The ministry of health should create and strengthen a joint national coordinating body and/or national technical expert working group to support national scale-up of PMTPT through implementation of the latest global guidelines. Alternatively, the mandate of an existing body that can serve both a management and technical function may be expanded to advise the ministry of health and national TB, HIV and other programmes. This will guide and support the efforts of governments towards fulfilling their national commitments on PMTPT made at the first UN High Level Meeting on TB in 2018. While technical expert inputs may be established at the national level, advise is required for all levels. The administrative bodies should be chaired by the highest administrative heads in the federal and local governments and have equal or reasonable representation of all relevant stakeholders.
Terms of reference
The joint national coordinating body for implementation of TPT services should be responsible for the governance, planning, coordination and implementation of PMTPT as well as mobilization of financial resources from the government as well as donors. The coordinating body should put together or identify an existing technical working group to provide advice on technical matters in the scale-up of PMTPT.
The National technical working group may be mandated to:
- review emerging national and global evidence, review current national policies and guidelines for PMTPT and lead the process of updating and aligning local guidelines with latest evidence.
- undertake situational assessments to guide policy decisions for PMTPT such as,
– estimates of burden of TB disease (and TB infection) among different at-risk populations;
– capacity of the existing health system (staff, skills and equipment) to assess intensity and risk of TB exposure and exclude TB disease;
– available financial resources and gaps to support nationwide scale-up of TPT services and implications of different approaches for impact and cost (using various regimens, using tests of TB infection);
– potential to mobilize additional resources as needed; and
– programme performance and implementation bottlenecks.
- provide scientific underpinnings for PMTPT components of national strategic plans and policy advice to the joint national coordinating body and/or national programmes.
- lead the identification and prioritization of target populations for PMTPT and strategies to reach these populations.
- develop national implementation guidance, standard operating procedures and job-aids (including content for training modules) suitable to the country context.
- • develop tools to address the concerns of TPT providers and dispel myths around TPT to promote implementation and national scale-up.
Membership:
Joint national coordinating body for implementation of TPT may consist of:
- Programme head in the ministry of health
- Programme heads from other relevant ministries as per country context (such as working on harm reduction, prison or mining health services)
- Members from the federal ministry responsible for public funding
- National TB, HIV and other relevant programme managers (such as from Reproductive, Maternal, Newborn, Child and Adolescent Health services, prison health services)
- Programme heads from key implementing partners in TPT
- Representatives from civil society
- People at risk of or affected by TB
- Country leads from key technical partners and funding agencies.
National technical working group for TPT scale-up may consist of:
- national TB and HIV experts
- stakeholders from national TB, HIV, Reproductive, Maternal, Newborn, Child and Adolescent Health and other relevant programmes
- representatives of clinicians, frontline health providers/nurses and community service providers
- representatives from agencies dealing with drug procurement and regulatory/safety affairs
- representatives from TB and HIV patient groups, civil society, people at risk of or affected by TB
- representatives from national research institutes
- local and/or international technical partners
- WHO country officer.
Frequency of meetings: The national coordinating body and technical working group should meet regularly as deemed appropriate for ongoing activities in the national context.
Secretaría: The national TB and HIV programmes may function as the secretariat for both the coordinating body and the technical expert working group and alternate to convene meetings of the groups based on priority issues for discussion. Both programmes should allocate funding for regular convening of these groups.