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Tailored Review Proposal for Tuberculosis

This tailored review proposal outlines Bhutan's efforts in ending tuberculosis by 2035. It includes the revised guidelines, enhanced infection control measures, and expanded prevention and care for high-risk populations. The proposal also highlights the funding requirements and targets set in the National Strategic Plan.

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Tailored Review Proposal for Tuberculosis

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  1. Tailored Review Proposal for Tuberculosis NTCP

  2. Background for Material Change • Bhutan is Gearing Towards Ending TB by 2035 • National Guidelines for Management of TB/DR -TB guideline revised • Moving towards treating latent TB infection • JMM mission recommendations (2016)

  3. Moving towards Active Case finding from Passive case finding • Enhancing Infection Control Measures • Targeted and focused intervention-More cases are concentrated in 8 districts-including districts bordering neighboring countries

  4. High prevalence of MDR-TB-10% of all new TB cases, and 37% among retreatment cases. • Expanded prevention and care to high-risk populations. • Expand diagnosis and care for the treatment of RR-/MDR-TB as recommended by the WHO. • WHO 2013 recording and reporting tools updated

  5. Epidemiology Update

  6. Estimate of TB Burden, 2015 MDGs achieved in 2015

  7. Estimated Vs Notified

  8. TB Case Notifications (2009-2016)

  9. TB Case notification by Dzongkhags (2016) 993 cases in 8 districts accounting to 87% of the notified cases (Wangdi, S/jong, Sarpang, Chukha, Thimphu, Samtse, Mongar and Paro)

  10. Estimated Vs. Notified

  11. Notification of MDR-TB Cases: 2005-2016

  12. National Strategic Plan II (2017-2023) Gearing towards TB Elimination by 2030

  13. Goal • To reduce TB and DR-TB burden until it no longer poses a public health problem in Bhutan

  14. Objectives • To increase case notification rate of at least 90% among estimated TB and MDR-TB • To maintain treatment success rate of at least 90% among Drug susceptible TB and 75% among MDR-TB • To Improve TB/HIV co-infection case detection and ensure 100% registration • To strengthen programmatic management of TB at all levels.

  15. Grant Recipients • Principal Recipient • Ministry of Health • Implementing Partners • University of Medical Sciences of Bhutan

  16. Modules and Interventions selected

  17. Targets The milestones for End TB strategy for 2030, the target year for the SDGs: • To reach 90% of people who need treatment and treat them successfully by 2030 • To reduce TB deaths by 90% by 2030 • To reduce TB incidence by 80% by 2030 (less than 20 cases per 100,000 population)

  18. Total Funding Need and Funding Request • Total NSP is USD 9.68 Million (2017-2023) • Total NSP Need for Funding cycle is USD 4.26 Million (2018-2021) • Anticipated Domestic Resources- 2.54 Million • Anticipated other resources-USD 30,000

  19. National Strategic Plan(funding requirement )

  20. Anticipated Domestic Resources

  21. Financial Gap- for the funding cycle

  22. Total Allocation for Tuberculosis 2019-2021 • USD 1,074,146.00 (1.074Million)

  23. Module wise budget forecast (%)

  24. Module wise budget forecast

  25. Sustainability • Commitment from RGOB • First Line TB Drugs procured through RGOB support • Infrastructure and HR • Bhutan Health Trust Fund mechanism

  26. Proposal Development Process

  27. Thank you

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