Monitoring and evaluating the End TB Strategy

Photo: Riccardo Venturi

Haileyesus Getahun, MD, MPH, PhD. Global TB Programme WHO

• CDR • TSR • DOTS coverage

The TOP 10 prirority Indicators • TB treatment coverage • TB treatment success rate • Catastrophic costs due to TB • newly notified patients diagnosed

with rapid tests • LTBI treatment coverage • Contact investigation coverage • DST coverage for TB patients • New TB drug treatment coverage • HIV status among TB patients • Case fatality ratio (CFR)

DOTS EXPANSION • Case detection rate • Treatment success rate new • DOTS coverage DOTS PLUS • MDR-TB patients detected • % MDR-TB cases treated in DOTS-Plus • MDR-TB treatment success rate (%) TB/HIV • TB screening • IPT • TB patients HIV tested • CPT • ART PPM • Notified TB Cases

Operational indicators and associated targets for 10 areas

NTP NTP + NAP + Private + NGOs

MoH+ Other ministries beyond health

Paper based Mix of paper and electronic ? Exclusively electronic/digital

Context and evolution : M&E of TB strategies

Goal 3: Ensure healthy lives and promote well-being for all

Target 3.3- End the epidemics of

AIDS, tuberculosis, malaria & NTD

From stopping TB to ending the TB epidemic

Vision: A world free of TB Zero TB deaths, Zero TB disease, and Zero TB suffering Goal: End the Global TB epidemic

The WHO End TB strategy

PILLAR 1: INTEGRATED, PATIENT-CENTRED CARE AND PREVENTION

Core indicators of PILLAR 1: 9 out of the top 10 priority indicators

• % of new patients diagnosed with rapid tests

• Contact investigation coverage

• DST coverage

• TB treatment coverage

• New TB drug coverage

• TB treatment success rate

• Case fatality ratio

LTBI treatment

coverage in PLHIV and under 5 years old

children

Documented HIV status among TB

patients

PILLAR 2: BOLD POLICIES AND SUPPORTIVE SYSTEMS

Core indicator of PILLAR 2: one out of the top ten priority indicators

Percentage of TB-affected households

that experience catastrophic costs due

to TB

X X

X

Other non-top-10-priority indicators to measure Pillar 2

• % of TB patients with social protection

• % of population adequately nourished (FAO/WFP)

• % of annual budget in NSPs that is funded

• Public health spending per capita

• Coverage of case reporting to NTP(%)

• Total TB notifications from community referrals(%)

• TSR of patients with treatment support (%)

• % of population covered with insurance

• % THE accounted for OOP expenditures

• Case notification mandated by law (Y/N)

Non-top-10-priority process indicators to measure research pillar

* Source: WHO global TB data collection system, 2016

However,

Benin, Swaziland,

South Africa lack

routine system to

track community

contributions.

Measuring community contributions

Measuring private sector contributions

Reporting from the

private sector

increases with the

introduction of case-

based electronic

registers (e.g. India,

China)

Digital health is crucial enabler of M and E

NTP Other programmes

Non-health sector

The future of good TB programming to end to end the TB epidemic is dependent

on massive investment, joint work, openness and desire to change.

The future of good monitoring evaluation of the end TB efforts depend on investment and transition from paper based to digital

health approaches.

The future

Key documents for M and E

1. Share experiences, best practices, bottlenecks and enablers for M and E of the End TB strategy, TB/HIV and latent TB implementation;

2. To provide inputs and get updates on novel methods of data collection to monitor the implementation of the End TB strategy;

3. Identify critical actions and interventions to strengthen the monitoring of the End TB Strategy, TB/HIV and LTBI implementation;

4. Adapt critical actions and interventions to country context (roadmap) for subsequent follow up and investment through the Global Fund.

What do we want to achieve out of this meeting?