. The World Health Organization (WHO) estimates that up to 80 percent of TB patients are living with HIV in the region. However, with today’s limited diagnostic tools and lack of laboratory capacity in many rural settings, smear-negative TB, extra-pulmonary TB (common in people living with HIV) and drug-resistant TB are difficult to detect.
Treatment for drug-resistant TB is not widely available in most parts of southern Africa. Where treatment exists, it is usually centralised and facility-based. This approach contributes to long waiting lists and poses constraints for patients and their families.
Experience in fighting drug-resistant TB to date comes mainly from Eastern Europe and South America, but the situation is radically different in southern Africa, forcing governmental and non-governmental agencies to think outside-the-box about where and how to manage diagnosis and treatment of drug-resistant TB, infection control, and treatment adherence.
At the TIME FOR CHANGE satellite, representatives of the WHO, national TB programs, field-based medical NGOs, and activists will discuss the merits and challenges of decentralized, community-based drug-resistant TB management in southern Africa.
Key questions to be addressed:
Agenda :
When: Friday, 9 November 2007; 13:00 – 15:30 (sandwiches provided)
Where: Arabella Sheraton Hotel, Convention Square, Lower Long Street, Cape Town.
Why: Tuberculosis (TB) is the leading cause of death among people with HIV/AIDS in sub-Saharan Africa. The World Health Organization (WHO) estimates that up to 80 percent of TB patients are living with HIV in the region. However, with today’s limited diagnostic tools and lack of laboratory capacity in many rural settings, smear-negative TB, extra-pulmonary TB (common in people living with HIV) and drug-resistant TB are difficult to detect.
Treatment for drug-resistant TB is not widely available in most parts of southern Africa. Where treatment exists, it is usually centralised and facility-based. This approach contributes to long waiting lists and poses constraints for patients and their families.
Experience in fighting drug-resistant TB to date comes mainly from Eastern Europe and South America, but the situation is radically different in southern Africa, forcing governmental and non-governmental agencies to think outside-the-box about where and how to manage diagnosis and treatment of drug-resistant TB, infection control, and treatment adherence.
At the TIME FOR CHANGE satellite, representatives of the WHO, national TB programs, field-based medical NGOs, and activists will discuss the merits and challenges of decentralized, community-based drug-resistant TB management in southern Africa.
Key questions to be addressed:
- What are the limitations and risks of hospital-based drug-resistant TB treatment in settings with limited resources and high HIV infection rates?
- What new treatment approaches could be implemented given the limitations of current tools?
- What is the most appropriate treatment regimen in a region where second-line drugs are largely used and extensively drug-resistant TB (XDR-TB) is already prevalent?
- How can access to culture and drug susceptibility testing be increased in the region?
- What would be the most appropriate case-finding strategy for early detection of drug-resistant TB in a context of high HIV and drug-resistant TB prevalence?
- What lessons for TB treatment can we learn from patient-centred approaches to HIV/AIDS treatment?
- How can community health workers and activists contribute to improving diagnosis of drug-resistant TB and adherence to treatment?
- How can governments, NGOs, and activists effectively push for research and development of new diagnostic and therapeutic tools?
- How can advocacy efforts ensure that patients benefit from the best possible quality of care according to today’s available tools and knowledge?
- What national, regional, and international policy opportunities and struggles lie ahead?
For any information about this satellite, please contact Marta Darder : marta.darder@msf.org.za
Agenda :
13h00 - 13h10 : WELCOME :
Vuyiseka Dubula, Western Cape Coordinator, TAC and Cynthia Eyakuze, Director, OSI Public Health Watch
Vuyiseka Dubula, Western Cape Coordinator, TAC and Cynthia Eyakuze, Director, OSI Public Health Watch
13h10 - 14h00 : THINKING DIFFERENTLY :
Governmental and non-governmental actors in southern Africa are thinking outside-the-box about where and how to manage diagnosis and treatment of drug-resistant TB, infection control, and treatment adherence.
Chair: Gregg Gonsalves, Coordinator, Regional Program on HIV Treatment and Prevention Literacy and Advocacy, ARASA
Governmental and non-governmental actors in southern Africa are thinking outside-the-box about where and how to manage diagnosis and treatment of drug-resistant TB, infection control, and treatment adherence.
Chair: Gregg Gonsalves, Coordinator, Regional Program on HIV Treatment and Prevention Literacy and Advocacy, ARASA
- Why the "old" way of diagnosing and treating MDR TB won't work in high HIV prevalence settings (Dr Salmaan Keshavjee, Deputy Country Director, PIH Lesotho)
- New approaches to diagnosing and treating MDR-TB and HIV (Dr Eric Goemaere, Head of Mission, MSF South Africa)
- The imperative of a Patient-Centered Approach to Adherence: Treatment Literacy for HIV/TB (Johanna Ncala, National Treatment Literacy Coordinator, TAC)
14h00 - 14h40 : FACING THE CHALLENGES OF IMPLEMENTATION: A LOOK TO LESOTHO
A moderated discussion to highlight specific initiatives underway in Lesotho at the programmatic level to address MDR-TB and HIV.
Chair: Dr Francis Varaine, Chair, TB Working Group, MSF
Speakers
A moderated discussion to highlight specific initiatives underway in Lesotho at the programmatic level to address MDR-TB and HIV.
Chair: Dr Francis Varaine, Chair, TB Working Group, MSF
Speakers
- Dr Pheello Lethola, HIV and TB Doctor, MSF Lesotho
- Dr Hind Satti, MDR-TB Project Director, PIH Lesotho
- Dr Kefas Samson, Advisor to the National TB Program, MOHSW, Lesotho
14h40 – 15h30 : CHALLENGING TB ORTHODOXY: CONFRONTING POLICY BARRIERS :
A moderated discussion with policy makers, clinicians and activists about what it will take to implement new approaches and validate new tools to improve diagnosis and management of MDR-TB in high HIV prevalence settings.
Chair: Dr. Joia Mukherjee, Medical Director, PIH
Panelists
A moderated discussion with policy makers, clinicians and activists about what it will take to implement new approaches and validate new tools to improve diagnosis and management of MDR-TB in high HIV prevalence settings.
Chair: Dr. Joia Mukherjee, Medical Director, PIH
Panelists
- Dr Rhehab Chimzizi, TB/HIV Program Officer, National TB Program, Malawi
- Dr Mario Raviglione, Director of Stop TB Department, World Health Organization
- Zackie Achmat, Chair, TAC
- A clinician - TBC
