Fighting Drug-Resistant TB in the 21st Century: Novel Approaches to Improving Access to anti-TB Medicines and Pharmaceutical Services
1st Conference on Pharmaceutical Management for TB and M/XDR-TB for WHO European Region
Antalya, Turkey, 10 – 13 December, 2013
The United States Agency for International Development (USAID)- funded SIAPS Program, implemented by Management Sciences for Health, the World Health Organization and Stop TB partners jointly hosted the first WHO European Regional conference on Improving Access to anti-TB Medicines and Pharmaceutical Services to fight TB and MDR/XDR-TB to highlight the importance of access to anti-TB medicines in the treatment of M/XDR‐TB.
Below is the agenda with links to the English and Russian presentations.
| Session Title and Chair | Content | Presenter |
| Day 1 – Tuesday, December 10, 2013 | ||
| Welcome and Official Conference OpeningDr. Raed Arafat, Conference Chair | Welcome by the Chair of the Conference | Dr. Raed Arafat, Secretary of State, Ministry of Health of Romania |
| Welcome by the Ministry of Health of Turkey | Dr. Seher Musaonbasioglu, Manager of the National TB Program of Turkey | |
| Welcome by WHO EURO | Dr Masoud Dara, WHO Regional Office for Europe Programme Manager / Medical Officer Tuberculosis and M/XDR-TB ProgrammeDr. Martin Van Den Boom, WHO Regional Office for Europe, TB Program Focal Officer | |
| Welcome by United States Agency for International Development | Thomas Chiang,Senior TB Technical Advisor, USAID | |
| Welcome by SIAPS | Francis Aboagye–Nyame, Director, Systems for Improved Access to Pharmaceuticals and Services (SIAPS) Program | |
| Welcome by Global Drug Facility (GDF) | Joel Keravec, Head of Operations, Global Drug Facility (GDF), Stop TB Partnership | |
| Opening Remarks | Pharmaceutical Supply Systems and Access to Anti–TB Medicines in the Environment of Growing Drug Resistance [ENG] [RUS] | Andre Zagorski, Principal Technical Advisor for Tuberculosis (SIAPS) |
| Conference Program Overview | Introduction to Conference Objectives and Program | Archil Salakaia, Senior Technical Advisor (SIAPS) |
| Panel 1: WHO Europe regional perspectives on current strengths and challenges for TB controlDr. Martin van den Boom, ChairDr. Olga Pavlova, Chair | Status of implementation of consolidated action plan to prevent and combat MDR/XDR–TB in the WHO Europe Region [ENG] [RUS] | Dr. Martin van den Boom, WHO Regional Office for Europe, TB Program Officer |
| Overview of TB control in Turkey [ENG] [RUS] | Dr. Seher Musaonbasioglu, Head of Tuberculosis Department, Public Health Institution of Turkey | |
| Overview of TB control in Russia with the emphasis on TB pharmaceutical management [ENG] [RUS] | Andrey Moskalev, Chief Specialist, Ministry of Health of the Russian Federation | |
| MDR–TB roadmap: management of anti–TB medicines in WHO Europe Region [ENG] [RUS] | Nigor Muzafarova, Technical Officer for Tuberculosis (GDF) | |
| Panel discussion and Q&A session | ||
| Panel 2: Regulatory and quality assurance implications on the management of anti–TB medicinesOlexandr Polishchuk, ChairRita Seicas, Chair | Main challenges for the region that may result from weak regulatory control [ENG] [RUS] | Olexandr Polishchuk, WHO |
| Promoting the quality of medicines program technical assistance for the WHO Prequalification Program [ENG] [RUS] | Allan Hong, Manager, Promoting the Quality of Medicines Program, United States Pharmacopeia (USP) | |
| Regulatory system for pharmaceuticals in Republic of Uzbekistan [ENG] [RUS] | Ismat Azizov, Deputy Director, Directorate of Medicines and Medical Equipment Quality Control, Republic of Uzbekistan | |
| Medicines regulation in Armenia: regulatory and quality challenges for TB drugs in small markets [ENG] [RUS] | Lilit Ghazaryan, Deputy Director of the National Scientific Center for Drug Expertise and Medical Technologies, Armenia | |
| Panel discussion and Q&A | ||
| Panel 3: Rational Use, Pharmacovigilance, and Patient Safety for TB MedicinesAskar Yedilbayev, ChairMavluda Makhmudova, Chair | Rational use of Anti–TB Medicines for management of DR–TB [ENG] [RUS] | Askar Yedilbayev, Program Director/Medical Officer (Partners in Health) |
| Pharmocovigilance: approach to addressing problems related to use of anti–TB medicines [ENG] [RUS] | Oksana Lebega, Senior Technical Advisor (SIAPS Ukraine) | |
| Pharmacovigilance system in Ukraine: role of pharmacovigilance in implementation of national TB control program [ENG] [RUS] | Irina Logvina, Deputy Director of Department for Post–Registration Medicine Use, State Expert Commission of Ukraine | |
| Drug use review programs: approach to ensure rational use of anti–TB medicines [ENG] [RUS] | Archil Salakaia, Senior Technical Advisor (SIAPS) | |
| Panel discussion and Q&A session | ||
| Reception | ||
| Day 2 – Wednesday, December 11, 2013 | ||
| Recap of Day 1 | Recap of day 1 discussions | Dr. Raed Arafat, Secretary of State, Ministry of Health of Romania |
| Panel 4: Ensuring uninterrupted supply: strengthening TB supply chain systemsFrancis Aboagye–Nyame, ChairAndre Zagorski, Chair | Overview of supply chain of anti–TB medicines [ENG] [RUS] | Francis Aboagye–Nyame, Director, SIAPS Program |
| Update on GDF new strategic direction: achievements and perspectives [ENG] [RUS] | Joel Keravec, Head of Operations, GDF | |
| System of procurement and distribution of TB drugs in the Republic of Kazakhstan [ENG] [RUS] | Gulnaz Musabekova, National Anti–TB Medicines Coordinator, Kazakhstan | |
| Logistics management information system for Anti–TB medicines in Tajikistan [ENG] [RUS] | Gulnora Dzhalilova, National Coordinator of TB Medicine Management, Ministry of Health of Tajikistan | |
| Current supply system of Anti–TB medicines in Romania–strengths and challenges [ENG] [RUS] | Dr. Cristian Popa, National Institute of Pulmonology “Marius Nasta,” Romania | |
| Anti–TB medicines procurement and distribution system in the Republic of Belarus [ENG] [RUS] | Dr. Ludmila Zhilevich, Head of Primary Health Care Department, Belarus Ministry of Health (MoH) | |
| Panel discussion and Q&A session | ||
| Panel 5: Using information and tools for effective decision makingKyle Duarte, Director of Systems Analysis and Software Products Unit, (SIAPS), ChairUcha Nanava, Chair | Elements of good information system [ENG] [RUS] | Kyle Duarte, Director Systems Analysis and Software Products, Center for Pharmaceutical Management, MSH |
| Improvement of the information management system by the use of the e–TB Manager [ENG] [RUS] | Olga Pavlova, Deputy Director, Ukrainian Center for Control of Socially Dangerous Diseases, MoH of UkraineDmitriy Moskalyk, Senior Technical Advisor (SIAPS Ukraine) | |
| TB pharmaceutical management information system–experience of Kazakhstan [ENG] [RUS] | Leila Zhorabayeva, Medicine Supply Coordinator, Shymkent Regional TB Dispensary, Kazakhstan | |
| Implementation of TB Information System–Open MRS: Experience of Tajikistan [ENG] [RUS] | Sayohat Hasanova, Country Programme Coordinator for STIs/HIV/AIDS/TB, Tajikistan WHO Country Office | |
| Implementing an electronic information system in Georgia using EPI Defender [ENG] [RUS] | Ucha Nanava, Database Manager, National TB Program of Georgia | |
| Panel discussion /Q&A session | ||
| Panel 6: Planning for adoption, introduction and implementation of new TB technologiesNiranjan Konduri, ChairArmen Hayrapetyan, Chair | Systems approach for adoption, introduction, and implementation of new TB medicines and regimens [ENG] [RUS] | Niranjan Konduri, Senior Technical Advisor (SIAPS) |
| Implementation of XDR–TB treatment program using compassionate drugs: experience of Armenia with bedaquiline [ENG] [RUS] | Armen Hayrapetyan, Director of the National TB Control Office, Armenia | |
| Implementation of Xpert MTB/RIF: experience of Republic of Moldova [ENG] [RUS] | Liliana Domente, Institute of Phthisiopneumology “Chiril Draganiuc”, Moldova | |
| Panel discussion and Q &A | ||
| Panel 7: Transitioning from Global to National Financing Mechanisms for TB ControlOlena Wagner, ChairNigor Muzafarova, Chair | Health Product Management in the New Funding Model [ENG] [RUS] | Olena Wagner, Associate Specialist, Procurement and Supply Management (Global Fund to Fight AIDS, Tuberculosis and Malaria ) |
| Country experience on transition to the government funding in Azerbaijan [ENG] [RUS] | Vafa Shahtakhtinskaya, Drug Manager, National TB Program in Azerbaijan | |
| Government takes over TB medicines supply in Moldova: way forward [ENG] [RUS] | Rita Seicas, Programme Coordinator, Center for Health Policies and Studies (PAS Center) | |
| Updates on GDF services [ENG] [RUS] | Nigor Muzafarova, Technical Officer for Tuberculosis (GDF) | |
| Panel discussion and Q&A | ||
| Day 3 – Thursday, December 12, 2013 | ||
| Recap of Day 2 | Recap of day 2 discussions | Dr. Raed Arafat |
| Introduction of QuanTB – New Tool for Quantification of Anti–TB Medicines | QuanTB: Forecasting, quantification, and early warning for problems with TB medicines supply [ENG] [RUS] | Andre Zagorski |
| Instructions for group work | Instructions for breakout discussions | Archil Salakaia, Senior Technical Advisor (SIAPS) |
| Group work sessions | Structured group work, documentation of findings, and development of recommendations for actions for WHO European Region –5 groups | |
| Breakout group discussion summaries/presentations and discussions | Presentations from break–out groups (10 mins each); open questions and discussions (10 mins of Q &A after each presentation) | |
| Breakout group discussion summaries/presentations and discussions (continued) | Presentations from break–out groups (10 mins each); open questions and discussions (10 mins of Q & A after each presentation) | |
| Instructions for MDR–TB country group strategic plan updates | Provide instructions for TB country strategic plan update | Archil Salakaia, Senior Technical Advisor (SIAPS) |
| Country strategic planning/update exercise | Country planning/updates of medicine management section of TB strategic plans | |
| Day 4—Friday, December 13, 2013 | ||
| Country strategic planning/update exercise (continued) | Country planning/updates of medicine management section of TB strategic plans (continued) | |
| Country plan dissemination fair | Countries flipcharts with suggestions for updates of medicine management section of TB strategic plans. |
|
| Summaries and discussions of country plans | Presentation of several country examples followed by discussions | |
| Conference closing remarks and evaluation | WHO, USAID, and SIAPS | |
Conference Objective and Content
The conference was held to identify specific actions the region can take, by building on the WHO EURO road map, to ensure universal access to quality TB medicines and commodities and contain drug resistance through their appropriate use. This is in line with the targets of the U.S. Government’s TB Program (2009-2014) to be achieved through 4-point key interventions as well as the Global Plan to Stop TB. Participants discussed and learned how to use modern technologies, frameworks, best practices, and new TB tools to improve access to anti-TB medicines and pharmaceutical services.
The conference addressed the following topics—
- Regional pharmaceutical management perspective on current strengths and challenges for TB diagnosis and treatment in WHO European Region
- Impact of current and new TB diagnostic tools on strategies to ensure access to anti-TB medicines and pharmaceutical services
- Supply chain planning and performance monitoring: the potential for Early Warning Indicators
- Formulating appropriate laws and regulations to improve standards of procurement
- Regional best-practices for accessing quality-assured first and second-line TB medicines
- Harnessing the power of Management Information Systems (MIS) for planning and decision making
- Rational use of TB medicines – at the point of prescribing, administration and patient use
- Pharmacovigilance: managing adverse events for better patient health
By the end of the conference, participating countries identified the main pharmaceutical management challenges hindering their achievement of TB targets. Participants developed country specific action plans through discussions and identified tools and frameworks to address challenges to ensuring enhanced access to anti-TB medicines and pharmaceutical services. Results and recommendations from the conference will be widely disseminated through WHO, Stop TB partners, Euro region TB programs, key donors and technical partners. Recommendations from the conference are expected to help establish priorities.
Conference Design
The highly interactive, four-day conference produced actionable results. Thematic panels with key speakers developed and linked to break-out discussion sessions. The final break-out group discussion session of the conference synthesized lessons, approaches, and recommendations across the main topics. The conference was conducted in English and Russian with simultaneous two-way interpretation.
Target Audience
Staffs from the following groups, organizations, and agencies attended—
- National TB programs
- Ministries of Health (pharmacovigilance unit, drug quality assurance, procurement, etc.)
- Donors (USAID, the Global Fund, KfW, etc.)
- Regional and International Partners working in TB
- Principle recipients of the GFATM grants
Questions?Comments? EuroTB2013@msh.org
