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China TB Control Progress Report The ninth Technical Advisory Group and National TB Programme Managers meeting for TB control in the Western Pacific Region.

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Presentation on theme: "China TB Control Progress Report The ninth Technical Advisory Group and National TB Programme Managers meeting for TB control in the Western Pacific Region."— Presentation transcript:

1 China TB Control Progress Report The ninth Technical Advisory Group and National TB Programme Managers meeting for TB control in the Western Pacific Region Manila, Philippines 9 -12 December 2014

2 TB Epidemiology in China China ranks second among the 22 high burden countries. It was estimated 980,000 new TB patients, accounting for 13.2% of the 22 high burden countries and 61.3% of the Western Pacific Region in 2013. The estimated incidence rate of TB was 70/100000 in China which ranks 21 st among the 22 high burden countries in 2013. In our national infectious internet report system 904, 434 PTB cases were reported with the reporting rate of 66.8/100,000 in 2013. Estimates of MDR-TB burden in 2013 was 54000 (MDR-TB cases among notified pulmonary TB cases) which ranks second and occupied 18% globally respectively in 2013.

3 Dramatic reductions in TB cases and deaths in China, 1990–2010 Incidence and notifications PrevalenceMortality 1990 2010 Halved in 20 yearsCut almost 80% Incidence falling 3.4%/year Realizing the TB target of MDG in advance Promoting WPR realizing the MDG targets which was the only area achieved the global control targets

4 Major challenges Severe TB epidemic – High TB burden – High PTB prevalence : rural, western region, elderly – MDR-TB, TB/HIV and floating population TB control strategies and measures – Control of infection sources : early diagnosis is difficult and cost much – Patient care: whole-course treatment management and compliance is hard to retain – Infection control : medical institutions and community both need to be improved – Free medical insurance policy need to be established – TB related health service system need to be strengthened R & D – Diagnostic tools are not sensitive enough – The vaccine protection force are still insufficient – New anti-TB drugs are not available Insufficient fund and human resource of TB control Laboratory capacity need strengthening

5 MOH are planning for the assessment of NTP(2011-2015), then will develop NTP(2016-2020), establish our renewed strategy for TB control. Future national TB control strategy will target at reducing TB incidence and mortality and will be incorporated into the national health development plan. We will take every necessary measures to ensure achieving objectives of WHO End TB strategy. Future TB control will be based on ensuring drug sensitive TB patients get good health care service, while strengthening MDR-TB control as well. National TB Strategy/Policies

6 国际项目 Funding sources from 2001 to 2013 Central government increased funding from 40 million in 2001 to 0.62 billion in 2013 F unds (RMB) for TB control was increased from 0.13 billion in 2001 to 1.4 billion in 2013 *Because of the GF project suspend payment, so there was a gap from GF funding in 2011. RMB (million) Mechanism of the funding input: Strengthened all level government commitment and funding input, multi-channel fund raising

7 Laboratory strengthening Laboratory developing target by 2015 – All counties have ability of culture – All prefecture and provincial laboratories have ability of DST and molecular test Rapid DTS test equipment – LED FM: 1523 – Gene-xpert: 1054 – HAIN LPA: 150 Quality control methods – Blind rechecking, Proficiency test, Field Supervision Laboratory information management system – Integrated into National TB information management system TA partner – Hongkong SRL,KIT

8 Intensive case finding: National basic public health program did TB symptom screening for elderly people, diabetes patients. Enhancing screening of close contacts of SS+ TB patients, especially in schools, etc. Mutual screening in TB, HIV/ADIS cases. From 2007 to 2013 , 1, 050, 000 TB patients received HIV test, 5530 were HIV positive. 730, 000 HIV/AIDS cases received TB examination, 22 thousands was TB/HIV. Enhancing trainings for TB diagnosis in children , making better plans for children’s TB control, establishing cooperation mechanisms with pediatric hospitals. Reach the unreached

9 Surveillance Using self-regulation of TB information system and site visit inspection for quality control. Currently capture-recapture research were ongoing for sensitivity evaluation of our information system. New TB definitions has been discussed in national TB expert group, necessary changes will be done in our new TB control guideline and in TB information system. Guidebook for TB surveillance data analyzing and using has been published. NCTB release quarterly and yearly TB report according to data analyzing result. Sub-national institutions do the same thing. Occasional analyzing will be done responding to different need.

10 Design-stepwise approach Current situation – launched in October 2006. Till Sep. 2014, the PMDT in China cover 90 prefectures(27%) in 30 provinces, will cover 50% prefectures by 2015. – Till November 2014, 14267 MDR-TB cases have been confirmed,9748 MDR-TB cases enrolled in treatment Barriers – Coverage need expanding – Screening rate was not high enough – Treatment management was difficult Priority actions – Adopting rapid screen methodology – Establishing prefecture level designated hospitals

11 Bold policies and supportive systems National medical insurance system has covered TB diagnosis and treatment partially, requiring NCMS to reach 70% reimbursement for TB outpatients and inpatients(including MDR-TB patients). National basic public health program will provide funding to primary health institutions, encouraging TB suspect referral, report and treatment management. Second-line anti-TB drugs have been included in the" National Essential Drugs List". MOH Issued "MDR-TB clinical path".

12 Patient centred care: involvement of patients and civil society Society mobilization − 3.24 TB publicity day − Millions of volunteer activities − In 2013, 240, 000 volunteers were motivated − Using social media like micro-blog to carry out health promotion and information dissemination Incentive mechanism − Transport fee (in the project areas) − Nutritional supplement fee (in some areas) − Hardship allowance from civil affairs department

13 Thank you for your attention!


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