The document outlines the Consolidated Action Plan to Prevent and Combat Multidrug- and Extensively Drug-Resistant Tuberculosis in the WHO European Region from 2011-2015. It discusses progress made towards tuberculosis goals, current epidemiological data on TB incidence and mortality in the region, and an overview of the action plan. The action plan aims to combat the growing threat of drug-resistant TB in Europe through improved detection, treatment and prevention efforts over the next five years.
Washington Global Health Alliance Discovery Series
Peter Piot, MD, PhD
March 2, 2009
'The Transformational Nature of the AIDS Response: Opportunities for Global Health'
Washington Global Health Alliance Discovery Series
Peter Piot, MD, PhD
March 2, 2009
'The Transformational Nature of the AIDS Response: Opportunities for Global Health'
Reported measles cases for the period November 2020—October 2021 (data as of 02 December 2021).A monthly summary of the epidemiological data on selected vaccine-preventable diseases in the WHO European Region
Similar to Consolidated Action Plan to Prevent and Combat Multidrug- and Extensively Drug-Resistant Tuberculosis in the WHO European Region 2011–2015 (6)
Reported measles cases for the period November 2020—October 2021 (data as of 02 December 2021).A monthly summary of the epidemiological data on selected vaccine-preventable diseases in the WHO European Region
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Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
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Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Consolidated Action Plan to Prevent and Combat Multidrug- and Extensively Drug-Resistant Tuberculosis in the WHO European Region 2011–2015
1. Consolidated Action Plan to Prevent
and Combat Multidrug- and
Extensively Drug-Resistant
Tuberculosis in the WHO European
Region 2011–2015
Zsuzsanna Jakab
WHO Regional Director for Europe
24 March 2012
2. Outline of presentation
• Progress towards the Millennium
Development Goal
• Latest TB epidemiological data
• Overview of the Consolidated Action Plan
• Next steps
3. MDG 6: Tuberculosis Prevalence
Rate per 100 000 population per year
Incidence, prevalence and mortality,
WHO European Region, 1990–2010
Incidence
MDG target for prevalence
Rate per 100 000 population per year
Mortality
Rate per 100 000 population per year
MDG target for mortality
TB/HIV incidence
Source: Global tuberculosis control 2011, WHO
4. TB burden globally and in the
WHO European Region
• The Region
contributes
4.7% of the
global TB
burden
• Estimated
418 000 new
TB cases and
60 000 deaths
in the Region
5. Notification of new and relapse cases, rate per 100 000
population, WHO European Region, 1980–2010
100
Notification rate, European Region
* 18 high priority
Notification rate, 18 high priority countries * countries
80 Notification rate, 27 EU countries ** Armenia
71.6 Azerbaijan
Belarus
Bulgaria
60 Estonia
Georgia
Kazakhstan
Kyrgyzstan
Latvia
40 34.61 Lithuania
Moldova
Romania
Russian Fed.
20 Tajikistan
Turkey
4.9 Turkmenistan
Ukraine
0 Uzbekistan
1980 1985 1990 1995 2000 2005 2010
Note: ** excluding Bulgaria and Romania entering to EU in 2007
Source: Global tuberculosis database, WHO. Ac cessed on 10 October 2011
6. Percentages of notified TB cases of foreign origin
among all TB cases, WHO European Region, 2010
Determinants of TB
TB is particularly linked to migration
and imprisonment
Identification of the geographical origin
Overall TB notification rate (all TB) per 100 000
of people with TB is significantly better inmates, WHO European Region, 2010
in countries in the western part of the Average = 280 per
100 000 population
Region
Identification of the imprisonment
status of people with TB is significantly
better in countries in the eastern part of
the Region
7. TB notification (0–14 years old)
per 100 000 population,
WHO European Region, 2010
Total = 10 000 TB
cases
8. Children with TB,
WHO European Region, 2010
About 10 000 children with TB
one dot = one child
9. Percentage of all children with TB who are
younger than five years old, WHO European
Region, 2010
About 2650 total
10. Treatment success rates for new,
previously treated and MDR cohorts in
WHO regions
Treatment outcomes for new laboratory-confirmed Treatment outcomes, WHO European
pulmonary TB cases in other WHO regions, 2010 reporting Region, 2010 reporting
100% 1 4.3 6.1 7.3
3 3
7 5 1
10 5 1 6.7
2 2
1
90% 6 3 4 11.3
14.1
1 8 11.3
6
1
80% 5
9.0 13.0
23.7
70%
93
88 88
9.3
60% 80
76
68.7
11.3
50% 56.3
47.6
40%
AFR AMR EMR SEAR WPR New pulmonary Re-treated MDR-TB cohort
lab.confirmed lab confirmed
Not evaluated Defaulted Failed Died Successfully treated
Source: the Global TB control 2011 report Source: T B surveillanc e and moni toring in
Europe, report 2012
11. Estimated percentage of MDR-TB among new and previously treated
TB cases, 15 countries with a high burden of MDR-TB, average by
region and globally, 2010
Previously TB treated cases
New TB cases
Source: Global tuberculosis control 2011, WHO
12. Facts about MDR-TB,
European Region, 2010
Estimated MDR burden among all 81 000 cases
TB cases, WHO European Region (73 000–90 000)
Estimated percentage of MDR-TB:
- Among new TB cases 13% (12–15%)
- Among previously treated cases 42% (38–47%)
Coverage of
- Culture confirmation 39% (152 827)
- Drug susceptibility testing 86% (131 007)
Notified percentage of MDR-TB:
- Among new TB cases 14% (11 659)
- Among previously treated cases 49% (16 587)
Detection rate of all MDR-TB 36% (32–39%)
cases (29 059)
13. Countries that had reported at least one
XDR-TB case by the end of 2010
European Region:
•7500 annual XDR-TB cases
estimated
•Only 212 XDR-TB cases notified in
2010
14.
15. Percentage of TB cases testing positive with HIV infection among
those tested, WHO European Region, 2006–2010
increasing by 20% per year
in the past 5 years
16. Treatment outcome, new laboratory-
confirmed pulmonary TB cases, European
Region, 2001–2009
17. Consolidated Action Plan to Prevent and Combat
Multidrug- and Extensively Drug-Resistant Tuberculosis
in the WHO European Region 2011–2015
• No business as usual (special project established)
• Inclusive approach to develop the Plan
• Building on the existing commitments
• SMART objectives, clear list of activities
• Full endorsement by the Regional Committee in Baku
• Fully costed and includes financial gap analysis
• Follow-up mechanism
18. Overview of the Action Plan
Goal
• To contain the spread of drug-resistant TB by achieving
universal access to prevention, diagnosis and treatment
of M/XDR-TB in all Member States of the WHO European
Region by 2015
Targets
• To decrease by 20 percentage points the proportion of MDR-TB
among previously treated people with TB by the end of 2015
• To diagnose at least 85% of the estimated number of people
with MDR-TB by 2015
• To treat successfully at least 75% of the notified people with
MDR-TB by 2015
19. Consolidated Action Plan to Prevent and Combat
M/XDR-TB
• Prompt diagnosis, including newly endorsed
molecular diagnostic techniques
• Equitable access to adequate treatment
• Health system approach to preventing and
controlling MDR-TB
• Emphasis on involving civil society organizations
• Identifying and addressing social determinants
• Working in partnership, twinning of cities and
programmes
• Robust monitoring framework, accountability
and follow-up
• Including neglected aspects (such as palliative
care and surgery)
20. Expected achievements of the Action Plan
• 225 000 people with MDR-
TB diagnosed
• 127 000 people with MDR-
TB treated successfully
• 250 000 MDR-TB cases
averted
• 13 000 XDR-TB cases
averted
• 120 000 lives and 12
US$ billion saved
21. Areas of intervention
1. Prevent the development
of M/XDR-TB
2. Scale up access to early
diagnosis
3. Scale up access to
effective treatment
4. Scale up TB infection
control
22. Areas of intervention (cont.)
5. Strengthen surveillance
6. Expand management
capacity of the
programmes
7. Address the needs of
special populations
23. WHO Regional Committee resolution on M/XDR-TB
adopts the Consolidated Action Plan and
Urges Member States Requests the Regional Director
• to harmonize as appropriate their • to provide leadership, strategic
national health strategies and/or direction and technical support for the
TB/MDR-TB response plans based on implementation of the Action Plan
the Action Plan
• to facilitate the exchange of
• to identify and address determinants experiences and know-how among
and health system challenges leading Member States
to emergence of drug-resistant TB
• to establish a platform to strengthen
• to provide universal access to early partnership for prevention and control
diagnosis and effective treatment of of TB and M/XDR-TB
people with MDR-TB
• to assess progress in the prevention
• to address the needs of special and control of M/XDR-TB every other
populations year starting from 2013 and report
• to closely monitor and evaluate the back to the Regional Committee
implementation of the actions outlined
in the Action Plan
Primary health care, psychosocial support, health funding
25. Next steps
• Comprehensive national MDR-TB response plans in accordance
with the Action Plan in 2012
• Health system audits to identify bottlenecks and propose
solutions
• Facilitate diverse models of technical assistance
• High-level visits to ensure commitment to implementing the
Action Plan
• Yearly progress report (WHO/ECDC annual monitoring and
surveillance report)
• Interagency Coordination Committee involving civil society
organizations for following up the Action Plan
26. Thank you for your attention
E-mail: Tuberculosis@euro.who.int
Editor's Notes
MDG6 Target 8: By 2015, to have halted and begun to reverse the incidence of malaria and other major diseases. TB targets to reverse the incidence of TB (on track), to decrease to half the prevalence and mortality comparing to their levels in 1990 (foreseen to be achieved). The incidence of TB has slowly declined during the past years, reaching 48 (confidence interval 44–50) per 100 000 population in 2009. However, there is a big discrepancy between east and west. The TB prevalence decreased from 96 (confidence interval 70–130) to 63 (confidence interval 49–81) per 100 000 population between 1990 and 2009 versus a target of below 48 set out for 2015. The TB mortality must decline further, from 6.9 per 100 000 population in 2009 to 6 by 2015. August 17, 2012
The WHO European Region only contributes 4.7% of the global TB cases, but many countries in the Region have a medium or high incidence of TB. Only 32 of the 53 European Member States have a low TB incidence (less than 20 per 100 000 population). The overall TB incidence in the Region is 47 per 100 000 population.
This slide shows the trends in notification of TB cases in the Region. Please note that not all estimated incident TB cases are notified; some may not be diagnosed, and even some that are diagnosed may not be reported (from the private sector, for example). TB notification in the high-priority TB countries was at its lowest level in 1990s. The TB rate increased sharply from 1995 to 2005. This period followed the collapse of the USSR and disruption in adequate treatment services. 18 countries are considered a high TB priority not only because of their TB incidence rate but also because of their population size. These countries include 85% of the TB burden in our Region. You can see these countries on the right. These include the former Soviet Union, Bulgaria, Romania and Turkey.
Two determinants play an important role for TB in our Region: migration and imprisonment. This slide shows two maps. The darker areas show the importance of these two determinants. The upper map shows that, in some countries, particularly in the western part of the Region, up to 50% of TB cases are among migrants. The lower map shows the TB rate among prisoners. In the eastern part of the Region and a few other countries, up to 2000 of every 100 000 prisoners (2%) have had TB. Some countries do not report TB cases among prisoners.
In 2010, 10,000 TB cases among children younger than 14 years old were reported. This year, World TB Day is dedicated to childhood TB, with the slogan “stop TB in my lifetime”. We need to pay special attention to TB among children. TB among children indicates unsuccessful programmes and ongoing transmission. The countries that reported no cases of TB among children in 2010 were: Andorra, Iceland, Malta, Monaco, and Turkmenistan. They are white on this map. Diagnosing TB among children is very difficult, and many cases may go undetected.
This shows the concentration of TB cases reported among children. Every child counts, and if we plot every child as one dot, this is the picture we get on the map of the Region. Some countries, even in the western part of the Region, have reported many TB cases among children. In some of the countries in the western part of the Region, half the TB cases among children are among those younger than five years old.
This slide shows the percentage of all children with TB who are under five years old. In 10 countries, more than half the children with TB are younger than five years old. The countries are Austria, Belgium, France, Greece, Israel, Italy, Latvia, Slovenia, Spain and Switzerland. This shows recent and ongoing transmission of TB, even in countries with a low incidence.
The right side shows the treatment results in our Region, and the left side shows the treatment results for new laboratory-confirmed pulmonary TB cases in other regions. The European Region had the less successful treatment outcomes than other regions. In fact, TB in the European Region is becoming more and more difficult to treat. During the past five years, treatment success rates have continued to decrease, declining from 72% in 2005 to 69% in 2010 among new TB cases and from 50% in 2005 to 48% in 2010 among previously treated TB cases. The treatment success rate among people with multidrug-resistant TB was 56% in 2010. These are well below the targets of an 85% success rate among new cases and 75% among those with multidrug-resistant TB and those being re-treated.
15 countries in our Region have a high burden of multidrug-resistant TB. The rates of multidrug-resistant TB in these countries are compared with the average in the Region and globally. We should all consider why the rates in these countries are higher than the average global level. Multidrug-resistant TB is a form of TB that is resistant to isoniazid and rifampicin, the two most important first-line anti-TB drugs. Poor treatment adherence, inadequate treatment and poor infection control contribute to the development and transmission of multidrug-resistant TB.
This shows an increase of multidrug-resistant TB in the Region from 2% to 14% among new cases and from 15% to 49% among previously treated cases in 2010. Further, only about 40% of people with TB have access to culture, and not all the people who are examined by culture undergo drug susceptibility testing. Therefore, many cases of multidrug-resistant TB may go undetected. In 2010, of 81 000 estimated cases of multidrug-resistant TB, only 29,000 were detected. You may ask how this is estimated. This is based on the national drug resistance surveys and quite reliable.
Extensively drug-resistant TB is a form of TB resistant to the most important first- and second-line drugs (multidrug-resistant TB that is also resistant to fluoroquinolones and second-line injectables). Chances of treatment of XDR-TB is low. An estimated 7500 cases of extensively drug-resistant TB occur annually in the Region, but only 212 were notified in 2010; Notification of extensively drug-resistant TB is not yet representative of the actual situation because coverage of second-line drug susceptibility testing is insufficient.
TB is a leading killer among people living with HIV. Our Region has good coverage for HIV testing among people with TB: 74%, with about 290 000 people with TB tested for HIV in 2010. The HIV prevalence among people with TB was 5.5% in 2010. However, only 70% of people with both TB and HIV infection are receiving antiretroviral therapy.
This shows the HIV positivity rate among people with TB. Red is the average for the Region and blue is the 18 high-priority TB countries. During the past 5 years, the rate of coinfection with TB and HIV has increased. In absolute numbers, the increase is from 5336 in 2006 to 15 954 in 2010. The rate of coinfection increased by 20% per year from 2006 to 2010. We need to pay attention to this problem, as we are facing a growing problem with HIV infection. Our Region is the only WHO region in which HIV infection is increasing.
This shows the trends in treatment success of new pulmonary TB cases that are laboratory-confirmed, either by sputum smear or culture. The treatment success rate has continually declined, with an increase in failure parallel to the increase in multidrug-resistant TB. The death rate has also increased because of the increase in multidrug-resistant TB and coinfection with TB and HIV.
In response to the problems mentioned, I have established a special project. The first and important task of the project has been to develop a comprehensive Action Plan. With unprecedented consultation with Member States, technical agencies, civil society organization and communities, the Consolidated Action Plan to Prevent and Combat Multidrug- and Extensively Drug-Resistant TB was developed. The Plan has clear activities that are specific, measurable, attainable, realistic and time-bound. The Regional Committee fully endorsed the Plan at its sixty-first session in Baku in September 2011. The Plan has also a costing elements and financial gap analysis. The Global Fund to Fight AIDS, Tuberculosis and Malaria has been foreseen to play an important role in funding the Plan, but unfortunately the Gobal Fund has faced problems. We hope the Member States continue to increase their funding so that activities proposed in the Plan can be implemented. The Plan also has a robust monitoring system to enable us and the Member States to measure the progress in implementation.
The overall goal of the Plan is universal access to prevention, diagnosis and treatment of multidrug- and extensively drug-resistant TB for all people. This is in accordance with World Health Assembly resolution WHA62.15 (to achieve universal access to diagnosis and treatment of multidrug-resistant and extensively drug-resistant tuberculosis as part of the transition to universal health coverage, thereby saving lives and protecting communities) The targets are reflected here to ensure that multidrug- and extensively drug-resistant TB can get under control.
This presents the Plan in a nutshell and what is new in the Plan. We work closely with all partners on preventing and controlling TB. The Action Plan has been developed with their input. There is also good collaboration with the Global Fund to Fight AIDS, Tuberculosis and Malaria and the STOP TB Partnership. As the Plan ihas been developed jointly, we will also implement it to work hand in hand with our Member States. A task force to prevent and control TB and multidrug-resistant TB among children and a task force to document the role of surgery in TB were established recently. We are the first region to work on these aspects and share experience with other regions.
These numbers are based on a Syblo model and estimating that one untreated person with TB can infect 10–15 other individuals yearly and 10% of them develop the disease , including 5% of these in the first two to five years. This shows the expected achievements of the Consolidated Action Plan. Implementing the Plan would cost 5 billion US dollars, and not implementing the Plan would cost the Region 12 billion US dollars. Annex 5 of the Plan provides details of how these are calculated.
There are seven areas of intervention, and each includes a specific set of activities.
The Resolution on multidrug-resistant TB that accompanied the Action Plan urges the Member States, civil society organizations, national and international partners and development agencies, in particular the Glboal Fund, to fully support the implementation of the Consolidated Action Plan. The foundation is good primary health care, strong psychosocial support for people with TB and efficient health funding to ensure progress We shall report the progress every other year at the sessions of the Regional Committee starting from 2013.
This slide shows the official launch of Consolidated Action Plan to Prevent and Combat M/XDR-TB. The Plan was launched in Moscow during the MDG-6 summit 10 October 2011 by GFATM, StopTB partnership, European Commissioner and Regional Director
We need to work with the countries to finalize their national response plans based on the Regional Action Plan. We emphasize a health system approach to preventing and controlling multidrug- and extensively drug-resistant TB. WHO together with partners (ECDC in Europe) is organizing programme reviews and country visits to assist Member States in developing short-, medium- and long-term interventions. Such extensive programme visits are conducted in several countries, such as Kazakhstan and Azerbaijan, but also in the Netherlands, Norway and soon in Hungary on 22–25 May 2012. We shall work on various models of technical assistance including intercountry work, knowledge hubs among others. WHO and other partners including the EC would organize high level visits to countries to ensure implementation of the Plan. We need to measure the progress in implementation and foster development of new tools and approaches together with scientific institutes I am planning to establish an Interagency coordination committee with involvement of key stake holders and civil society organizations to oversee the progress in implementation of the Plan.