12 April 2019 | Geneva: Following the release of the 2018 WHO consolidated guidelines on the treatment of drug-resistant tuberculosis, the Western Pacific Regional Office (WPRO) of WHO through its Green Light Committee (GLC) mechanism organized a consultant training workshop held from 27-29 March 2019 in Sydney, Australia. A total of 25 experts were equipped with the necessary knowledge and skills, including practical problem-solving, diplomacy and cultural competencies to ensure delivery of high quality support and constructive communication at all levels within the TB programme and government in line with WHO standards.
The workshop enabled the development of a reliable pool of competent next-generation specialists on drug resistant TB from across the Western-Pacific Region, to support countries in scaling up the programmatic management of drug resistant TB. This in turn is crucial to optimizing investments made by the Global Fund, USAID, and other donors in country programmes.
The workshop was co-hosted by the Centre for Research Excellence in TB (TB-CRE) of the Centenary Institute, University of Sydney. The Burnet Institute, KNCV, the UNION and Australian Respiratory Council also contributed significantly to the course design and facilitation. This represents a clear demonstration of effective collaboration between WHO, government agencies, academic institutions, international and local NGO partners including civil society towards country level impact.
The course content covered current technical updates and transition planning including details of the new WHO policy changes on multidrug-resistant TB (MDR-TB) treatment, TB preventive treatment, and infection control. The course also had a strong focus on laboratory support systems critical for an effective MDR-TB response including the WHO and FIND technical guide on the use of next-generation sequencing technologies for the detection of mutations associated with drug resistance, and the WHO and GLI detailed guide on the interpretation of line probe assay techniques. In addition, procurement and supply management in the context of transition planning was also discussed. The course paid specific attention on the use of active drug safety monitoring and management, which is now recommended for all patients, monitoring and evaluation of the programmatic management of drug resistant TB, commodities management, MDR-TB treatment in children and management of co-morbidities.
The course also highlighted the role of the rGLC as a Global Fund-supported partnership platform led by WHO solely dedicated to country support; and provided an opportunity for experience sharing and lessons learnt by rGLC members and countries on support provided through the mechanism.
Professor Ben J Marais, Infectious Diseases Clinician, Westmead Children’s Hospital, and Co-Director, Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), who was the lead facilitator of the course remarked: “The course can serve as a template for other regions as well and its materials can be useful resources for new consultants in future missions”. Similarly, Dr Richard Stapledon, the Chair of rGLC WPRO applauded the conduct of the course saying: “The overall standard and interest shown by course participants was excellent and has certainly been a great starting point for helping to enhance the pool of rGLC consultants in the region”.
Dr Kefas Samson and Dr Shalala Ahmadova of WHO/HQ and WPRO respectively, highlighted the necessity of rapid adoption and implementation of better diagnostic tools and treatment options at country level as key to achieving the goal of ending TB by 2030 as envisaged by the SDGs. They also communicated WHO’s strong commitment to intensifying efforts in continuously reviewing newly emerging evidence to inform such policies and called for the need to adopt a dynamic approach to embrace change.
Conveying the general impression of the trained consultants, Dr Mitz Nisbet, remarked: “We greatly enjoyed the consultant training course and appreciated the opportunity to learn from experienced TB consultants across a wide breadth of issues. It was also a unique opportunity to reflect on our local TB programmes and to meet many regional experts. Facilitators gave excellent examples. Overall great experience and value!.”
Dr Tereza Kasaeva, Director of the WHO Global TB Programme said, “This workshop organized by the WHO Western Pacific Regional Office through the rGLC is an important step to build much-needed capacity to accelerate efforts in the region to tackle drug-resistant TB and scale up access to TB preventive treatment. This will be critical as we gear up to reach the bold targets set in the political declaration of the UN High Level Meeting on TB.”
The next step will be the engagement and deployment of the newly trained consultants in rGLC missions to provide the much-needed support to countries in the Western Pacific region.