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Transcript of The Global Laboratory Initiative Assisting countries to implement the WHA resolution on MDR-TB Karin...
The Global Laboratory Initiative
Assisting countries to implement the WHA resolution on MDR-TB
Karin Weyer, WHO-STB, GLI secretariat John Ridderhof, CDC, GLI chair
TB/HIV Core Group meetingGeneva, November 3-4, 2009
Global Laboratory Initiative
Platform of coordination and communication, providing the required infrastructure, focused on TB laboratory strengthening, in the areas of:
•Global policy guidance (norms, standards, best practices)
•Laboratory capacity development
•Interface with other laboratory networks, enabling integration
•Standardised laboratory quality assurance
•Coordination of technical assistance
•Effective knowledge sharing
•Advocacy and resource mobilisation
GLI structure & governance
GLI Secretariat
GLI Partners Committee
GLI Core Group
Stop TB Partnership
Laboratory strengthening roadmap
Human resource development strategy
Laboratory biosafety
Laboratory accreditation
Other
Evaluates, approves, governsprojects; Advises GLI Secretariat
Advises and approves strategic agenda of GLI; Monitors project progress
WHO Stop TB Department
Priority projects and activities Time limited
Partner approach
Tec
hn
ical
Wo
rkin
g G
rou
ps
GLI Secretariat GLI Working Group
GLI Network
~100.000 smear lab centers200.000-300.000 personnel
~8.000 advanced diagnostic centers40.000 – 50.000 personnel
28 SRLs supporting 150 NRLs
>70 GLI Members
WHO GLI Office
Knowledge sharing - Coordinating TA, training- Communication
technologies- Online knowledge
resource network
Interface connection- Matchmaking projects
between countries and implementing partners
- National “roadmaps”- Advocacy - Other disease networks
Assurance activities - Coordination of EQA- Equipment specifications- Global accreditation system- Monitoring/evaluation
Guidance- Laboratory policies- Laboratory manuals- Training materials- Resource mobilization- National roadmap advice
Key GLI activities
Capacity building(expanding SRLN, building diverse and flexible national, regional, international
consultants base, systematic and structured training)
7 STP WGs
Technical Agencies
Other Laboratory Networks
Other Diseases
GLI strategic priorities
• Accelerating evidence-based policy development on diagnostics and laboratory practices
• Promoting a structured framework/roadmap for TB laboratory strengthening within the context of national laboratory plans at country level
• Developing a comprehensive set of tools, norms and standards based on international standards and best-practice
• Advancing laboratory strengthening through global, regional and local partnerships
• Developing multi-level laboratory human resource strategies to address the capacity crisis
• Accelerating new diagnostics into countries
• Accelerated uptake of new MDR-TB diagnostics in 27 countries, 2009 - 2013 (additional 15 planned by 2012)
• State-of the-art commodities (instruments, tests, reagents) funded by UNITAID
• Leverage other local partners to address non-commodity components (infrastructure, training, etc.)
• Long-term mentoring and TA: in-country hands-on support to optimise technology and knowledge transfer, closely linked to capacity building
• Full ownership of MOH, NTP, Laboratory• Integrated laboratory approach (notably TB and HIV)• Adjustment based on growing evidence ('learning by
doing')
• Policies, norms international standards
• Participate in lab assessments
• Provide long-term, on-site monitoring
• Develop indicators and tools for M&E
Funding for essential instruments, reagents, supplies
Logistics and supplies
Human Resources
(Guidelines
Technology transfer)
Infrastructure Quality Assurance
Linked referral systems and
reporting
• Negotiate with partners to ensure lowest prices
• Ensure customer support in place
• Share know-how from product development process
• Provide long-term, on-site mentoring for technology transfer
• Coordinate and manage procurement and delivery
• With FIND, engage industry to ensure affordability and sustained price decreases
• Collaborate with WHO Pre-qualification to include diagnostics
8
Category 1: start in 2009Category 2: start in 2010Category 3: start in 2011
Recipient countries Recipient countries
2,036
31,227
94,443
115,929129,670
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
pa
tie
nts
2009 2010 2011 2012 2013
Project targets*
6
25
25
2727
Co
un
trie
s
Total
* Targets calculated as a % of estimated MDR-TB burden: 80% for most countries; 35% for India and 60% for Zambia and Cameroon
Country partners
• American Society for Microbiology• Centers for Disease Control and Prevention• Johns Hopkins University• GHESKIO• Global AIDS Programme• GTZ• KfW Bank, Germany• KNCV• Ministeries of Health, through NTPs• Partners in Health• PEPFAR• OGAC• Project Hope• ICRC• The Global Fund• The Union• USAID• WHO Supranational Reference Laboratory Network• …
Future scale-up
• EXPAND-TB– 15 additional countries by 2012
• Other low-income, high-endemic countries– Adoption of EXPAND-TB model with other funding sources and
other laboratory initiatives (eg. HIV, Malaria, H1N1)
• Middle-income, high-endemic countries– Two-pronged approach (manufacturers and laboratory networks) in
innovative PPM models
• Acceleration of GLI human resource development plan– At least 50 global consultants– At least 50 long-term, on-site mentors– Up to 20,000 laboratory technicians with advance skills– MOH responsibilities in revised human resource plans & strategies
Global targets met for MDR-TB patients diagnosedand provided with appropriate treatment
under international standards of care
Diagnostics
Drugs
Patient care