- Inter-Provincial Quarterly Meeting
The Quarterly Inter-Provincial Meeting discussed in detail the progress in order to identify the strengths, weaknesses, opportunities and challenges faced by the program in all the provinces including FATA, FANA and AJK. Also discussed was the future plans of the program. The Meeting recently held at Karachi was arranged by Ministry of Heath Islamabad. The National TB Control Program (NTP) considered the over all TB situation in Pakistan.
Dr. Noor Ahmad Baloch, National Manager NTP chaired the two-day meeting. The Provincial Managers, Mangers/Focal persons, Representatives of Directorates of AJK, FATA and FANA, Representatives of Provincial Laboratories, National Program Officers, ACSM Coordinators, Sociologists, Partners from Private Sector and the whole National team attended the meeting.
Dr. Noor Ahmad Baloch in his welcome address briefed the participants about the over all TB situation in Pakistan. He said that TB is a major public health problem today. WHO declared it as Global Emergency in 1993 and after that TB DOTS strategy was adopted by the world. In Pakistan every year 0.3 million new TB cases develop.
NTP & PTP with private sector implemented the New Stop TB Strategy and achieved 100 percent DOTS Coverage in 2005. Through sustained Commitment, Strengthening Partnership with Public and Private Sectors and introducing new initiatives, the program steadily improved case detection and treatment outcome for TB patients.
Dr. Ismat Ara, Program Manager, Provincial TB Control Program Sindh through her presentation briefed the participants about TB DOTS situation in Sindh. Talking about the health facilities she said that, there are 265 BMUs, 948 treatment Centers and more than 21000 LHWs in Sindh. At present 265 diagnostic centers have been established by the efforts of Provincial TB Control Program where free diagnosis facility is available. She highlighted the indicators from 2000 to 2008 and informed that in Sindh the default rate is 7%.
She said that, PPM activities have been initiated with the assistance of National TB Control Program in two districts i.e. Karachi and Larkana.
She urged that there is need to establish peripheral labs at intermediate levels. The drug management issue is also very important and it must be given total attention.
Dr. Abdul Latif, Project Director PTP NWFP briefed the participants about TB DOTS situation in NWFP. He informed that the population of NWFP is 22.5 million and in the province there are 219 Diagnostic Centres and 805 Treatment Centres.
In 2009, 18005 TB cases were registered whereas the Treatment Success Rates in 2008 was 94%.
Provincial TB Control Program NWFP plays an important role for rehabilitation of IDPs. The aims and objectives is to identify and encourage TB suspect referral for diagnosis to the nearby diagnostic centres and to operationalize TB services in affected districts on repatriation of IDPs.
Services like Establishment of diagnostic centre, Anti-TB Drugs, IEC Material, Banners & posters, Established linkages for TB suspect referral to diagnostic centres were given in collaboration with partners within the camp, he added.
Dr. Zafar Iqbal Toor, TB/HIV & MDR Coordinator, National TB Control Program Islamabad gave an Update on MDR-TB.
He stated that the National Guidelines for MDR-TB management have been developed and published. An Application to the GLC for procurement of SLD has been approved for 1500 pts in the next 2 yrs. Three institutions naming Indus Hospital Karachi, Ojha Institute of Chest Diseases Karachi and Gulab Devi Chest Hospital, Lahore has been selected for piloting MDR-TB in 2010.
A service contract with Aga Khan University for TB for 200 patients is under negotiation whereas first draft of National Infection Control Guidelines has been developed and circulated.
Representative from the Department of Health, Government of the State of Azad Jammu & Kashmir briefed the participants about TB DOT situation in AJK.
He further said that the CDR New all type up to Q-2, 2009 is 86%. Sputum Conversion Rate in Q-2, 2009 is 96%. The Treatment Success Rate in Q-2, 2008 is 96%.
Dr. Noor Ahmad Baloch through his presentation revealed that TB is a major public health problem. It is 8th among the HBCs and contributes about 55% of tuberculosis burden in EMR. Estimated 300,000 new TB cases develop each year. The incidence of sputum positive TB cases is 80/100,000 per year and for all types it is 181/100,000.
TB is responsible for 5.1 percent of the total national disease burden in Pakistan. The impact of TB on socio economic status is substantial.
NTP vision is a TB-free Pakistan whereas the goal is to substantially reduce the burden of TB by 2015 in line with the MDGs. The NTP objective is to reduce the human suffering and socioeconomic burden associated with TB and to protect vulnerable populations from TB, TB/HIV and drug resistant TB.
The New National Stop TB Strategy (2010–2015) includes six elements i.e. pursuing high-quality DOTS expansion and enhancement; Engaging all care providers; Addressing TB-HIV, MDR-TB and other challenges; Empowering people with TB, and communities; Enabling and promoting research; Contributing to health systems strengthening.
Through ACSM there can be improvement in TB knowledge, attitude, practices and the quality of life of people living with TB..
The second day of the meeting started with opening remarks by Dr. Iqbal Lahri, National Coordinator for PHC&FP in which he said that by playing direct and indirect role we can reduce poverty by influencing health status of people of Pakistan and also the health status of their community.
We are also contributing towards the gender empowerment by giving training to Lady Health Workers (LHWs) in rural areas. We are not only creating awareness but advocacy as well. We are also providing prevention, curative and rehabilitated services to their county and improving family individuals towards the health of mothers infant and children. Therefore, we are improving towards our health indicators, he added.
There is need to create more awareness for communicable disease. TB needs to be addressed. In Pakistan 0.3 million people die by TB. In the end, he extended his cooperation as coordinator to the NTP.
Dr. Ejaz of National TB Control Program on the occasion said that NTP is for the vulnerable public health initiative which have the largest number of partners. It works from the highest level policy making to inter level coordinator to district level coordination.
It is hoped that these partnership in future will address all those issues for which NTP have been competitive. The strategic framework would have to incorporate them in its future action for better outcome of TB Control activity.