In late 2013, Guinea Conakry was set to scale up its efforts to address multidrug-resistant tuberculosis (MDR-TB) with support from The Global Fund. A full course of second-line drugs had been ordered from the Global Drug Facility, but other aspects of the programme were not yet in place, so The Global Fund invited The Union’s MDR-TB Unit to assist the NTP and their partners to complete their preparations.
Although the treatment of MDR-TB patients is not a new activity for the NTP, a clear plan for managing these cases had not been agreed. Consequently one of the first tasks was to collaborate with the NTP, the National TB Laboratory, reference TB hospital and ambulatory services and other stakeholders, such as the World Health Organization and Action Damien, to define this plan.
This work ranged from empowering the MDR-TB multifunctional committee and identifying appropriate interventions to assess the actual number of patients waiting for treatment, developing clinical and M&E tools for the management of cases and planning a training package. To expand services, three sites were also selected for decentralised MDR-TB case management.
Through reviewing laboratory registers and updating databases, the team discovered that the number of cases to be treated was much higher than expected – a result that underlined the urgency of scaling-up and rolling out the new programme.
It also highlighted the urgency of increasing the “critical mass” of professionals skilled in managing MDR-TB, so, at the end of the mission, The Union offered a four-day training. The course was open to health professionals working with MDR-TB patients at both the new and existing sites, as well as NTP staff. This cadre of people is now prepared to offer the best care with the available resources and to implement and revise their policies as needed.
While the in-country mission lasted only 4 weeks, intensive online consultation continued through December and January, and also later. Now the GDF anti-TB drugs have arrived in the country, and one of the decentralised sites has been renovated and is ready to start enrolling MDR-TB patients. For The Union MDR-TB Unit, the mission is over, but the linkages and collaboration developed with the staff in-country will continue.