MINSANTE LOGO, LOGO CNLS, NTP LOGO, LOGO ICN, USAID LOGO, LOGO CAMNAFAW

CAMEROONCAMEROONCAMEROONCAMEROON

GLOBAL CONSULTATION TO DRAW LESSONS FROM DEVELOPMENT OF SINGLE TB AND HIV CONCEPT NOTE AND DEFINING THE WAY FORWARD FOR JOINT

TB AND HIV Programing

18-20 November 2015; Venue Elilly International Hotel, Addis Ababa

MARKET PLACEMARKET PLACEMARKET PLACEMARKET PLACE

SINGLESINGLESINGLESINGLE CONCEPT NOTE TUBERCULOSISCONCEPT NOTE TUBERCULOSISCONCEPT NOTE TUBERCULOSISCONCEPT NOTE TUBERCULOSIS AND HIV IN CAMEROONAND HIV IN CAMEROONAND HIV IN CAMEROONAND HIV IN CAMEROON

INVESTING FOR IMPACT AGAINST TUBERCULOSIS AND HIVINVESTING FOR IMPACT AGAINST TUBERCULOSIS AND HIVINVESTING FOR IMPACT AGAINST TUBERCULOSIS AND HIVINVESTING FOR IMPACT AGAINST TUBERCULOSIS AND HIV

1. Country: CAMEROON

Area: 475 442 km² - Population (2010): 19,406,100 approx.

Administrative capital:Administrative capital:Administrative capital:Administrative capital: Yaounde) / Economic capital: DoualaEconomic capital: DoualaEconomic capital: DoualaEconomic capital: Douala

RELIEFRELIEFRELIEFRELIEF CLIMATECLIMATECLIMATECLIMATE

• Isolated plains and mountains é es

North

• The Arc of the highlands of the

Centre and West

• Southern Plateau Cameroonians

• The Plains c O ti è res

Humid Tropical in the South and dry in the North;

with an average of 25 ° C in the South and 32 ° C

North. In mountain areas in the west, the

temperature varies with altitude and becomes

cooler.

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EPIDEMIC SITUATION AND PROGRESSEPIDEMIC SITUATION AND PROGRESSEPIDEMIC SITUATION AND PROGRESSEPIDEMIC SITUATION AND PROGRESS

IndicatorsIndicatorsIndicatorsIndicators 2005200520052005 2014201420142014

TBTBTBTB

1 Estimated TB prevalence 401 / 100.000 266 / 100.000

2 Estimated TB Incidence 311 / 100.000 220 / 100,000

3 TB notification rate 119 / 100.000 114 / 100,000

4 Estimated number of MDR TB cases Among all

pulmonary TB cases Enable notifications 580 in 2010 630

5 MDR-TB cases Enable notifications 35 in 2010 126

6 Number of MDR TB cases started treatment 35 in 2010 75 in 2013

7 Number of TB diagnostic laboratories providing

good services using Xpert MTB / RIF 0 3

HIV HIV HIV HIV

1 Adult HIV prevalence (15-49 years) 5.3% 4.8%

2 Total Estimated number of PLHIV 550,000 660,000

3 Percentage of PLHIV receiving send ART 15% in 2010 22%

4 Number (%) of PLHIV-have beens Who

Diagnosed HIV infection of Not reported Not reported

5 Number (%) Retained ART at 12 months was 62% (2011) 81% (2013)

6 Number (%) are virally suppressed ART Not reported Not reported

7 New HIV infections 52000 48,000

8 Number (%) of pregnant women ARVs for

PMTCT Who Receive (2014)

41% (13818)

(2010) 66% (22297)

9 Number of AIDS Deaths per 100,000

population 182 149

10 Percentage of HIV response Domestically

financement 10.2% 34% (2012)

HIV associated TB HIV associated TB HIV associated TB HIV associated TB

1 Estimated number of PLHIV Who Developed TB 23000 20000

2 Estimated number of TB / HIV Deaths 13000 (2004) 7600 (42% reduction *)

3 Proportion of TB patients with HIV status

Known 37% in 2006 87%

4 Proportion of HIV positive TB patients 39% in 2006 37%

5 Proportion of PLHIV screened for TB 11951/122783

(10%) 2012

57682/145038

(40%)

6 Proportion of HIV-positive TB patients are able

ART 4% in 2006 70%

7 Number of HIV positive people with IPT

Provided Not reported

* Achievement Against the Global Plan to Stop TB to halve number of HIV associated TB death entre 2004 and

2015

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HISTORY CONCEPT NOTE JOINT TB / HIV CAMEROONHISTORY CONCEPT NOTE JOINT TB / HIV CAMEROONHISTORY CONCEPT NOTE JOINT TB / HIV CAMEROONHISTORY CONCEPT NOTE JOINT TB / HIV CAMEROON

Under the control of the Global Fund grants against AIDS, Tuberculosis and

Malaria, the period 2014-2015 was marked in Cameroon by introduction of the New

Funding Model.

The elaboration of the Concept Note joint TB / HIV was the major exercise which has

submitted the Cameroon through the CCM.

The development process of the joint NC TB / HIV was punctuated by some time:

• The elaboration of Strategic National Plan (TB and HIV);

• 2013 The launch of the Country Dialogue with all the partners;

• The elaboration and submission of the first Version NC in October 18, 2014;

• The rejection of the of the first Version of NC joint TB / HIV in December 2014

and formulation of recommendations by the TRP;

• Mobilization of technical, financial, human and community resources in all the

country;

• Development of a scale-up plan for ART treatment;

• The revision (January-May 2015) and the submission of the second version of

the joint NC TB / HIV in May 18, 2015;

• The validation of the joint NC H VI / TB by the TRP in July 2015;

• Launch of Grand Making

Partners involved in the process NC JOINT TB / HIVPartners involved in the process NC JOINT TB / HIVPartners involved in the process NC JOINT TB / HIVPartners involved in the process NC JOINT TB / HIV AROUND CCM

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LARGE AREA JOINT TB / HIV IN NCLARGE AREA JOINT TB / HIV IN NCLARGE AREA JOINT TB / HIV IN NCLARGE AREA JOINT TB / HIV IN NC

Areas Joint interventions

Coordination • Gestion and Planning Joint

Services • Health services offered integred (TB / HIV) by the providers;

• Integration of points of services TB / HIV (UPEC-CTA / CDT);

Procurement • Joint purchase and medicines TB / HIV

• Joint use of a same system to supply and distribution of drugs

Community System • Pooling of the organization of the Community r e ry matter in

response to HIV-TB-Malaria;

Monitoring and evaluation

• The integration indicators

• The development tools integrate data collected

• Collection integrate of data in TB and HIV service delivery points

BOTTLENECKS AND THE SOLUTIONSBOTTLENECKS AND THE SOLUTIONSBOTTLENECKS AND THE SOLUTIONSBOTTLENECKS AND THE SOLUTIONS

specific bottlenecks and challenges in TB

and HIV programming gasket innovations

NFM short period (2016-2017) • Development of a plan the scale –up of ART (2017-

2018)

The scaling up ART treatment • Staff reinforcement form and quantity and quality

• Implementation of the manual of decentralizing tasks

• improvement of system supply

Integration of the service offering in the

delivery points

• Reinforcement the capacity of providers and the

technical platform

Multiplicity of community actors • Harmonization community response HIV-TB-Malaria

OTHER OPPORTUNITIESOTHER OPPORTUNITIESOTHER OPPORTUNITIESOTHER OPPORTUNITIES

• Existing community intervention strategy paper will allow joint planning of

community interventions between programs ( PES- HIV- NTP - PNL- Oncho .. )

• HIV / HEPATITIS;

• Financing other donors.