OpiniãoMinistries of health should create a national coordinating body and/or national technical expert working group to support national scaling up of PMTPT according to the latest global guidelines. Alternatively, the mandate of an existing body that could serve both management and technical functions could be extended to advise the ministry of health and national TB, HIV and other programmes, thus guiding and supporting governments in fulfilling their national commitments to PMTPT. The technical expert group, although established at national level, should provide advice at all levels. The coordination body and technical working group should be chaired by the highest administrative heads in federal and local governments and have equal or reasonable representation of all relevant stakeholders.
Terms of reference
The national coordinating body should be responsible for the governance, planning, coordination and implementation of PMTPT, as well as mobilization of financial resources from the government and donors. It should establish or identify an existing technical working group to provide advice on technical matters in scaling up PMTPT.
The mandate of the national technical expert working group may be to:
- review emerging national and global evidence, review current national policies and guidelines for PMTPT and lead updating and alignment of local guidelines with the latest evidence and WHO guidelines;
- undertake situational assessments to guide policy decisions for PMTPT, such as:
- estimates of the burden of TB disease (and TB infection) in various at-risk populations;
- the capacity of the health system (staff, skills and equipment) to assess the intensity and risk of TB exposure and to exclude TB disease;
- the available financial resources and gaps for nationwide scaling up of TPT services and the implications of different approaches for impact and cost (various regimens and tests of TB infection);
- mobilization of additional resources as required; and
- programme performance and implementation bottlenecks;
- provide a scientific basis for PMTPT components of national strategic plans and policy advice to the joint national coordinating body and/or national programmes;
- lead identification and prioritization of target populations for PMTPT and strategies to reach them;
- develop national implementation guidance, SOPs and job-aids (including for training modules) suitable to the country context; and
- develop tools to address the concerns of TPT providers and dispel myths about TPT to promote implementation and national scaling up.
Membership
A joint national coordinating body for implementation of TPT could consist of:
- a programme head in the ministry of health;
- programme heads in other relevant ministries according to the country context (such as those responsible for harm reduction, prisons or mining health services):
- members of the federal ministry responsible for public funding;
- national TB, HIV and other relevant programme managers (such as for reproductive, maternal, newborn, child and adolescent health services, prison health services);
- programme heads in implementing partners for TPT;
- representatives of civil society:
- people at risk of or affected by TB; and
- country leads in technical partner organizations and funding agencies.
The national technical expert working group for scaling up TPT might consist of:
- national TB and HIV experts;
- stakeholders from national TB, HIV, reproductive, maternal, newborn, child and adolescent health and other relevant programmes;
- clinicians, front-line health providers, nurses and community service providers;
- representatives of agencies responsible for drug procurement, regulation and safety;
- representatives of TB and HIV patient groups, civil society, people at risk of or affected by TB;
- representatives of national research institutes;
- local and/or international technical partners; and
- the WHO country officer.
Frequency of meetings: The national coordinating body and technical expert working group should meet regularly as deemed appropriate for current activities in the national context.
Secretariat: The national TB and HIV programmes could function as the secretariat for both the coordinating body and the technical expert working group and convene alternate meetings of the groups according to the priorities for discussion. Both programmes should allocate funding for regular meetings.