Phase 2 of a TB grant to Namibia will address gaps in treatment success rates, case finding, and coverage of antiretroviral therapy (ART) among HIV-positive TB patients. To accomplish this, more emphasis will be placed on the provision of community-based TB care and TB/HIV services, and on activities related to multiple-drug-resistant TB (MDR TB), including patient support.
The Global Fund recently approved $13.1 million in renewal funding for Grant NMB-T-MoHSS, for which the principal recipient is the Ministry of Health and Social Services. The decision was announced on 4 November.
The Grant Approvals Committee (GAC) said that community TB care is considered essential in the context of Namibia, one of the most sparsely populated countries in the world, to address barriers to increasing TB case detection and TB treatment success rates.
According to a report from the GAC, which cited other sources, Namibia, with a population of 2.3 million, faces a substantial TB burden, mainly driven by a generalised HIV epidemic. TB/HIV co-infected patients account for nearly 50% of the reported TB cases. However, both TB incidence and TB prevalence have been decreasing over the past decade. The treatment success rate among new smear-positive TB patients increased from 76% in the 2006 cohort to 84% in the 2012 cohort. In 2012, 89% of TB patients were tested for HIV (up from 16% in 2005).
The GAC said a national TB drug resistance survey planned for 2013–2014 will provide more insight into current prevalence of MDR-TB in Namibia. In addition, a national TB prevalence survey will be carried out to establish baseline estimates of the TB burden in the general population and among specific key populations.
The GAC said that the Ministry of Health has begun a multi-year rollout of a strategy involving the use of community health extension workers (CHEWs), modelled after a similar initiative in Ethiopia, and based on an extensive dialogue between the two countries. In Phase 2, Namibia hopes to train 4,113 CHEWs, 550 of which have already started the training and will graduate in March 2014.
The GAC said that it welcomes the increased financial commitment of the government of Namibia, which finances 63% of TB programme funding, as well as the renewed commitment between Namibia and Angola to strengthen cross-border collaboration linked to wider regional TB control efforts within the Southern Africa Development Community region. Some Phase 2 funds have been earmarked for cross-border activities, including the harmonisation of treatment protocols, systems for referrals and counter-referrals, training, and systematic local meetings between TB focal points. These activities will be further refined during grant-making.
Information for this article was taken from Board Decision GF-B29-EDP13 and from GF-B29-ER9, the Report of Secretariat Funding Recommendations. These documents are not available on the Global Fund website.
Source: Aidspan