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Regional Meeting of National Tuberculosis Control Program Heads

(Havana, Cuba, 11-13 September 2002)

Final report (97 pp, in Spanish): HTML   | PDF (4095 KB)     | TB page
Note: The report in PDF contains bookmarks to enable instant access
to the separate chapters, including data from the individual countries (Annex I).

Executive Summary

The Regional TB Meeting of TB takes place every two years with the involvement of National TB Program Heads from the Latin American countries. This year, Puerto Rico was also included as a guest. The last meeting was held in Mexico City in September 2000. This year's meeting included TB Program Heads from Argentina, Bolivia, Belize, Brazil, Chile, Colombia, Costa Rica, Cuba, the Dominican Republic, El Salvador, Guatemala, Haiti, Honduras, Nicaragua, Panama, Paraguay, Peru, Venezuela, and Uruguay. Representatives from the WHO global initiative STOP/TB were present as well, along with organizations and institutions that they provide support to TB programs in the Region (see List of Participants at end of report).

Objectives

1. Review of progress made in compliance with the recommendations of the Mexico meeting in September 2000.
2. Review the status of DOTS/TAES in the Region and the fulfillment of plans to expand the strategy in those countries that do not have total coverage (WHO Goals).
3. Analyze relative aspects to the Global Fund to Fight AIDS, TB and Malaria (GFATM).
4. Consolidate strategic partnerships with members for the plans to control TB.
5. Discuss the Regional Strategic Plan for 2003–2004.

Meeting Development: On the basis of the objectives of the meeting, an agenda was prepared on issues to be covered. A summary of the points discussed is presented below:

World TB Situation and of DOTS Expansion

Dr. Mario Raviglione (Stop TB, WHO) briefly summarized the global TB situation with regard to incidence reported to WHO, pointing out the challenges this represents for controlling the HIV/AIDSepidemic, as well as the steady increase of resistance to tuberculosis drugs, especially MDR-TB multidrug resistance.

Mr. Raviglione pointed out that the 22 countries with greatest TB burden at world level report nearly 80% of all cases, thus constituting the highest priority for TB control of TB at the global level. In the Region of the Americas, only Brazil belongs to this important group, since Peru was eliminated from this list in 2001 thanks to the reduction of incidence that the country has maintained in recent years.

The DOTS strategy and its expansion continues to take first priority for global TB control, both in the 22 countries of with the highest disease burden and in the remaining countries. Mr. Raviglione pointed out that, although progress has been made in expanding DOTS coverage, it is minimal. Expansion needs to proceed more rapidly, since at the current rate, the WHO targets will not be met until after 2015 and not in 2005, as has been proposed.

TB Situation in the Region of the Americas

The PAHO Regional Advisor on Tuberculosis, Dr. Rodolfo Rodríguez, presented the situation of TB in the Region as well as the status of the implementation of the DOTS/TAES strategy and the plan of action for its expansion in the next biennium (2003–2004).

The reported TB incidence trend over the past ten years is very regular, although in the years 1999, 2000, and 2001 a light decline of the attributable curve was recorded in such countries as Peru, the USA, and others, which diminished the number of reported cases. HIV/AIDS and TB/HIV co-infection already constitute a significant problem in some countries, determining an increase (of between 3% and 5%) of TB cases among doubly infected populations.

Multidrug-resistant tuberculosis (MDR-TB), with some exceptions, is not a big problem yet in the Region, thanks to a good level of surveillance by national surveys in the majority of the countries. DOTS implementation coverage reached 73% of the population in the Region in 2001. There are nine countries prioritized according to rate of TB burden that report nearly 75% of all cases each year. DOTS expansion has made notable progress in several of these countries, but the great challenge for the Region lies in Brazil, which represents 33% of the regional TB burden, where DOTS coverage only reaches 17%–20% of the population.

In his presentation, the Dr. Rodríguez insisted on the need to accelerate the implementation of the DOTS/TAES strategy and develop plans of action to bring about an increase in DOTS coverage, with support from governments and with partners contributing funds.

Country Reports: See Annex I of the Report, which contains a series of graphs and figures with country data.