Some updated information from Consultation on Research for
Tuberculosis Elimination, Karolinska Institutet, Stockholm, 24,
2014 A/Prof. Nguyen Viet Nhung, MD., PhD Director, National Lung
Hospital Manager, National TB control Program Viet Nam NINTH
TECHNICAL ADVISORY GROUP AND NATIONAL TB PROGRAMME MANAGERS MEETING
FOR TB CONTROL IN THE WESTERN PACIFIC REGION Manila, Philippines,
9-12 December 2014
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Result of BREAKOUT DISCUSSION (GROUP 4) Liz Corbett Afranio
Kritski Viet Nhung Nguyen Joseph Cavanaugh Nadia Khelef Ajaya M.V.
Kumar Tom H.M. Ottenhoff Melvin K. Spigelman Alison Kraigsley Abdul
Ghaffar Anna Scardigli Tom Evans Knut Lnnroth
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AspectGlobalCountry (LMIC) Curent situation - There are some
models in several countries: Brazil, Viet Nam, India, Indonesia, -
Multi-country academic networks - WHO Training package for TB
control, but not yet for TB research training There are available
TB research in all countries, but still: - Lack of information
about Research (Capacity, HR, opportunity, ) - Lack of effective
models for Capacity building - Lack of coordination of all
existing, ongoing research in countries (projects, institution,
researchers, resources) overlap, no translation into practice,
waste - There are various level of TB research: R&R, data
management, basic implementation research The needsThere are
Roadmap and OR priority - Toolkit for evaluation: SWOT analysis -
Guidance for create research demand for the new strategy - A new
program, model for TB research training - TA for TB research -
Mapping key institutions Country TB Research Agenda - SWOT analysis
on Tb research - Prioritizing the gaps - Planning to fill the gaps
- Mapping, inventory all available, ongoing project, HR, partners -
True partnership for TB research - Coodination and ownership: MoH,
NTP, MoEdu, - NTP needs to be the core Solutions - Guideline /
recommendation - Framework for capacity building for TB Research -
Model and piloting model - Identify the priority researches that
should be focus of the country (basic implementation research) -
Establish strategic plan of TB research in the national strategy
for TB control as the whole (TB research agenda) - Create a
leadership, partnership for implementing the plan for better
coordination and collaboration DO BETTER AND DO MORE
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AspectGlobalCountry (LMIC) 1 yearEstablish a ad hoc WG &
ToR based in WHO -Define needs for 1 year deliverables -Identify
key players (TB Programme, TDR, Alliance, the Union, ) -Guide for
conducting in-country mapping and situational analysis -Develop
participatory workshop facilitator guides for NTP to support
comprehensive research strategy generation -Share training and
research materials -Repository for materials -Hold workshop for
exchange of ideas and lessons learnt between key players in TB and
broader research capacity building initiatives -Best practice
country examples to share learning points and draw guidance
-Encourage in-country mapping and situational analysis with needs
assessment of TB activities and NTP capacity to conduct research in
all countries -Develop clear plan for comprehensive National TB
Research Agenda and capacity building strategy (inc OR, basic etc)
-Example Research Strategy plans from key countries -Pathfinders
-Viet Nam, Kenya, BRICS, Uganda, Malawi -Invite applications from
all countries -Ask regional offices to nominate -In-country
regulatory review to define functionalities, timelines and
information for international collaborators -Initiate consideration
of regional harmonization plans -Initiate consideration of regional
research networking plans -Include critical assessment meetings in
regional meetings and International Union Conferences
EXPECTATION
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AspectGlobalCountry (LMIC) 5 years Researchers toolkit,
databases, and data sharing Established global research movement
with regional hubs Expansion of TB research network in regions and
countries All high burden countries have a Strategic research and
capacity building plan Regional networks established Individual and
multicountry studies providing results OR funds available from
Global Fund are fully utilized Funding sources diversified and
increased, including in-country investment Supportive research
environment and regulatory processes 10 years Researchers toolkit,
databases, and data sharing Scale up TB research network in
countries, regions and global to know how to achieve the TB control
Goal. Capacity to evaluate TB epidemic and control interventions
Established leadership in comprehensive TB research platform from
(formerly) high burden countries Clear examples of contribution of
national research to local control efforts
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Messages to region and countries 1.Adapt the Global research
movement in regions with regional hubs 2.Establishment and
expansion of TB research network in regions and countries
3.Countries should develop a Comprehensive TB Research Agenda
integrated in the National Strategic Plan with appropriate research
capacity building 4.Countries should be involved and responsible in
all kind of research for TB Control
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PILLAR 3 POST 2015 NATIONAL STRATEGY FOR TB CONTROL PILLAR 3
Viet Nam an example
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Pillar 3 - an example: Viet Nam LevelFrameworkFunding resources
Government / MoH National Strategy to 2020 with vision 2030:
Optimize the application of current and new technologies,
approaches in TB detection, diagnosis, treatment and prevention
Govt National ProgramNational Strategic Plan for TB control
2015-2020 Objective 4 (of 4). To sustain and promote monitoring,
evaluation and surveillance of the TB epidemic and control while
applying new technologies and approaches in TB control by routine
data, surveys and researches. - 16 projects in agenda 2015-2020
with Govt and partners GFATM, AUSAID, USAID, CDC, WHO, Projects,
Partnership National Lung Hospital / NTP: Core partner TB and lung
disease research coalition: MoH, MOST, Academy, University,
Institution. International partners: KNCV, WHO, UCSF, Sydney
University, WMRI, LSHTM, Provincial program and other institution
-R&R, case based, web based surveillance system -Research
Project implementation: capacity building on needs -Promoting
younger researchers
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16 ITEMS IN THE AGENDA 2015 -2020 VTN NSP TB CONTROL 4.1.
Further development and updating of both paper based and electronic
R&R systems (VITIMES and e-TB manager) to support the program
measure indicators for IC, Childhood TB, PPM, Community engagement,
Pharmacovigilance and new drugs and regimens initiative, equipment
maintenance etc. 4.2. Develop and implement data quality assurance
and security system for protection of electronic records. 4.3.
Identify new gaps from the feedback of M&E and supervision
visits and strengthening health facilities to fulfil the needs for
PPM and PMDT scale up. 4.4. Strengthen research partnership with
universities in Vietnam 4.5. Analysis of population access to TB
services per province and population groups 4.6. Enhanced
surveillance for risk group identification and follow-up of yield
attributable to active and passive case finding in each risk group
4.7. Operational research to underpin and support the stepwise
introduction of new regimens for TB and/or MDR, including
pharmacovigilance 4.8. Continuation of the STREAM trial in HCMC,
ACT3 in Ca Mau (Community based genExpert screening for TB), TBTC
in Ha Noi (clinical trials for TB drugs and regimens), GeneTB. 4.9.
Operational research to support and evaluate new tools (mHealth,
CAD4TB), in public and private sector 4.10. Studies on elimination
of TB in Vietnam, modeling of the epidemic in collaboration with
the London School of Hygiene & Tropical Medicine (LSHTM),
piloting interventions in preparation of scenarios for TB
elimination 4.11. National Prevalence survey of Tuberculosis
(2015-2017) 4.12. 5 th National Drug Resistant Survey (2015-2016)
4.13. Studies related to health financing (Vietnam transitioning
towards full coverage of health insurance, paying for TB diagnosis
and treatment) 4.14. Study on fluoroquinolone and pyrazinamid
resistance among new patients 4.15. Sentinel survey for TB in KAPs
4.16. Mortality and fatality of TB in sentinel areas