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Meeting of National Managers of the Tuberculosis Control Programmes in the Eastern Mediterranean Region Damascus, Syrian

April 2002. WHO / CDS / STB / TBS DOTS-Plus and the Green Light Committee. Chronic cases of TB. Drug resistance surveillance: tool for assessing situation of chronic cases'240,000 to 380,000 cases of MDR TBMultidrug-resistant TB (MDR-TB) present in 63 of 72 countries surveyed in 19941999. Apr

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Meeting of National Managers of the Tuberculosis Control Programmes in the Eastern Mediterranean Region Damascus, Syrian

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    1. April 2002 WHO / CDS / STB / TBS DOTS-Plus and the Green Light Committee Dr Ernesto Jaramillo WHO/CDS/STB/TBS Meeting of National Managers of the Tuberculosis Control Programmes in the Eastern Mediterranean Region Damascus, Syrian Arab Republic, 15th 17th September 2002

    2. April 2002 WHO / CDS / STB / TBS DOTS-Plus and the Green Light Committee

    3. April 2002 WHO / CDS / STB / TBS DOTS-Plus and the Green Light Committee

    4. April 2002 WHO / CDS / STB / TBS DOTS-Plus and the Green Light Committee Should we treat persons with MDR-TB?

    5. April 2002 WHO / CDS / STB / TBS DOTS-Plus and the Green Light Committee DOTS-Plus: working definition DOTS-Plus is a case-management strategy under development designed to manage MDR-TB using 2nd line drugs within the DOTS strategy in low- and middle-income countries. DISCLAIMER: DOTS-Plus means DOTS first

    6. April 2002 WHO / CDS / STB / TBS DOTS-Plus and the Green Light Committee Linking independent concepts

    7. April 2002 WHO / CDS / STB / TBS DOTS-Plus and the Green Light Committee Green Light Committee (GLC) Releases preferentially-priced, quality-assured drugs Members: WHO, CDC, KNCV, IUATLD, NTP-Estonia, Harvard Univ Decision process application review: Instructions for Applying to the Green Light Committee for Access to Second-line Anti-TB Drugs Guidelines for Establishing DOTS-Plus Pilot Projects for the Management of MDR-TB potential site visit Continual monitoring of projects Possible technical assistance via Working Group

    8. April 2002 WHO / CDS / STB / TBS DOTS-Plus and the Green Light Committee Green Light Committee (GLC) Conceived: November 1999 January 2000 Established in WHO: March 2000 First meeting: 26 June 2000 Refusal of procurement agents to sell to non-GLC approved projects Long-term support via Gates Foundation Identification of unknown projects Promotion of DOTS and DOTS-Plus

    9. April 2002 WHO / CDS / STB / TBS DOTS-Plus and the Green Light Committee Advantages for projects Access to quality-assured drugs Access to low-cost drugs Access to a continuous drug supply Access to technical assistance Access to an external monitoring mechanism Increased rational use of drugs Creation of wide evidence base for policy development

    10. April 2002 WHO / CDS / STB / TBS DOTS-Plus and the Green Light Committee Application process to the GLC

    11. April 2002 WHO / CDS / STB / TBS DOTS-Plus and the Green Light Committee Application process to the GLC Pre-aplication process phase Application (submission) phase - Cover letter - Body of the application - Annexes Operation phase

    12. April 2002 WHO / CDS / STB / TBS DOTS-Plus and the Green Light Committee Sources of delay Submission of revised application Submission of response to GLC inquiries Lack of response to GLC inquiries GLC evaluation process Unclear criteria for applications

    13. April 2002 WHO / CDS / STB / TBS DOTS-Plus and the Green Light Committee Summary of GLC activities: June 2000 September 2002 Number of meetings 15 Number of applications received 19 Number of applications deemed compliant with guidelines 9 Number of patients being enrolled in approved projects 3,370 Number of applications under review 6 Average time for application review (months) 4 Average time from approval to drug delivery (in months) 4

    14. April 2002 WHO / CDS / STB / TBS DOTS-Plus and the Green Light Committee

    15. April 2002 WHO / CDS / STB / TBS DOTS-Plus and the Green Light Committee Should we treat persons with MDR-TB?

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