1. Expert consultation on TB/HIV research priorities, 14-15 February 2005 Mesdames et messieurs, soyez les bienvenus On behalf of the organizing committee of WHO's Stop TB & HIV Departments and TDR

2. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 Content The aim of the presentation HIV research agenda TB research agenda How TB/HIV research agenda has evolved Objectives and expected outcomes of the consultation Context of the consultation (Paul's)

3. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 The aim of this presentation is to explain why we are here today

4. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 HIV research agenda To assist ART scale up plans To reflect prevention and care needs Four domains (clinical, health system, socio-behavioural and economics) Country driven

5. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 TB research agenda Operational: WHO & partners –PPM –DOTS plus –PAL –Community TB care –TB/HIV Biomedical: TDR/FIND –(Rx shortening) and 4FDC vs loose (Rx simplification) –New diagnostics –ART for HIV-infected patients with TB (PK)

6. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 TB/HIV research agenda September 1991: TB research meeting February 1992: TB/HIV research meeting May 1995: TB/HIV research workshop aimed at developing a new research strategy to improve TB control in areas of high HIV prevalence.  PROTEST and other country TB/HIV experiences

7. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 The policy itself

8. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 Logic for TB/HIV policy Joint TB/HIV interventions, jointly delivered, are needed to control HIV- associated TB, expand DOTS, and indeed, to control HIV

9. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 Principles “Two diseases, one patient” –Patient focused care delivery for both diseases at the same time There is an ongoing catastrophe, therefore –No more “projects” –Immediate scale up of what works (WHO Strategic and Technical Advisory Group 2001) –Revise as more evidence becomes available No separate programme –Collaborative activities add to existing TB and HIV/AIDS control strategies Policy needs to be global

10. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 Process for Interim Policy Under auspices of Global TB/HIV Working Group Iterative drafting process by: –technical experts from TB and HIV, –health management policy makers, –persons living with HIV and their advocates, –International, regional and national TB and HIV program managers, partners & donors

11. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 In 2004

12. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 Collaborative TB/HIV activities A. Establish the mechanism for collaboration A.1. TB/HIV coordinating bodies A.2. HIV surveillance among TB patient A.3. TB/HIV planning A.4. TB/HIV monitoring and evaluation B. To decrease the burden of TB in PLWHA B.1. Intensified TB case finding B.2. Isoniazid preventive therapy B.3. TB infection control in care and congregate settings C. To decrease the burden of HIV in TB patients C.1. HIV testing and counselling C.2. HIV preventive methods C.3. Cotrimoxazole preventive therapy C.4. HIV/AIDS care and support C.5. Antiretroviral therapy to TB patients.

13. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 TB/HIV research priorities areas Developed at the 3 rd WG meeting in 2003 (before the Interim policy)  individual interventions (questions that countries wanted to be answered) Following the production of the Interim policy (4 th WG mtg in 2004 and other initiatives)  Other domains: economic evaluation, community contribution, regional needs, TB/HIV surveillance, entry point, and delivery of care.

14. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 Is the TB/HIV research agenda comprehensive? The primary domain is the health system Some areas are covered in the HIV and TB research agenda (HR, drug development, socio- behavioural)

15. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 Collaborative TB/HIV activities A. Establish the mechanism for collaboration A.1. TB/HIV coordinating bodies A.2. HIV surveillance among TB patient A.3. TB/HIV planning A.4. TB/HIV monitoring and evaluation B. To decrease the burden of TB in PLWHA B.1. Intensified TB case finding B.2. Isoniazid preventive therapy B.3. TB infection control in care and congregate settings C. To decrease the burden of HIV in TB patients C.1. HIV testing and counselling C.2. HIV preventive methods C.3. Cotrimoxazole preventive therapy C.4. HIV/AIDS care and support C.5. Antiretroviral therapy to TB patients.

16. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 Objectives and expected outcomes of the expert consultation 1.To define TB/HIV research priorities 2. To encourage stakeholders/partners to carry out the prioritised operational research through linking it with routine programme activities.

17. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 1. To define TB/HIV research priorities Day 1 –Challenges on 1) how to implement the TB/HIV package 2) Cross-cutting domains: health system, HR, community role, delivery to affected groups Day 2 –Research priorities on individual TB/HIV interventions Three discussion groups (background papers)

18. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 2. Implementation of TB/HIV research agenda Day 1: –From research to implementation –Donor and partner perspectives Day 2 –Research priorities identified –Discussion with partners on how each partner/donor will contribute to the process to implement the research activities identified

19. Expert consultation on TB/HIV Research priorities, 14-15 February 2005..to assist you to develop the TB/HIV research agenda. ……that WE will all use to improve TB & HIV control and the health conditions of millions of people.

20. Expert consultation on TB/HIV Research priorities, 14-15 February 2005 BON TRAVAIL!