MULTI-COUNTRY WESTERN PACIFIC PROGRAMME

Empowered lives. Resilient nations.

PROGRAMME BRIEF

OCTOBER 2017

TUBERCULOSIS

SUPPORTING NATIONAL PROGRAMMES

Tuberculosis remains a major cause for concern, particularly in the North Pacific. However, countries are making progress thanks to the grant implementation:

• Kiribati, Tonga, Tuvalu and Vanuatu were provided with GeneXpert diagnostic devices, along with master class training at each location to more than 10 personnel including Lab Staff, Clinical Staff and Coordinators. Similar training was also provided in FSM, RMI and Palau to improve skills.

• Direct laboratory support to eight Pacific countries continues for blinded smear re-checking, panel sending, interpretation and reporting of testing results. This support is critical for quality assurance and greatly improved effective management.

The Multi-Country Western Pacific Programme seeks to improve coverage of HIV and tuberculosis (TB) prevention, treatment and care in 11 Pacific island countries (PICs),* as well as to provide universal coverage of long-lasting insecticide treated nets (LLINs) to combat malaria in Vanuatu. The programme is implemented by the United Nations Development Programme (UNDP) and supported through a US$16.9 million grant from the Global Fund.

The Multi-Country Western Pacific Programme provides support to national programmes, including:

• Budget support for staffing

• Medicines, diagnostics and commodities

• Quality assurance and technical assistance

• Operational research for evidence-based action

• Capacity development

* The 11 countries the programme operates in are Cook Islands, Federated States of Micronesia (FSM), Republic of Marshall Islands (RMI), Palau, Nauru, Tonga, Samoa, Niue, Kiribati, Tuvalu, and Vanuatu.

Mass tuberculosis screening in Ebeye, RMI

In February to March 2017, a mass screening campaign was undertaken in Ebeye, RMI to identify, detect and treat TB. The screening also identified patients with Noncommunicable Diseases, particularly diabetes which is a ommon co-morbidity of TB.

The campaign is a very successful partnership between UNDP, the Ministry of Health–RMI, WHO, US Centers for Disease Control and Prevention, and Pacific Island Health Officers’ Association.

While results are still being compiled, the campaign is expected to make a major contribution to control TB and other diseases and offers potential for replication in other locations.

Read more

• Joint operational policy for Regional Second Line Medicines stockpile access is in place and ensures cost effectiveness by using a pay-per-use approach. The facility is managed by WHO-WPRO and accessible to all 11 PICs under the grant upon notification of a multidrug-resistant TB (MDR-TB) case.

• The Eighth TB Control Meeting for the Pacific Islands in November 2016 saw 80 participants attending to identify joint priorities and develop specific regional and national actions to operationalize the Regional Framework for Action on Implementation of the End TB Strategy in the Western Pacific, 2016-2020. In addition, a TB drug management workshop held in October 2016 addressed issues of medicines management, including quantification, procurement systems, stock management and patient centred care.

• Engagement of civil society is important for better managing TB at the community level. In Vanuatu, the Vatu Mori Consortium which benefits from a grant provides support for contact tracing and logistics, working closely with the Ministry of Health with a focus on households, people living with HIV and other sub populations at high risk.

• Operational research is key to improve TB management and control, and several projects are due to commence soon in Kiribati, Tonga and Vanuatu while Palau has also shown interest. Operational research is expected to improve early case detection and to improve treatment adherence in particular.

HIV

REGIONAL RESULTS FOR JAN-JUN 2017

• Civil society organizations (CSOs) are scaling up the response with 11 CSOs newly engaged. The focus is on reaching key populations, including transgender persons, men who have sex with men, seafarers and sex workers.

• Condom uptake is critical for prevention to work. Based on research by UNFPA the programme is now providing ‘pleasure enhancing’ condoms to increase uptake among youth. Various Ministries of Health are rolling out distribution in partnership with CSOs.

• Technical assistance for HIV and STI guidelines review is ongoing in the programme countries (already completed in FSM). The guidelines review will update diseases management with the latest recommendations. The team is led by Dr. Dennie Iniakwala from the Secretariat of the Pacific Community.

• HIV viral load testing now possible with GeneXpert technology. The approach was introduced in Kiribati, Vanuatu, Tonga, Palau, RMI and FSM. The technology is assisting HIV Core Teams to monitor patients.

• Behavioural research improves evidence base for HIV programming. Behavioural studies in nine countries have been completed by a team from the University of New South Wales with support from UNDP, UNICEF and CSOs. The evidence produced will support countries’ reporting commitments and improve targeting of prevention programmes.

• FJN+ leads Stigma Index studies to provide evidence on extent of stigma and discrimination and improve programming. Data has been collected in RMI, FSM and Vanuatu.

Number of TB cases - all forms 487Number of TB cases - bacteriologically confirmed 219TB Case notification rate per 100,000 - all forms 54TB Case notification rate per 100,000 - bacteriologically confirmed 24TB Treatment success rate - all forms 51%TB Treatment success rate - bacteriologically confirmed 78%TB Treatment success rate (RR-TB and/or MDR TB) 100%% of previously treated TB patients receiving DST 100%% of RR-TB and/or MDR-TB that started treatment within four weeks of diagnosis 100%% of TB patients tested for HIV 63%% of PLHIV on ART 12 months after initiation 100%% of pregnant women who know their HIV status 83%% of pregnant women on ART to reduce mother to child transmission 100%% of infants born to HIV positive women tested for HIV within 2 months of birth 100%% of PLHIV on ART 60%% of pregnant women tested for syphillis 87%

Public-Private Partnership with DIGICEL to tackle TB, HIV and STIs

Partnership between Ministries of health and telecom operators such as Digicel are helping to improve outreach.

In Samoa, 110,000 people will be reached through Digicel’s network, which now has 98.5% population coverage. Text messages will be delivered to subscribers and direct them to a webpage with more information on prevention and where to go for testing, treatment, care and support services.

In order to market the campaign effectively, the messages are being delivered in both local and English languages. In Samoa, a tailored slogan is being used: “T3: Talk It, Test It, Treat It”. This slogan refers to the need to: 1) Talk about these issues as a community and promote awareness; 2) Get tested for free at all National Health Service facilities to improve screening rates and surveillance; and 3) Get treated to reduce transmission and ensure a healthy life.

Similar endeavors are in the pipeline in other countries covered by the grants.

Read more

Inclusive media reporting – Samoa Fa’afafine Association A media consultation was hosted by the Samoa Fa’afafine Association on 29 March 2017 in Matautu in a bid to correct some of the misconceptions about transgender people in the media.

The event was opened by the Samoa Fa’afafine Association President, So’oalo Roger Stanley, who noted the importance of working with the media to ensure they provide “fair, accurate and inclusive” coverage of issues in relation to fa’afafine. The Association’s eventual goal is to compile a SFA Media Guide which will be circulated to all media organizations as guidelines for reporting on fa’afafine.

CONTACT USUNDP Pacific OfficeLevel 8, Kadavu House 414 Victoria Parade Suva, FijiPhone: +679 330 0399Fax: +679 330 1976Email: globalfund.pacific@undp.org

FOLLOW US ON:

@GlobalFundPacific

SUBSCRIBE TO OUR MAILING LIST:

http://eepurl.com/cARteL

• The US$2.6 million programme provides replacement to all Long Lasting Insecticidal Nets (LLINs) in Vanuatu and strengthens monitoring and supervision of the national malaria programme.

• In 2016, a total of 108,705 LLINs were distributed through a vast and complex operation reaching households in remote locations and making a real difference towards malaria elimination.

MALARIA

“The bed nets are making a huge difference in the communities. In some parts of the countries we have seen no more local transmission in a while.”

– John Sanga, Malaria Control Officer, Torba Province, Vanuatu