TB/HIV Workshop: DRC Group Work and Country Presentations

Not yet established nationally, only for Union IHC project, USAID/WHO Is needed to be formalized to give it more status and impact 1stQ 2008 with consultant already programmed to come, institutional assistance MAP in country already wants to integrate TB/HIV already. M&E to be adjusted 1.1 Coordinating mechanism

1.2 Conduct surveillance HIV in TB (NTLP) First base-line in Kinshasa, Belgium Gvt, pilot in Conflicting data from other sources. PICT is not well established countrywide, needing a prevalence survey/sentinel surveillance ANC is well established Action: Agree on protocol (sites, sample, methodology) and funding MAP? Needs reprogramming, indicator exists Utilize funds faster and request more. Explore with TTL WB.

1.3 Planning New strategic plan for HIV/AIDS needed Action: TA required for revision of 5 year strategic plan for HIV/AIDS, and advise on inclusion of TB/HIV, MAP 2 years and GF7 already won (WB, The Union promised, Belgium Government). U$: WB (MAP) working in zones and funded, GF (2 rounds)

1.4 M&E Joint supervision TB/HIV in IHC and other funding Joint revision of data collection tools completed, but not yet widely implemented because of lack of printing and distribution Satellite internet connections in all zones Action: Funds for printing and distribution Training of Health workers Present to donors (WB, GF)

2.1 ICF Not yet established in technical policy NACP; methodology, guidelines, training and M&E Problems of access to good diagnosis when TB suspect is identified: knowledge and skills and equipment (Xray, AFB etc.) Action needed: Intermediate measures for improving diagnosis particularly in (referral) hospitals: train, equipment Training of HCWs in TB diagnosis in HIV/AIDS care settings Training of HCW in HIV/AIDS settings (VCT, PMTCT, HAART centers) in identification of TB suspects (all forms) based on symptoms Same for community-based programs Same for organizations of PLHIV

2.2 IPT Not yet included in technical policy Fear for mono-therapy,exclusion of active TB Action Organize a meeting in DRC on IPT Protocol Development of policy and technical policy together between NTLP/NACP Pilot project in a few sites Adherence support Evaluation

2.3 Infection Control Already in TB/HIV policy Not integrated in general MOH IC policy, which is also not well functioning in MOH Simple measures: Isolation, Cough hygiene, Not on MDR/XDR with isolation wards Special need for prisons in transmission prevention TB screening and RX available (NTLP) Action Revision of national policy for TB-IC and in prisons Integration in general IC Dissimenation and training in health facilities and congregate settings Refurbishment of health facilities

3.1 Provide HIV testing and counselling Scaling up is the issue of IHC pilot projects Action Scaling-up

3.2 Introduce HIV prevention methods

3.3 Introduce cotrimoxazole preventive therapy Scaling-up needed of IHC pilots

3.4 HIV/AIDS care and support Done by Community-based organization Is not very strong No psychological support Nutritional support needed Action: TA for revision of psychological care and support for PLHIV Capacity building

3.5 ART scale-up Scale-up needed

What can be done in the next 6 months and what is required in DRC? Priority ActivityChallengeInputs Required: external / internal Who will take the action? 1. Formalize a national coordination committee Current modality of coordination too informal TA for institutional capacity building, TOR, membership NACP NTLP 2. Organize HIV/TB surveillance and base-line survey Fragmented information, not standardized TA for Protocol formulation Person time Resource mobilization NACP/NTLP TTL-WB Other donors 3. Formulation of new 5-year strategic HIV/AIDS Plan, including TB/HIV co- infection MAP funding only 2 years TA for strategic planning and implementation plan development Resource mobilization NACP NTLP 4. Finalize, print, disseminate and train staff on new M&E tools in NACP and NTLP Lack of fundingAdvocacy and resource mobilization NACP/NTLP

What can be done in the next 6 months and what is required in DRC? Priority ActivityChallengeInputs Required: external / internal Who will take the action? 5. Revise guidelines for VCT, PMTCT, ART, on TB- ICF ICF not included in current guidelines TA for revision and reformulation of policy, technical guidelines, training tools, and M&E on ICF NACP NTLP 6. Strengthen diagnostic capacity for all forms of TB (training, infra- structure) TB diagnosis inadequate Funds for infrastructure improvement, training, equipment NTLP NACP 7. Organize a national consultation on IPT with stakeholders IPT not included in technical policy TA for facilitating a consultation meeting on IPT Proposal of pilot project NACP TB CAP 8. Revise national TB-IC policy, formulate, disseminate, training, rehabilitation for national scale-up TB-IC not up-to- date TA for actualisation process Resource mobilization NTLP NACP MOH/4th Directorate 9. TA for revision of psycho-social care and support for PLHIV and capacity building Inadequate capacity Current guideline not up-to-date TA for revision of guidelines and training program and capacity building NACP