USAID Eliminating Tuberculosis in Central Asia

The USAID Eliminating Tuberculosis in Central Asia activity reduces the burden of tuberculosis (TB) in Central Asia by building local and regional capacity to improve the detection and treatment of drug-resistant TB (DR-TB).

Overview

The USAID Eliminating Tuberculosis in Central Asia activity is leading measurable and sustainable improvements in the quality and availability of DR-TB services by building the capacity of Central Asian institutions in TB leadership, management, financing, and information systems. The activity improves TB service delivery by ensuring availability of skilled and motivated providers in laboratories and health facilities and accessible drugs, supplies, and services. The activity works with communities to reduce TB stigma and provides comprehensive support services to TB patients to ensure successful treatment completion.

Objectivies

• Increase detection of TB and DR-TB;    
• Increase treatment success for TB and all types of DR-TB; and    
• Improve enabling environment and financial sustainability of TB and DR-TB programs.

Challenges and Solutions

The high proportion of multidrug resistant-TB (MDR-TB) among patients across Central Asia suggests continued challenges in the detection and treatment of both TB and DR-TB. Countries in the region have made significant progress in strategic planning and aligning clinical practice guidelines with international recommendations but improving TB outcomes cannot be achieved at the service delivery level alone.

KEY ACHIEVEMENTS IN 2020-2021

Kazakhstan

• Educated 23 civil society organizations (CSO) trainers, provided trainings on TB detection, treatment and TB stigma reduction for health care providers and the general population.
• Supported the development of several national documents such as Guideline on TB Detection, Treatment, and Stigma Reduction for CSOs, new National Strategic Plan (NSP) for 2021-2025, recommendations on TB financing optimization.  
• Updated the TB diagnostic algorithm including GeneXpert testing, rapid molecular culture, and drug susceptibility testing technologies in accordance with WHO recommendations.    
• Updated 318 Standard Operating Procedures (SOPs) to be aligned with the latest international standards, and to ensure safe, effective, and up to date quality assurance procedures for TB laboratory tests.
• Raised awareness on TB and TB related stigma and discrimination among 536,518 people through several events devoted to World TB Day, including seven video stories of six people affected by TB and three video spots on TB related stigma reduction rotated on social networking sites.

The Kyrgyz Republic

• Organized regional capacity building events on TB case management, TB drug supply chain management, and social contracting in TB care, involving professionals from all levels of TB service in the Kyrgyz Republic.

Tajikistan

• Facilitated TB screening for over 26,603 people, including vulnerable populations, and provided psycho-social support to 997 new and relapsed DR-TB patients to support adherence to complete the treatment since June 2020.
• Provided psycho-social support to 38,714 households (reaching 181,642 individuals) affected by TB, conducted counseling sessions to raise TB awareness and promote active TB case detection.
• Updated all 318 Standard Operating Procedures of the National Reference Laboratory to be aligned with the latest international standards, and to ensure safe, effective, and up to date quality assurance procedures for TB laboratory tests.
• Facilitated the state approval in February 2021 of national legislation on free of charge X-ray examination for TB contacts; supported the development of the National Guidelines on Management of Latent TB Infection and the new National Tuberculosis Program for 2021-2025.

Turkmenistan

• Prepare for the procurement of BD Max molecular diagnostic testing system in line with the needs of the National Reference Laboratory in Ashgabat, Turkmenistan.

Uzbekistan

• Supported the development of the new National Strategic Plan (NSP) for 2021-2025 through provision of technical expertise on TB diagnostics, TB treatment, TB drug management, strengthening TB laboratory network, and TB outreach to vulnerable populations including migrants; and contributed to development of the country's application to the Global Fund.
• Supported the development of several national documents such as Guideline on Management of Latent TB Infection, National Protocol on Video Supported Treatment, Guideline on TB Laboratory Diagnosis to improve TB diagnosis and treatment.
• Delivered medical equipment to 12 district medical institutions of the Syrdarya region.    
• Updated 82 Standard Operating Procedures of the National Reference Laboratory to be aligned with the latest international standards, and to ensure safe, effective, and up to date quality assurance procedures for TB laboratory tests.

Project Duration:

September 2019 –September 2024                    

Regional Budget

$31,574,313

Implementing Organizations: 

Abt Associates with the Institute of Microbiology and Laboratory Medicine red GmbH, SNRL Munich-Gauting, Gauting, Germany; PATH, Republican Public Organization Afif Tajikistan; Public Fund AIDS Foundation East-West in Kazakhstan, The Resource & Policy Exchange, Inc.; and Red Crescent Society of Tajikistan.

Project Area: 

Kazakhstan, the Kyrgyz Republic, Tajikistan, Turkmenistan, and Uzbekistan

CONTACT:

Arman Toktabayanov, Regional TB Advisor, USAID/Central Asia 

e-mail: atoktabayanov@usaid.gov