The National TB Programme was featured at Tuesday’s plenary at the 37th Union World Conference on Lung Health in Paris.
This incomprehensible transcript was provided by the Kaiser Family Foundation website at http://www.kaisernetwork.org/health_cast/uploaded_files/103106_wlh_ws_countries1_transcript.pdf
If you don’t have time to go through it the [him] moderator would like to turn your attention to the amusing answer given to the question in the last few lines of it.
The well-produced slides are attached or available at http://www.kaisernetwork.org/health_cast/uploaded_files/103106_experiences_Maung1.pdf
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We move on. The next presentation will be from Win Maung and I’d like to invite Dr. Win Maung to present his presentation.
DR. WIN MAUNG: Good morning and good afternoon for all our participants. Our colleagues, I am from Myanmar and I would like to present the planning in line with the Stop TB strategy and the global plan to stop TB 2006-2015. Now okay.
Myanmar is surrounded by China, India, Bangladesh, Laos and Thailand. Our population is about 51.4 million for 2005 and our country is in low-income levels and our national TB program [inaudible] more than 100,000 TB cases in 2005 and HIV situation, HIV prevalence in the general population is estimated at 1.3-percent and HIV prevalence among the TB patients is estimated as 7.1-percent and our nationwide drug resistance done in 2002 and 2003, which showed that our [inaudible] new cases MDR-TB is 4-percent and re-treatment is [inaudible] MDR-TBs is about 15.5-percent and our [inaudible] started the [inaudible] in 1994 with only 18,000 [misspelled?]. In our country there are about – there 325,000 and we started in 1997 with [misspelled?] dose strategy. In those days, our country implemented dose strategy in 152,000 – that is less than [inaudible] is 15-percent. In 2003, our gradually expand [misspelled?] our DOT expansion and improved on the treatment with [inaudible] we can cover the whole country, 325,000 and as you see in our outline [misspelled?] in 2005, our case deduction rate is 95-percent and the [inaudible] rate is 84-percent and our [inaudible] rate since 1997-1998 to 2004, our [inaudible] rate is [inaudible] in line with the 82-percent. In 2005, it rose up to the 84-percent and – yes – progress in the control TB in 2001 to 2004 is our decentralization of [inaudible] microscopy as [inaudible] and some in the rural areas and the establishment of the national TB laboratory in 2001 and public-private [inaudible] with the NGOs and [inaudible] drug facilities supported since 2002 and 2002 and 2004, we had the standard [inaudible] review [inaudible] is done and the standard quality [inaudible] laboratory and the first nationwide drug assistance [inaudible] in 2002 and 2003. I have already mentioned it and the progress in TB control in 2005 is that we have developed a 5-year mission strategy plan in 2005 and our Ministry of Health has proved it and we drove this 5-year mission strategy plan in line with [inaudible] TB strategy and global TB plan and with the [inaudible]. Our public-private [inaudible] operational guideline is published and TB/HIV treatment guideline published in 2005 and Global Fund [inaudible] fight TB and malaria grant is we implement [inaudible] generally fast to [inaudible]. Although the Global Fund is dominated, but we have [inaudible] to implement our activity in the face of [inaudible] up to the [inaudible] but although we can get opportunity, we can [inaudible] of like [inaudible] and we can continue [inaudible]. So that is the Global Fund, [inaudible] 82-percent who [inaudible] is one of the assistant - the one of the [inaudible] of the Global Fund [inaudible] Global Fund. Integrated HIV care for TB patients with the [inaudible] order of union [misspelled?] and [inaudible] started in 2005 [inaudible] and two additional TB/HIV [inaudible] TB/HIV [inaudible]. HIV prevalence among TB patients in [inaudible]. HIV [inaudible] patient is 32. In the [inaudible] is 15-percent and [inaudible] is 25-percent and TB cases and the [inaudible] is [inaudible] is 62-percent, in the region it’s 52-percent and in the county [misspelled?], it’s 34-percent and global drug facility [inaudible] 2008. As progress in TB control in 2006 and we have the new three disease fund established to fight TB, HIV, and malaria totally for three disease, $99.5 million for five years and human [inaudible] is [inaudible], TB/HIV initiated of HIV [inaudible] and [inaudible] TB [inaudible] can be established to develop national guidelines to treat the [inaudible] and TB. [inaudible] treated by our national TB control program. Our [inaudible] Association - [inaudible] establishment of a standard quality [inaudible] quality control of [inaudible] and [inaudible] project in the one division [inaudible] division to implement in hard to reach areas and the [inaudible] drug facility review in 2006 and that is with the Global Fund, we can train the [inaudible] in 2006 is in the [inaudible]. We can train the targeted of [inaudible] is 81-percent and [inaudible] is 7-percent and the lab technician is 46-percent. So that the rest, we train, we hope that with the assistance of the three disease fund or the [inaudible] and TB prevalence [inaudible] division is finalized in 2006 and we found that 15-percent of half of the TB patients are underdosed and ¼ is in the private sector or the GP and ¼ is [inaudible] they don’t know where to go and they don’t [inaudible] highlights to me or to us how this area is [inaudible] and give our effort. Planning for the [inaudible] 2006 and 2010 – in 2005, we had a 5-year mission strategy plan for TB control we have already mentioned and then we developed a regional plan for [inaudible] our national strategy plan, which includes the [inaudible]. The [inaudible] when the Global Fund is downgraded in the 21st of August, 2006 and the three disease fund will come but we don’t know when we will start and so the [inaudible] that we need [inaudible] fund so that in the three disease fund, that we propose the [inaudible] fund and it included design to have mobilized funding from the new disease fund [inaudible] implemented by our national TB program and [inaudible] implemented by our Global Fund [inaudible], our global partner - INGO [misspelled?], and our NGO [inaudible] plan facilitated by the [inaudible], which is designed to help plan [inaudible] by getting in line with the global plan and Stop TB strategy at country level. The budget for operational plan – all activities and that is for the year one – that is available [inaudible] for the first line drug that is for the program management and supervision like that. That is for the 3-year our operational plan. There is a funding [inaudible]. For the year 1, our available money funding is $7.5 million and our funding cap is 5.5. For year 2, our funding availability is $3.9 and the cap is 10.2. That is why we cannot [inaudible] our international NGO – they don’t know how many funds will come to then so that we cannot include their international NGO fund in this towards year two and year three so that funding cap is high. This figure includes all partners of national and international NGOs [inaudible] and global drug facility to [inaudible] HON [misspelled?], that is, we hope that three disease fund. We have plenty activities and challenges for the Stop TB strategies. Therefore, the Stop TB strategy - high quality, dose expansion, and enhancement so we decentralized [inaudible] through the health center and we revised national TB guidelines and we mobilized the team for the remote and hard to reach areas by our [inaudible] and we consider [inaudible] guideline [inaudible]. Our other challenge is you really assess a patient to dose strategies [misspelled?] and resource mobilization for first line drug for up to 2008 after global drug facilities [inaudible], that is maybe our challenge. The Stop TB strategy component to TB/HIV and MDR-TB and other challenges. We have the [inaudible] collaborated TB/HIV prevention and control activities and TB/HIV and MDR-TB guidelines, we will develop in the near future, integration of TB and HIV [inaudible] and our HIV prevalence among TB patients [inaudible] will be included in that national AIDS program [inaudible] and [inaudible] application for the MDR-TB treatment project – we will start and the one is [inaudible] but that will come in the near future and [inaudible] to establish the guidelines and for application [inaudible] and establishment of services [inaudible] at sub-national level. In our country, there is only two facilities – one in [inaudible] and one in [inaudible] facility and the only one drug facility or [inaudible] disease facility in the [inaudible]. So the [inaudible] the established sub-regional level – one sub-regional level in [inaudible] division and second regimen [inaudible] drug resistance [inaudible] in 2007. Our challenges may be the [inaudible] high drug resistance levels – I have already mentioned in the past and the immediate capacity to diagnose and management of the MDR-TBs. That is our challenges for TB/HIV, MDR-TB, and other challenges. The strategy component two – health systems [inaudible] health [inaudible] at all levels including [inaudible] training, logistic management, budgets, and planning. In 2006, a standard review mission [inaudible] come to our country and the challenges, the limited human resources with necessary competency at the [inaudible] level. The [inaudible] strategy – another one is engage all care providers. [inaudible] public, private [inaudible] and the public [inaudible] activities including integration of major public hospitals and the prison [misspelled?]. The challenge - maintain quality during scaling up of [inaudible] dose. Scaling up of [inaudible] activities including integration of major public hospitals and the prison. Our [inaudible], we plan to give training in the GB [misspelled?] [inaudible] training to the private laboratory and training to our public hospital and the township covers. We plan like this to engage all care providers.
Another disease Stop strategy is involving people with TB in the community. Our major activity planned is [inaudible] strategy and implementation of the [inaudible] project for hard to reach populations in one division in Yema [misspelled?]. Our challenges [inaudible] scaling up of communication strategy, improving community awareness of TB program and another strategy is [inaudible] and the [inaudible]. National prevalence survey – now we have conducted the Yema [misspelled?] division TB prevalence survey [inaudible] and so that we went to [inaudible] TB [inaudible]where we are so that we went to two national prevalence surveys and the number two is maintaining the partnerships with the researcher and the academic institutions. That is regional planning and budgets too and this is very comprehensive and easy to use and requirement [inaudible] easily identified. The issue that is [inaudible] and graph it can get to [inaudible] in time and [inaudible] approved by all partners of the developmental joint operational plans and all major funding - the proposal - and that is like a [inaudible] budget sheet so that we can see it separately, clearly and easily but when we already developed the 5-year mission and strategy plan, we can get the regional planning and budget [inaudible]. In [inaudible] it is easy to update and revise [inaudible] automatically update [inaudible] when something is delayed and activities are postponed.
In our conclusion – number one is Stop TB Partnership in Yema is moving toward global TB control target despite the very limited resources and thanks to our high quality commitment, dedicated our staff and strong community support [inaudible] coordinating with our partners and continue to raise your technical assistance and number two is the [inaudible] additional resources mobilization is necessary to build on the three disease fund mechanism supported by the [inaudible] European community and also [inaudible] government to fully cover our [inaudible] needs.
Thank you. [applause]
MALE SPEAKER: Thank you very much Dr. Maung for the presentation of the solid work and planning in Myanmar. Is there any questions? I will allow for one. Yeah?
MALE SPEAKER: Thank you very much for your presentation. My name is [inaudible] and I am representing AIDS Foundation East-West. We work in Eastern Europe and Central Asia and there the epidemic is a bit similar in your country in that I believe your country has also a high number of HIV-infected people who are infected through injecting drug use, am I right?
DR. WIN MAUNG: Yes and now there is not so many.
MALE SPEAKER: But you have quite a number of injecting drug users who are infected with HIV, is that right or not? Because otherwise my question is irrelevant.
DR. WIN MAUNG: [inaudible] country, the HIV positive man is sexually transmitted…
MALE SPEAKER: Mostly sexually transmitted?
DR. WIN MAUNG: Yes.
MALE SPEAKER: Okay. Then I will leave my question because…
DR. WIN MAUNG: Because they use disposable needles.
MALE SPEAKER: Okay. Let me just [inaudible]. Do we have any TB services directed at injecting drug users especially as a vulnerable group?
DR. WIN MAUNG: Yes. I’m the TB program manager. This question should be asked to the Mission to AIDS program
MALE SPEAKER: See that’s the problem. Yes.
MALE SPEAKER: Okay. Thank you very much again Dr. Maung.
