The Asian National
Stop TB Partnership Forum 2016

Date: 14 and 15, March, 2016
Venue:
United Nations University, Shibuya, Tokyo (14, March)
Research Institute of Tuberculosis, JATA, Kiyose, Tokyo (15, March)
Stop TB Partnership Japan
Japanese Council of Women’s Anti-TB Associations
Japan Anti-Tuberculosis Association

Table of Contents
page#
Table of Contents

1

Report of the Asian National Stop TB Partnership Forum 2016

3

Appendix 1

List of Participants

7

Appendix 2

Introduction of Japanese Women’s Anti-TB Association

9

Appendix 3

Challenges of Current TB Problem to Today’s Asia

13

Appendix 4Country
Presentations

WHO Epidemiological data

19

Cambodia Anti-TB Association

25

Forum Stop TB Partnership Indonesia

30

Stop TB Partnership Korea

35

Myanmar Maternal and Child Welfare Association

39

Japan-Nepal Health & TB Research Association

47

RIT/ JATA Philippines, Inc.

52

Chang-Hua TB Care Association Taiwan

60

TB/HIV Research Foundation Thailand

65

Appendix 5Group Discussion 1 Challenges of NGO to End TB and role of women71

Appendix 6Group Discussion 2 Fundraising for the community activities

75

Appendix 7

Tokyo Statement on Community Engagement in End TB Strategy

79

報 告

アジア・ナショナル・ストップ結核パートナーシップフォーラム 2016

85

東京宣言

「結核早期根絶戦略」におけるコミュニティの参加

89

写真集

93

（Photographs)

1

2

Report of the Asian National Stop TB Partnership Forum 2016
The Stop TB Partnership Japan
The Asia Stop TB Partnership Forum 2016 was held in Tokyo, Japan, on 14 and 15
March, 2016. Following is the summary report of the presentations and discussions in
the Forum meeting.
Main theme
Community people’s roles in End TB Strategy in Asia
Purposes of the ForumTo bring together the delegates of Stop TB Partnerships (or similar
non-governmental organizations, e.g., Anti-Tuberculosis Association)) of
Asian

countries/

territories,

and

to

discussoverthecurrent

non-governmental efforts against tuberculosis, their perspectives into thenear future, with special emphasis on the roles of women, and possibility ofits strengthening, and collaboration between partnerships across borders,aiming at the earlier achievement of End TB Target in Asia.
Expected Outcomes
１． To enhance people’s awareness of the importance of their ownership for andcommitment with the tuberculosis control activities
２． To

promotetheeffective

collaboration

betweengovernmental

andnon-governmental sectors in the fight against tuberculosis
３． To clarify the problems and challenges of tuberculosis control of each country / area
and to develop action plan addressing them with non-governmental efforts
４． To deepen the understanding of the potentiality of women’s efforts in thecommunity activities
５． To advance cooperation between partners of different countries / territories
Date

14 and 15, March, 2016

Venue
United Nations University, Shibuya, Tokyo (14, March)
Research Institute of Tuberculosis, JATA, Kiyose, Tokyo (15, March)

1
3

Participants
A total of 18 participants representing non-governmental organizations of 8
countries / territories were invited (see Appendix 1). In addition, there were 26
observers from various governmental and non-governmental institutions / groups,
including Ministry of Foreign Affairs and JICA.
Agenda and Results
1. Opening and Introduction of Participants and Staff
Chair:

Dr. Toru Mori (Executive Board Representative, Stop TB PartnershipJapan)

2. Lecture 1: 14 March (United Nations University)
Thema:

Women’s Anti-TB Activities in Japan

Lecturer:

Ms. Takeko Yamashita
Secretary

General,Japanese

Councilofwomen’s

Anti-TB

Associations
Abstract (see Appendix 2)
3. Lecture 2: 14 March (United Nations University)
Thema:

Challenges of Current TB Problem to Today’s Asia

Lecturer:Dr. Nobuyuki Nishikiori
Coordinator, Stop TB and Leprosy Elimination, WPRO, WHO

Abstract (see Appendix 3)
4. Courtesy visit and exchange with Japanese Council of Women’s Anti-TB
Associations members, 14 March (Hotel New Otani, the venue of Annual National
Assembly of the Council)
5. Presentation and discussion of activities of Country / Territory partnerships: 14 and
15 March (Research Institute of TB)
Chair:

Dr. Kosuke Okada (Director, International Cooperation, Japan
Anti-TB Association)(See Appendix 4)
6. Group Discussion 1: 15 March (Research Institute of TB)
Thema :

Challenges to NGO’s activities and women’s roles

Moderator: Dr. Nobukatsu Ishikawa (Director, Research Institute of TB, JATA)
2
4

(See Appendix 5)
7. Group discussion 2 : 15 March (Research Institute of TB)
Thema:

Fund raising plan in the community activities

Moderator: Ms. Jintana Ngamvitayapong-Yanai (TB-HIV Research Foundation,
Thailand)(See Appendix 6)
8. Adoption of the Forum Statement: 15 March (Research Institute of TB)
Chair:

Dr. Toru Mori (Executive Board Representative, Stop TB PartnershipJapan)(See Appendix 7; Tokyo Statement of Asian National Stop TB Partnership Forum2017)
9. Reception: 15 March (Research Institute of TB)
Special Guest: Mr. Kintaro Shibuya, Mayor of Kiyose City

3
5

4
6

Appendix 1
List of Participants
CountryName/Territory

Khloeung Phally
Cambodia

Monyrath Chry
Chharvy Ringsey KEO

Indonesia

Mariani Reksoprodjo
Fitriani Manan
Seungjoon Chang

Korea

Kanghee Kim
Hong Jo Choi
Tha Zin Nwe

MyanmarEi Ei Chaw

Nepal

Ram Sharan Gopali
Jamuna Panthi

Philippines

Aurora G. Querri
Leonardo G. Parungo Jr

Chih-Yun Lin
TaiwanWei-Wen Chen

Thailand

Luangjina Sarmwai
Jintana Ngamvitayapong-Yanai

Affiliation

Deputy Director of National Center for Tuberculosis andLeprosy Control (CENAT)
Program manager of Cambodia Anti-Tuberculosis
Association(CATA)
Cambodia Anti-Tuberculosis Association(CATA)
Head Quarter/ Executive Secretary of Forum Stop TB
Partnership Indonesia
Board member of Stop TB Partnership Cimahi City
Executive Director of Stop TB Partnership Korea , Korean
National Tuberculosis Association(KNTA)
Chief of Stop TB Partnership Korea,
Korean National Tuberculosis Association(KNTA)
Korean Institute of Tuberculosis(KIT)
Chairperson of Myanmar Maternal Welfare
Association(MMWA)
State TB Officer of National Tuberculosis Program, Kachin
State, Myitkyinar
Country Representative of Japan-Nepal Health & TB
Research Association RIT(JANTRA)／JATA Nepal Office
Board member of JANTRA
Deputy Executive Director of RIT/JATA, Philippines,
Inc.(RJPI)
Administrative Officer of RIT/JATA, Philippines, Inc.(RJPI)
Research Assistant of Tuberculosis MDR Department,
Chang-Hua Hospital/Anti-TB Association(TATA)
Chang-Hua Hospital MDR TB Department/Anti-TB
Association(TATA)
Secretary of THRF, Member of the Chiang Rai Volunteer
Ladies against TB
President of TB/HIV Research Foundation (THRF)

7

8

Appendix
Appendix
2 2
Abstract
Abstractof Lectureof Lecture
2 2
Beautiful
Beautiful
Health:Health:Introduction
Introductionof Japaneseof Japanese
Women’s
Women’s
Anti-TB
Anti-TB
Association
Association
OriginOriginThe- 30-year
The 30-year
historyhistoryof theofJapanese
the Japanese
Women’s
Women’sFightFightagainstagainstTB –TB –The Association
The Association(Officially:(Officially:
Council
Councilof Japaneseof Japanese
Women’s
Women’s
Anti-TB
Anti-TB

Associations)
Associations)
datesdates
back backto thetofoundation
the foundationof theofWomen’s
the Women’s
Committee
Committee
of Naganoof NaganoCity City
in Julyin 1950,
July 1950,
whenwhentherethere
was anwasopportunity
an opportunity
for theforleaders
the leadersof theofwomen’s
the women’s
association
associationof Naganoof NaganoCity City
to haveto havean audience
an audience
with with
Princess
Princess
Chichibu,
Chichibu,
who who
was then
was then
the President
the Presidentof theofJapanthe Japan
Anti-TB
Anti-TB
Association
Association(JATA).
(JATA).
The Princess
The Princess
inspired
inspiredthemthem
to dedicate
to dedicate
themselves
themselves
to TBtocontrol.
TB control.
The Theanti-TB
anti-TB
movement
movementof Naganoof Nagano
was wasfurtherfurther
stimulated
stimulated
by a bytuberculosis
a tuberculosis(TB)(TB)
outbreakoutbreakthat occurredthat occurredin September
in Septemberof theofsame
the sameyear.year.
The TB
Theepidemic
TB epidemic
brokebrokeout out
in a primary
in a primaryschoolschoolof a townof a townof Naganoof NaganoPrefecture.
Prefecture.
This This
incident
incident
ignitedignitedthe women’s
the women’s
activity
activity
to eliminate
to eliminate
TB from
TB fromtheir theircommunitycommunityand homes.
and homes.
This This
movement
movement
developed
developed
into anintoorganizationan organization
covering
covering
the entire
the entire
prefecture
prefectureof Naganoof Naganoby 1957,
by 1957,
the Nagano
the Nagano
councilcouncilof Women’sof Women’s
Anti-TB
Anti-TB
Association,
Association,
as theasvery
the veryfirst organization
first organizationof thisofkindthis kindin Japan.
in Japan.
Development
Development
The Themovement
movement
to eliminate
to eliminate
TB throughTB throughthe wisdom
the wisdom
and efforts
and efforts
of ofhousewives
housewives
has been
has beenfurtherfurther
expanded.
expanded.
It became
It becameincreasingly
increasingly
activeactive
and hasand been
has beenmaterializedmaterialized
as theas Allthe Japan
All Japan
Housewives’Housewives’
Convention
Conventionfor Healthy
for Healthy
Family,Family,and theand theLeaders’
Leaders’
SeminarSeminarof Women’sof Women’s
Anti-TB
Anti-TB
Association.
Association.
A poster
A posterfor Anti-TB
for Anti-TB
WeekWeek
adoptedadoptedthe slogan,
the slogan,“The“The
Housewife
Housewife
is a key
is aperson
key person
in TBinprevention.”
TB prevention.”
In 1975,
In 1975,
the National
the National
Women’s
Women’s
Anti-TB
Anti-TB
Association
Association
was wasestablished.
established.
It was
It wasapproved
approved
as a ascorporatea corporate
juridical
juridical
personpersonin 1977
in 1977and hasand becomehas become
the largest
the largest
women’s
women’shealthhealthorganization
organizationin Japan.
in Japan.
In 1996,
In 1996,
the Association
the Association
celebrated
celebrated
its 20thits 20th
anniversary.
anniversary.
The Association
The Association
has come
has comea longa longway, way,
extendingextendingactivities
activities
all overall overJapan,
Japan,
responding
responding
to to
the changing
the changing
time timeand situation,and situation,
as theaslargest
the largest
women’s
women’shealthhealthmovement
movementin Japan.
in Japan.
DuringDuringthesetheseseveralseveraldecades,
decades,deathsdeathsdue todueTBto that
TB usedthat used
to betofeared
be feared
as a as a
non-curable
non-curable
illness,
illness,
have havedecreased
decreased
drastically.
drastically.
This Thismay may
be ascribed
be ascribedto theto efforts
the efforts
of ofrelatedrelatedorganizationsorganizations
and andauthorities,
authorities,
as wellas wellas theas activities
the activitiesof theof women’s
the women’s
Association.
Association.
To disseminate
To disseminate
ideasideas
of TBofprevention
TB prevention
and its
andmotivation,
its motivation,
the Association
the Association
7

7
9

continues its activities at the grass-roots level, as an organization for protecting people’s
health.
Liaison with JATA

The National Assembly of TB Prevention of JATA has been

held every year since 1949. This assembly discusses what to do in the
non-governmental anti-TB activities and how to address their current challenges. The
Women’s Association supports this assembly and is actively involved in planning andimplementing this event. The National Assembly is also the venue for the Women’s
Association to convene for the Annual Convention Meeting and the Annual Board
Meeting to discuss the future agenda of the Association.
National Seminar

The National Seminar of the Women’s Ant-TB Association

was launched in 1997. The seminar provides the opportunity for learning about TB andother related public health issues and also for exchanging information among members.
Having acquired new knowledge and information in the course, the participants became
more aware of the importance of community activities for communication with thepeople.
Local Leader’s Seminar

Such achievements as these could be reflected in thelocal leaders’ seminar in a total of seven areas of Japan, as bases for local associations’guidelines, which in turn will be a source of their community activities.
Advocacy in Community

The Association actively targets the communication

and advocacy activities on TB prevention not only for the family but for the society ingeneral. Public information media such as leaflets and brochures have been developedin order to disseminate the ideas and knowledge of TB prevention to children and adults.
Regarding actions toward local governments, the Association members pay courtesy
visits to governors/mayors to appeal for strengthening the public TB control services.
Such grass-roots activities of women are significant for disseminating knowledge of TB
and for increasing the awareness of the people, and can also help to fill any gaps ingovernmental services.
Fund Raising The Association has been involved in fund raising as a means oftalking about TB prevention directly to the people. In cooperation with the JATA branchof prefectures, the Association runs the double-barred cross-seal campaign forfund-raising all over Japan during the TB Prevention Week, i.e., during the 4th week of
September. Indeed, the women’s activities provide important support for the
double-barred-cross seal campaign. The double-barred-cross seal campaign was
810initiated in the beginning of the 20th century in Denmark as the Christmas Seal
Campaign and now has now become a symbol of TB prevention worldwide. In Japan,
JATA has devoted itself to this program since 1952 with the support of the government
to promote TB control with the support and cooperation of the general public and in
partnership with foreign countries.
The funds raised by this campaign are an important source for supporting
JATA’s activities. The Women’s Association plays the most vital role in this campaign,
contributing about 30% of the total funds raised. The funds thus raised by this campaign
are spent for the various activities of JATA for the sake of people’s health.
International Cooperation: Study TourAn important area of activity

supported by the fund from the campaign is international cooperation. JATA’s
international cooperation includes its unique grass-roots project that is a long-lasting
program with promoting DOTS as its core. The study-tour is a group tour for themembers of the Association who are involved in fund raising to become more aware of
the TB situation of developing countries. The tour is a good opportunity to understandthe significance of the seal campaign vividly and is a source of energy for future activity.
The program of the study tour was launched in 1994, and since then, we have visited TB
project sites, such as Nepal and Myanmar, and we visited Cambodia in 2006.
The Association’s cooperation has been extended to the national anti-TB
associations of developing countries that are faced with various difficulties in TB
control.
TB control takes a long time to bear fruit and needs a solid organizational basis withfinancial assistance. In this context, the seal campaign can be a great help for people ofdeveloping countries, and it proved surely useful.
Publication“Health Circle”is the official journal of the Association intended totransmit the newest knowledge of tuberculosis and public health in general to the
Association members, and to strengthen the partnership among members. The journal
was first published in 1977 and is now issued three times every year (40,000 copies
each). This communication paper is distributed not only to the Association members,
but also widely to related organizations throughout Japan, such as JATA branches; theMinistry of Health, Labour and Welfare; and Prefectural and Local governments andPublic Health Centers to broadly report the activities of the Women’s Association.
The Way Forward

Thirty years have passed since the foundation of the911Association as a corporate juridical person. Its contribution to TB control in Japan has
been indispensable. However, TB still has not been eliminated. The emergence ofmultidrug-resistant TB, the upsurge of TB among elderly persons and urban youngsters-- -- -- all these issues are complicating the TB problem, and we should address themproperly. Also, we need to address the increasing life-style related illnesses and newly
emerging respiratory diseases.
Globally, over 1.5 million people lose their lives due to TB every year. In order tocontribute to the worldwide fight against TB, the Association joined the Stop TB
Partnership Japan. The Women’s Anti-TB Association is steadily endeavoring to achieve
its purpose. Its current slogan is: health management throughout the life of the people
through promoting control of TB and life-style related illnesses so that people can enjoy
a happy and healthy life. This slogan was adopted in the 58th National Anti-TB
Assembly. Thus, the women are determined to lead the national movement for thepeople to maintain their own health.

1012Appendix 3

13

14

15

16

17

18

Appeendix
4 4Appeendix
Counntry
Present
ationsationsCounntry Present
1. E
Epidemiolog
gicalgData(Citedfromfrom
obal
TB Repport
2015,
a nd others)
WHO:
Glo
1. E
Epidemiolog
ical Data(Citedobal
TB
Rep
port 2015,a nd others)
WHO:
Glo

12

12

19

20

21

22

23

24

Nepal
28
44
39 - 50
158
139-178
1.5
1.2 - 1.9
5.4
4.2 - 6.7
5.3
3.7 - 7.1

Taiwan
Korea
Population (1000)
50
Number43
41 - 46
include. HIV
Incidence
Rate
86
81-91
Number0.51 0.44 - 0.59
(Estimate)
HIV+ onlyRate
2.6
2.2 - 3.0
609
Number
1.9
1.8 - 2.1
Mortlity
2.6
Rate
3.8
3.6 - 4.1
Case detection Rate (%)
19
93
88 - 99
3.2
New
2.7
2.1 - 3.4
MDT-TB (%)
8.2
Retreatment
15
10 - 23
14
10 - 19
2,011
2,004
2005 - 2011
Survey yearNew &35,27740,19011,326
Number
125
80
48
Rate
RelapseCase
15,947
18,784
New, Pulm, bacteriol confirmed
notification
8,445
9,350
New, Pulm Clincal
8,583
6,987
New, Extrapulmonary
Treatment success
91
82
65
%
33,87740,794
Cohort size
(2013 Cohort)
Note : For Taiwan the data are for 2014 for notification, 2013 for mortality, and 2012 for Treatment results.
For Nepal, Korea and Japan figures are based on Global Tuberculosis Report 2015 (WHO).

Japan
127
23
20 - 2618
16 - 210.099
0.089 - 0.12
<0.1
<0.1-<0.1
2.2
2.2 - 2.3
1.8
1.7 - 1.8
84
75 - 960.7
0.42 - 1.1
9.8
7.1 - 13
2,002
19,61515
12,120
2,061
4,255
54
15,941

TB Statistics of Non-High Burden Countries (2014)

About CATA (1)Presentation and discussion ofactivities of partnerships

1. Background:
Cambodia Anti-Tuberculosis Association(CATA), a
local NGO established in 2003, as a TB professional
association of individual and institution committed tocontribute to the fight against TB in Cambodia.
2. Vision:
Make Cambodia free from TB and Lung Disease.

Cambodia Anti-TB Association
Cambodia

About CATA (2)Asian National Stop TB Partnership Forum"Community people’s roles in End TB
Strategy in Asia”
United Nation University, Tokyo, Japan
14 and 15 March, 2016

3. Mission
Coordinate and advocate for TB free Cambodia and ensuresocial and community enabling environment through: Promoting the institution and the individual to involve in
Stop/End TB strategy
 Information sharing, research and capacity building

Dr. Khloeung Phally
Mr. Chry Monyrath Promoting the quality of effective prevention, early detection
and treatment of Tuberculosis and Lung disease Strengthening the effective enforcement of relevant laws,
policies and guidelines.

TB Burden in Cambodia

About CATA (3)• Cambodia is still one of the 22 HBC with TB in theworld• Incidence rate of TB all forms in 2014 is 390/100,000*.
• Prevalence rate of TB all forms in 2014 is668/100,000*.
• Prevalence rate of Sm+ for age 15 and over in 2011 is272/100,000.
• Death rate 58/100,000*

4. GoalStrengthening the coverage and quality of TB services
by increasing commitment of the institution and theindividual and promoting the social and community
environment.

* Global report 201525

1

Current Projects
Project NameCoverage Area

Public-Private Mix-DOT in
Factory (work place)
Active Case Finding
among Elderly and other
Vulnerable Communities

14 Factories, Phnom Penh

TB Control in Factory (2)2. Current Methods:• Trained peers to conduct peer contact activities.
• Conduct follow up (FU) meetings with peers• Refer suspected TB case from factory to public healthcenter• Implement DOT in factories ( work place)

12 Operational Districts in 8
Provinces.

TB Control in Factory (3)3. Results:• 14 garment factories were implemented.
• 11,553 workers were contacted by peer educators( 11 months ).
• 12 sessions of FU were conducted• 108 TB suspects referred to HC (11mths).
• 10 TB cases registered (5s+, 4s- and 1EP) for
treatment by DOT in factory (11 months).

TB Control in Factory (1)TB Control in Factory (4)1. Background:• Factories, the poor ventilated settings where thousandsof workers work and share room air are at high risk for
TB• Patients with TB symptoms may receive symptomatic
treatment at the factories as factory clinics support only
primary health care, leading to diagnostic delay.
• Untreated, some one with chronic TB may face being
dismissed from employment due to frequent
absenteeism , and bring additional hardship to thevulnerable family.

4. Cases notified by TB types/years
EP
BKBK+

25

5
20

6

15

12

7
10

5

1
0

5

2
2

9

6

4
4

7

7

4

5

3

3

9

9

3
3

5

0

2007 2008 2009 2010 2011 2012 2013 2014

26

2

TB Control in Factory (5)Active Case Finding (2)5. Lesson Learnt:• Lack of awareness raising activity, the discrimination
among workers might be not reduced leading to lessnumber of referral• Limited budget for FU meeting with Peers is the causeof less peers’ activity.
• TB patients can work regularly during the course oftreatment( in the exception of 1st month therapy ofsmear positive cases).
• In congregated settings, one case treated can prevent
hundreds of co-workers from TB

2. Methods:• Active case finding using mobile teams equipped with a chest xray (CXR) and Xpert machine in 12 Operational Districts.
• 1 to 2 weeks before field operation, each health centre wasvisited for one day by the team:- Volunteers performed door to door symptom screening
prior to CXR screening day.
- TB suspects with a positive CXR were then tested by
Xpert MTB/RIF assay- TB cases were registered and put on treatment• Elderly were primarily targeted.
• Project yield and TB notification data were analysed to assess
impact on treatment initiation.

Active Case Finding (3)3. Results (1):Year 1 (2014)
Indicators

Year 2 (2015)

Annual Planned
TargetAchieved
Target%Annual Planned
TargetAchieved
Target%1) #of people screened

113735

68846

61%

57810

56996

99%

(2) #of TB suspects

21840

11995

55%

16830

16043

95%

(3) #of people tested by TB X
ray.

18055

11650

65%

15810

12147

77%

(4) #of TB suspects tested byGene Xperts.

3276

2520

77%

3478

2084

60%

(5) #of people confirmed as SS+/B+ (yield SS+/B+)

663

397

60%

557

334

60%

(6) #of people confirmed as TB
all forms (yield all forms)

1243

1064

86%

1265

1094

86%

Active Case Finding (1)Active Case Finding (4)1. Backgrounds:

3. Results (2):•

TB burden in Cambodia has decreased by > 50% by
end 2015 compared to 1990 data.
• Cambodia still one of the highest TB prevalence in theworld- Prevalence all form : 668 cases/100,000 population- Prevalence survey in 2011, TB burden in elderly is≥3time higher than the general population.
- Prevalence/Notification ratio in >55 years = 1.5• Hypothesis: poor access to TB diagnosis and treatment

•
•
•
•

12 operational districts visited.
193 health facilities visited.
23,797 individuals screened by CXR.
4,604 (19.0%) individuals were tested using the Xpert
MTB/RIF assay,• Resulting in the detection of 731 (16%) MTB-positive
patients.
• Total cases : 2158 (MTB positive + others)27

3

Active Case Finding (4)Active Case Finding (6)3. Results (3):New bacteriologically-positive notifications

4. Lesson Learnt (2):• The conditions to replicate and expand the successful
strategy are:
– The combination of the team 1 and team 2 to work
together for:• Increasing the number screened by CXR,
• Saving fuel needed to supply 2 generators that
operated separately.
• Minimizing interruption of the operation due to unsafe
power supply.
– Procure a set of new CR machine to avoid interruption
due to Prima console system error or broken.

increased +119.2% for all ages and +262.7% for those ≥55 years
during the ACF quarters compared to trend expected notifications.
Changes in new Bac+ and All Forms of TB treatment initiation and reporting in 4 Operational Districts of Year 1
Trend
ActualExpected
Additional
Patients Detected Intervention
Additional
Intervention
Notifications(Project Yield)
Quarter
Notifications
Quarterto Yield Ratio
Notifications
Notifications
399
182
217 (+119.2%)
68.00%New Bac+, All Ages
319
Ang Roka
58
24
34 (+141.7%)
97.10%
35
Battambong
68
115
56
59 (+105.4%)
86.80%
110
Kong Pisey
105
45
60 (+133.3%)
54.50%
106
Sampovmeas
121
57
64 (+112.3%)
60.40%
243
67
176 (+262.7%)
76.20%New Bac+, ≥55 Years
231
Ang Roka
34
8
26 (+325.0%)
89.70%
29
Battambong
62
61
13
48 (+369.2%)
66.70%
Kong Pisey
68
71
24
47 (+195.8%)
69.10%
62
Sampovmeas
77
22
55 (+250.0%)88.70%All Forms of TB, All Ages
1,232
653
579 (+88.7%)
73.10%
893
98
Ang Roka152
68
84 (+122.4%)
69.40%
230
Battambong
445
196
249 (+126.6%)
85.20%
Kong Pisey
318
344
245
99 (+40.3%)
77.00%
247
Sampovmeas291
143
148 (+103.6%)
57.90%

Active Case Finding (4)Active Case Finding (7)3. Results (4):NTP notifications in intervention period compared to

4. Lesson Learnt (3):• The strategy used is likely appropriate for ACF but there aresome constraints factors as following:– Road conditions are bad due to rainy season, causing
difficulty to reach the HCs, leading to implementation timeis short.
– Elderly need to look after their grandchildren at home andsometime cannot come to HCs.
• The project screens/tests a lot of patients per day for a long
period of time, so it may cause to damage the material. To
avoid that and ensure the project run smoothly, CATA seeksfund to buy new equipment especially CR and X-ray
machine for security.

expected notifications based on 3 year trend:New Bac+ notifications
were +54.0% and +109.2% higher than expected for all ages and ≥55
years respectively.
New Bacteriologically‐positive TB Notifications by Age Group400
350

TB Patients Treated

300
250
200
150
100
50
0

TB Patients Treated, All Ages

Pre‐Intervention Trend

TB Patients Treated, ≥55 Years

Trend Expected TB Patients Treated

Active Case Finding (5)Active Case Finding (8)4. Lesson Learnt (1):• The factors contributing to the success are the involvementfrom stakeholders and the trust to the project for its newtechnology, and quick diagnosis.
• The conditions for success to be continued are:1)
proper maintenance of all equipment to avoid being broken
during implementation,2) well calculation and implementation of project’s resources
supplied and demand3) continue providing transport cost to the poor and those
who live far away from HCs, and;4)
The use of communication skills and incentive provided toall stakeholders for better involvement is still key factors for
success.

5. Conclusion:• ACF using mobile teams was able to increase access
to TB diagnosis, especially the elderly people.
• Compare to baseline data, the intervention can detectand treat many patients who previously missed routine
TB services.
• We recommend to consider targeted ACF interventionsin other settings where access to diagnosis andtreatment is limited.

28

4

29

5

29/04/2016...Indonesia...

Presentation and discussion ofactivities of partnerships

Indonesia is the biggest archipelago in the worldthat consist of 17,000 islands.
It also comprises administratively of :
 34 Provinces-416 districts and 98 cities-7,094

subdistrics-8,412 hamlets and 74,093 villages

Forum Stop TB Partnership Indonesia

Indonesia...Indonesia...
Current result :Stop TB Partnership is only available in :
 1 city in west java province 1 city and 2 districts in east java province 4 districts in south Sulawesi Province

presented during“THE ASIAN NATIONAL
STOP TB PARTNERSHIP FORUM”,
14 and 15 March 2016,
Tokyo, Japan

Based on those data, it is significantly obviousthat “our homeworks” remain so many toaccomplish.

prepared by:

Drg Mariani Reksoprodjo & Dr Fitriani Manan

Indonesia

Area : 1,913,578.68
Population :254,826,034

Systematic Presentation

1. Name and Legal Corporate Status
2. Short History
3. Relationship with Other Organizations
4. Members:

Membership, Current Members

30

1

29/04/2016...Systematic ...

5. Purposes
6. Activities
7.

Current Challenges... History...

Name and Legal Corporate Status
Name:

FORUM STOP TB PARTNERSHIPINDONESIA (FSTPI)

Status:Meanwhile, it remains temporarily as a Forum.
Chairman of FSTPI is attempting to make the
FSTPI a legal organization and formallyregistered to the Ministry of Legal and Human
Rights, Republic of Indonesia•

Address of Secretariat:

Phone / Fax:
Website:Twitter:
Facebook:

Jalan Sultan Iskandar Muda No. 66A
Kebayoran Lama Utara
Jakarta Selatan
DKI Jakarta, Indonesia+62 21 739 74 94
www.stoptbindonesia.org@StopTBIndonesia
StopTBIndonesia• 3 -4 March 2014:

Host for The 2nd Forum of National Stop TB
Partnership in South-East Asia, West
Pacific and East Mediterranian Region
This meeting was attended by 13
out of 14 invited countries(Myanmar regretted to come) and theywere:... History...

Short History••

30 May 2013:

October 2013:

FSTPI was officially established andlaunched in Jakarta.
This is a partnership groupconsisting of diverse organizations
and individuals who have similarcommitment in dealing with TB
problems



SEA:

India, Bangladesh, Thailand
Nepal and Indonesia



WP:

China, Philippines, Cambodia,
Vietnam, South-Korea and JapanEM:

Pakistan and Afghanistan

Operational Guideline on FSTPI was
published312

29/04/2016

5.

MEMBERSHIP,
CURRENT NUMBER

6.

Based on the List of FSTPI members at central level,
there are 54 members that consist of:1.

Health Service Group• Indonesian Hospital Association• Indonesian Primary HealthCare Facilities and Clinics
Association• Gunung Sahari Clinical Laboratory

Government Group• Ministry of Health• Coordinating Ministry of Human
Development and Culture• Ministry of Legal and Human Rights• Ministry of Defense• Ministry of Manpower andTransmigration• Centre of Health of National Army
• Centre of Medical and Health of Police
Department

7.

Academician Group• Faculty of Public Health, University of Indonesia

8.

University Students Group• Asian Medical Students Association (AMSA Indonesia)• Centre for Indonesian Medical Students Activities(CIMSA)• Students Executive Board of Facultiy of Public Health,
University of Indonesia

PURPOSES

2. State Owned and Private Companies Group• BPJS (Universal Health Coverage) of
Manpower• BPJS (Universal Health Coverage) ofHealth• Indonesian Entrepreneurs Association

 The main goal is to contribute in supporting thegovernment on TB control

 The Forum is expected to be able to assist in

3. Development Partners Group• WHO Indonesia• USAID• DFAT• KNCV• FHI 360
4.

Professional Organizations• Indonesian Medical Doctor Association• Indonesian Internist Association• Indonesian Lung Doctor Association• Indonesian Pediatric Association• Indonesian Public Health Educators
Association• Indonesian National Nurses Association• Indonesian Pharmacists Association• Indonesian Midwives Association• Indonesian Blood Transfusion Technician
Association• Indonesian Medical Laboratory Technology
Expert Association

overcoming the burden of national TB problem.

 In TB control, it will be difficult to do it if each groupexercises it without good cooperation and coordination,
as it can lead to the less optimal result.

CSO Group• 9 CBO• 7 FBO

32

3

29/04/2016

Activities
1. Quarterly plenary meeting
2. Facilitated meeting for developing national strategicplan on TB

4. Only around 30% of hospitals that have conducted Hospital
DOTS Linkage.

3. Facilitated PHO/DHO/CSO to establish the forum StopTB Partnership

5. Very limited budget allocated for TB Control from central andlocal governments.

4. Upload any news related TB / FSTPI into website
5. Share information to all of members (from Union, WHO,

6. Inappropriate TB facilities

Global Stop TB Partnership)

7. Lack of understanding of community on TB...Activities...

6. Will Establish 5 working group in the forum :• Public communication• Advocacy• Community• Health service• Resource Mobilization

1. High Incident Rate and Prevalence Rate in Indonesia(based on the result of survey of 2013-2014)• Incidence Rate: 403 / 100,000 population• Prevalence Rate: 660 / 100,000 population
Total Population in Indonesia:+ 250 million

2. TB-related Issues:• The quality of DOTS should be improved• TB – MDR• TB-HIV• TB-DM• TB-with bad smoking habit
3. a.
b.

Recording and Reporting System for private
physician are notyet formulated
ISTC is not yet fully functioning

33

4

29/04/2016

34

5

2016-04-29<History of Korean TB situation>

Presentation and discussion of activitiesof partnerships

Stop TB Partnership Korea
Korea(Kim and Yim, 2015)

Name and legal corporate status

INTRODUCTION OF
STOP TB PARTNERSHIP KOREA• Name : STOP-TB Partnership Korea(STBK)• Legal corporate Status : None
- Secretariat of STBK was installed under Korean National
TB Association in 2009

Hongjo Choi, MD. PhD(KNTA, KIT)

Short history

Table of Contents<Progress>
2008. 3 : Announcement of establishment / operation plan of the STOP-TB Partnership
KOREA by the Ministry of Health and Welfare and Korean Center for Disease Control

1. Name and legal corporate status2009. 6 : Establishment of the STBK's Secretariat under Korean National Tuberculosis
Association

2. Short history

2010. 3 : Formal registration as the national cooperation partner of WHO Stop TB
Partnership

3. Relationship with other organizations
4. Members: Membership, Current number

2010. 12 : STBK inaugurated with 19 partners(Chairperson : Sook Mi Son, , Member of National Assembly)

5. Purposes

2012. 11 : Hold 1st forum of national to stop western pacific & south-east asia regions

6. Activities

2015. 9 : Appointment 2nd chairperson, Myung Yeon Kim, Member of National Assembly

7. Current challenges

2016. 3 : 44 organizations and almost 60,000 individual partner take part in35

1

2016-04-29

Members: Membership, Current number

Relationship with other organizations<STBK Organization Chart>
Government

STBK
Cooperation
Committee
STBK
Advisory Committee(Working Group)

국회의원

국회의원

국회의원

국회의원

김광림

김명연

김무성

문정림

국회의원

국회의원

국회의원

이자스민

국회의원

유기준

이만우

국회의원

국회의원

나경원

신상진

김용익

National
Assembly

Academic &Expert Group

Civil Societies

KOREA

Anti -TB
Organizations& Hospitals

Business GroupInternational
Organizations
PublicRelationship with other organizations

Purposes<Business Implementation System>• TB prevention education and support for the vulnerable,
particularly, migrants and homeless people• Development and promotion of tuberculosis elimination
projects among underdeveloped countries and exchange
programs for global & National STOP-TB Partnership• Establishment of cooperative system to raise social
awareness and participation into the domestic and global
plan to stop TB.

Members: Membership, Current number

Activities<Advocacy>

Secretariat(4 staff)

STBK

Cooperation Committee(44 representativesof partner organizations)
Advisory Committee(36 expert s & person in
charge of partner organizations)

TV Documentary production for
Improving TB Awareness36

A commemorative eventon the “World TB day”

2

2016-04-29

Activities<Advocacy>

Policy forum to support
efficient TB patient care

<Pilot programs to support homeless TB patients>

Monthly webzine publicationand e-mail service

Activities

Activities<Advocacy>

Appoint the representatives of 12
national communities as foreign
TB honorary ambassador<Education>

Health lecture for TB high risk groupsuch as the immigrants, homeless

Production of various IEC materials

Activities

Activities<International Cooperation><Support for The Vulnerable population>

Providing free TB X-ray
screening joint with TB related
partners during multicultural
festival for the immigrants

STOP-TB Camp for youth

Project for Korea-Mongolia Anti-TB
Collaboration in Ulaanbaatar

Providing treatment expense
for MDR-TB Patients37

1st forum of national to stop TB western
pacific & south-east Asia regions

3

2016-04-29

Current challenges• Development and vitalization of various tuberculosis eradication
activities joint with partners to support NTP• Improvement of sustainability STOP-TB Partnership Korea
through developing unique fundraising method besides
government aid• Participating in active international tuberculosis eradication
movement through the reinforcement of global cooperation
capability by developing specific cooperation project andreinforcing link with other national partnership38

4

4/29/2016

This presentation includes;

Presentation and discussion ofactivities of partnerships

 Brief information about MMCWA
 MMCWA’s participation in community based TB care activities

Self-reliance Approach

MYANMAR MATERNAL AND
CHILD WELFARE ASSOCIATION
Myanmar4

Target areas
Methodology
 Achievements
Project Approach- CBTBC Project in collaboration with
National TB Program(NTP) and Global Fund(Round-9)
Target areas
Methodology
Achievements and challenges

Profile of MMCWA
Myanmar Maternal and Child Welfare
Association
Established since 30th April 1991
(according to law No: 21/90 – November 9th, 1990)
Non-profit Voluntary Organization
5

5

Mission Statement

Acitvities on Prevention and Control Measures of TB
byMYANMAR MATERNAL AND CHILD WELFARE ASSOCIATIONThe Myanmar Maternal and Child Welfare
Association is a voluntary organization dedicatedto serve the Myanmar Society in promoting thehealth and well-being of mothers and children

14-15th Mach,2016
Tokyo, Japan

with the aim to improve the quality of life of the

Daw Thazin Nwe
President
MMCWA

people.
6

39

6

1

4/29/2016

Objective
To carry out activities related to development ofhealth, education, economic and social aspects ofbeneficiaries with priority to the grassroots level
residing in wards and villages.

Health Activities

10

7

MMCWA Organizational Structure

Provision of Community based health care services

Central Council

Central Executive Committee

Health Education

Programme for Congenital DefectPrevention and Control ofCommunicable diseases

Eye Care Activities

Programme for Chronic
Non-communicable diseases

State and Regional, NPT Council Area Supervisory Committees(15)Safe motherhood programmeDistrict Supervisory Committees(72)8Members of MMCWA- > 12millions

Programme for Traditional
Medicine

Immuization programme

Capacity Building Programme

11

Prevention and control of communicable diseases(HIV/AIDS, Malaria, TB, Leprosy, other infectious d/s..)

MMCWA activities in line with its objectives

Health Education- IEC dissemination- Mass Media- Community health talks- Outreach round table talks
 Early Case Detection
 Referral Support for care and treatment

1. Health Activities
2. Educational Activities
3. Economic Activities
4. Social Activities

9

Anti Tobacco activities

Nutrition Progamme
Township Associations ( 330 )Branch Associations (Wards/Villages) (22063)

Environmental Health

9

12

40

2

4/29/2016

Formal Education◌ၤ

Educational Activities

Stationary Support to needy students

School Enrollment Week-Community
Mobilization13

Non-formal Education

Educational activities
1. Early Childhood Development Centre (ECCD)
2. Participation in mobilization for School enrollment
week
3. Stationeries, Uniforms and Financial Assistance forFormal Education
4. Adult Literacy
5. Evening classes

3-R Classes
14

17

Early Childhood Care and Development (ECCD)

Activities
Establishing holistic development

Continuous Learning Initiative
for Adult Literacy

Libraries – 12873 numbers
Community learning Centre – 3260 numbers

from transition period of the children
Creating opportunities for income
generation for mothers
Provision of parenting education
Pre-school Teacher training
In 2014,
Number of Pre-school - 730
Children (male) - 12349(female) - 15317
Number of Day Nursery 39
Children (male) ( female) -

574
738

Provided Books to Libraries

41

3

4/29/2016

Economic Activities

Social Activities

19

22

Income Generation Programme
1.
2.
3.
4.

Social activities

Provision of vocational training courses(VCT) on sewing, knitting,cooking etc.
Micro-credit small loan scheme
Financial assistance for small household farming, agriculture andsmall scale home industries
Finding Job Opportunities

 Elderly Care Program ( Home based care services for physical & psychosocial

well-being) Bringing social support to orphanages and vulnerable group
 Maxillofacial correction to promote self esteemed for cleft children
 Promoting and assisting civic duty and cultural heritage for future generation
 Risk management and rapid response in time of disaster20

23

Micro-credit small loan scheme

MMCWA participation in Elderly Care Activities
Approaches
1.

Training on Embroidering
Tapestry

Self reliance Approach-by MMCWA (Central)/State & Regional /Township
MCWA supervisory committees

2. Project Approach(MMCWA+DSW)(MMCWA Funding)Training on Basic Computer
Skills42

44/29/2016

II. Home-based care for elderly projectMMCWA+ Dept; of Social Welfare

Collaborating Agencies of MMCWA
Government sector

Total -35 townships

1. Ministry of Health2. Ministry of Education
3. Ministry of Social Welfare

Amayapuya
2007

Chauk

TatkoneYaynanchaungLeiwayAyarwaddey Region
26 townships

Tanphyuzayat

4. Ministry of Internal Affairs
International
1.WHO
2.UNICEF
3. IPPF
4.UNFPA
5.UNAIDS
6.JOICFP
28
7.GGA

2010

Dawbon2011

Malamyaing
Myeik

MMCWA Community Based TB Care Activities

Conducting Home Based
Medical Care

Provision of eye care for elderly
29

Participation in relief matters at the effected area of disasters

Approaches
1.

Self reliance Approach-by MMCWA (Central)/State & Regional / Township
MCWA supervisory committees

2. Project Approach(MMCWA+NTP)(Global Fund Round-9 Funding)Donation for Flooded Townships in
Kalay and Tamu

Preparation Dignity Kits for Disaster-riskareas at MMCWA HQs

27

43

5

4/29/2016

Community based TB Care (MMCWA+NTP+GF)(Townships - 69 townships)

MMCWA Self reliance TB Care Activities Target2011
2012-2015- 15 States and Regions(330 townships)

 Methodology- 37 townships- 69 townships

 Dissemination Health Talks on prevention of TB

Mandalay Region (26 /s) Referral of presumptive TB cases

Naypyitaw (3 t/s)

 MMCWA volunteers’ participation on DOTs

Bago Region (27 t/s)

programme

Mon State (10 t/s)

Yangon Region (1 t/s)
Kayin State (2 t/s)

34

31

MMCWA Self reliance TB Care Activities(Cont;)
120000100000
80000
60000
40000
20000
0

Health Education
Referral cases
DOTs Supervision2010 2011 2012 2013 2014 2015
Health Education 71328 96425 72847 55928 48881 43286
Referral cases
36923 38034 43271 26783 20723 19846
DOTs Supervision 48144 32473 30292 18999 12237 11860

32

35

Activities(1) Central Training of trainers on Community TB Care (Naypyitaw)(x 2 days) (1 volunteer/tsp)(2) Township Multiplier Training for Community volunteer on DOTS(x 2 days) (30 volunteer/tsp)(3) TB case finding and/or treatment activities at community level(4) Community education session(5) Half yearly evaluation meeting for community volunteer at
respective township level
33

36

44

6

4/29/2016

(6) Central Annual Evaluation Meeting at MMCWA HQ(Yearly)(7) Refresher Training for community volunteers at
MMCWA HQ
(once in 3 year)

Supervision(1) Supervision from Central to State/Regional level- One visit per year to the respective State/Regions(2) Supervision from Districts to Townships level- One visit per year to the respective townships
37

40

Indicators
3500
3000
2500
2000
1500
1000
500
0
No. of community volunteer
trainedNo. TB suspected cases
referred by community
volunteers
No. of TB patients detected
and put on treatment
No. of health talks
conducted at community
lavel
38

2011

2012

2013

2014

2015

1147

2139

2190

2070

2069

2357

531

2255

3177

2921

282

298

344

589

615

1606

1468

2251

2905

3126

41

MMCWA contribution to National TB Program(NTP)

39

45

7

4/29/2016

Strengths

Supervision from Central to Mon State

1

MMCWA Volunteers reach to the gross-root level2

Volunteers are enthusiastic and energetic in finding new cases andreferral3

MCWA Volunteers participate in Home-based Care for providing DOTS

4

Community participation are active;- Interested in Health Talks on TB preventive and control measures

1

Supervision from District to township level reports are not receiving
regularly.

2

Attrition within the ToT volunteers

Challenges

43

3

Reporting system sometimes weak, not received in time.

4

Need patient support and transportation fees for patients

Volunteerism

Supervision from Central to Mandalay
RegionPerforming an act of kindness , freely giving of talent, time,effort for the simple fulfillment of community expectations.

44

Training of Trainers(ToT) Refresher Training

48

45

46

Thank You48

8

2016/4/29

Scenario:2015

Presentation and discussion ofactivities of partnerships• Major Public Health Problem• Priority 1 Programme of the Government
Population
Incidence rate (all TB cases) Prevalence rate (all TB cases) Mortality rate
 TB patients co-infected with HIV: 27 million: 163 /100,000: 241/ 100,000: 20/100,000Japan-Nepal Health & TB Research Association: 2.4%

Proportion of MDR-TB

 New cases
 Previously treated cases

Nepal: 2.2%: 16%

Who we are…………?
JANTRA is a non-profitable, public service
oriented non-government organization
JANTRA is affiliated with Research Instituteof Tuberculosis/Japan Anti-Tuberculosis Association
JANTRA is a member of Nepal TB Control-Network

Ram Sharan Gopali (MPH)
Executive Director

MissionBasic Facts of Nepal

To franchise in the prevention/control of Tuberculosis,
Public Health and Social Development issues in Nepal.

Nepal is a landlocked country located in the WHO South
Asian region at the edge of the Himalaya mountains
between India and the Peoples Republic of China
Area

Areas of Intervention;

147,181 Sq.
km

 Policy and Advocacy at all level

Region5

 Community System

Zone

14

District75

Strengthening (CSS) Knowledge Management
 Partnership and networking(Nationally & Internationally)

Treatment Centre

1140

Sub-treatment

2907

Microscope Centre

554

Gene-Xpert Center

22

MDR Centre

13

MDR Sub-Cen.

71

47

1

2016/4/29

Our Steps for………..

2. Community engagement and their role

• To enhance collaboration between TB patients,

NGO’s/CSO’s, Research Institutions, Universities,
Government line agencies

 Active case finding door to door visit by volunteers
 monthly meeting for TB• To care and support for those who are infected andvolunteers

affected by TB, for the purpose of controlling and caring all
forms of TB (TB, DR, TB/HIV)

 School health program Volunteer Trust Fund
 Referral and cross referral of• To reduce stigma and discrimination related with TB and its

presumptive cases

co-infection

 Tracing of loss to follow up TB

patients• To improve community health through innovative models up

 Organize advocacy and social

to grassroots level by knowing the local contexts

mobilization

10

Current Projects

3. Net-working and Social Protection
 Communication and social mobilization

activities for factory workers andvulnerable groups
 Strengthening coordination &collaboration with partners and synergy

Urban TB
Control
RIT/JATA

TB
REACH
Wave 4
UNOPS/Stop
TB Partnership Tangible & intangible support for TB

Post Disaster
Recovery
Projectpatients who are in need
 Initiation of TB patients club
 Empowerment of TB patients

UNOPS/Stop
TB
Partnership Enhanced understanding on Patient

Character among service stakeholders
and service providers

11

1. Quality DOTS services is provided for TB patients

4. Strengthening Urban TB control

 Innovative DOTS and Sputum

 Organizing regular meeting withexamination (8:00 AM-4/5 PM)

stakeholders and partners
 Carrying-out joint supportive Referral, cross-referral and countersupervision with concerned
stakeholders and immediate feedback
mechanism
 Establishment of Volunteers Trust fund Support for poor TB patients who are
not eligible in public social protection
scheme Logistic management support

referral from community and private
sectors
 Operational partnership with partners

and CSO’s Capacity building of key stakeholders(Health care providers public andprivate), volunteers, local administrative
authorities

9

12

48

2

2016/4/29

DOTS service & SPUTUM EXAMINATION

Hotline Consultation(2014/2015)

Consultation from Hotline telephone
274

300

140

123

214

250

120

103

200
100
150

110

89

78

80

100

66

15

50

60

0

40

PBC

PCD

EP

Total

Sputumexamination

200

071/072072/073
Male

FemaleCase finding
Key Q & A of hotline consultation
2067/68 (2010/11)

2068/69 (2011/12)

2070/71 (2013/14)

2071/72 (2014/15)

2069/70 (2012/13)

 Sign and Symptoms ofTuberculosis

300

 Location of DOTS Centre

254
241238250232

 Venue of Microscopic

201
200

Camps
 Information about daily

150

94

100

DOTS and assurance oftreatment Minor side effects
 Clinic opening time

110
102
79 84

79
66

50

59

65

46
14 11

29 32 3223
9 10

2 0 2 1 1

37
23

15

10

1 3 0 0 0

16

25

22
10

12

18 18
6

0

Systematic Screening of target populations &microscopy camps

Trend of Treatment Success Rate
100%
90%

17%

9%

15%

 Community-Based;

19%- TB screening/presumptive TB
identification/examination/treatment enrollment
and contact investigation

80%
70%

- Awareness raising

60%
50%

Success

FailureDied

Default

TO

 PPM

NR

- Strengthen cross referral mechanism

40%- Refer TB suspects to microscopic camp andother laboratories

30%- Collaboration with private laboratory

20%



10%
0%

Hotline Consultation

2067/68 (2010/11)

2068/69 (2011/12)

2069/70 (2012/13)

Meaningful involvement and mobilization of healthworkers (Public and Private and volunteers)

2070/71 (2013/14)

49

3

2016/4/29

Case finding framework

Intervention
Mapping of IDP s Camps
Capacity building of Volunteers andkey stakeholdersooPresumptive TB Case identification
Sputum sample collection, sputumtransportation & Test by Gene XpertooChest Camp
Treatment enrollment and follow upoo

TB REACH (WAVE 4) Achievement
From July 16, 2014 to November 15, 2015
110000

Post Disaster Recovery TB Program

112341

Sep 2015- 20 jan 2016

10000090000

Male

Female

Total

5730

6000

Male

80000

60000

Female

Total

5000

70000
5552556816

4000

50000

3462

3000

2268

40000
2000

30000

24086

20000
1184212244

10000
0

20123

1000

Presumptive

TB Microscopy

240

461
14

3

17

11

3

14

0

134

Screening

221

208

216

9418 10705

82

Dignosis129

Screening of IDPs

79

Gene-Xpert Test

Bac Positive

Treatment enrollment

Treatment

Lesson Learnt …………..

Post Disaster Recovery ProjectSupport from NTP:
 leads to sound implementation of theplanned activities



Proper Orientation & consistent followup:
 To continue engagement of stakeholders

Thematic Program Thrust-

Early TB Case finding
Target Beneficiaries-

Internally Displaced Peopleof Kathmandu valley andSindhupalchok district(sample transportation from community to
Microscopy Centre)•

Intensive Advocacy Programme:

 More partners are interested tocollaborate (local CBOs shows theirinterest for the collaboration)

50

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2016/4/29

Acknowledgements

Lesson Learnt………

 National Tuberculosis Centre Research Institute of Tuberculosis/JATA

Highly enthusiastic and committed
volunteer;

 UNOPS/Stop TB Partnership Global Affairs, Canada

 Leads to productive and sustainable
programme in the community

 World Health Organization
 Regional Health Directorate OfficeEstablishment of Patients club; District (Public) Health Offices

 Leads to effective contact tracing
and peer education in the community

 Urban Health Clinics
 Health care Providers (Public & Private) Female Community Health Volunteers

Consistent IEC/BCC Programme:
 To change service seeking behavior

 TB Patients and Family members

Supportive Supervision & Result based
monitoring Result based M&E and discussion

with NTC

Thank you

 Regular follow-up and monitoringfrom the RHD and respective
project districts
 Project review and assessment

from the TB REACH &RIT/JATA

Issues to be address;
o

o
o

o
o
o

Sustainability and ownership
Compatibility of TB Program inline with
Sustainable Development Goal.
Factor affecting TB Treatment and its success;co-morbidity for instance- diabetes, malnutrition
etc
Funding gap
Logistic, documentation and monitoring.
Research and development ; TB and Gender,
PPM, Community Engagement, UHC

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RIT/JATA Philippines, Inc.

Presentation and discussion ofactivities of partnerships• Local-based NGO• Established in 2008

RIT/JATA Philippines, Inc
Philippines• 7 staff

Accreditation/Membership
RIT/ JATA Philippines, Inc.
Activities and Accomplishments• Securities and Exchange Commission• Philippine Council for NGO Certification

STOP TB Partnership Forum – Asia
March 14-15, 2016

• NTP – Technical Working Group

About us….

JATA
(Japan)Research Institute of Tuberculosis /Japan Anti-Tuberculosis Association
Philippines, Inc.
(RIT/ JATA Philippines, Inc.)JATA HQ

RIT

Hospital

47 Officebranches

Overseas
OfficeExtension office

PHILIPPINESCAMBODIAZAMBIA52

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PhilPACT Strategies
Vision:• Strategy 5: Address MDR-TB, TB/HIV and theneeds of vulnerable populations

TB- Free Philippines• Strategy 6: Regulate and make available quality TB
diagnostic tests and drugs

Mission:To contribute to the NTP of the Philippines intheir goal of ensuring that quality TB services areavailable, accessible and affordable for all TB
patients.

• Strategy 7: Certify and accredit TB care providers• Strategy 8: Secure adequate funding and improve
allocation and efficiency of fundutilization.

Objective:
THE TUBERCULOSIS PROJECT IN SOCIO-ECONOMICALLY URBAN AREAS IN
METRO MANILA, THE PHILIPPINES
2008- June 2011

To improve the access of the community to quality
DOTS implementation by strengthening the linkage
between GOs and NGOs/private organizations

Funded by : Ministry of Foreign Affairs

PhilPACT Strategies• Strategy 1: Localize implementation of TB Control• Strategy 2: Monitor health system performance
TB CONTROL AND PREVENTION PROJECT IN SOCIO-ECONOMICALLYUNPRIVILEGED AREAS IN METRO MANILA, THE PHILIPPINES
2011- June 15, 2014

• Strategy 3: Engage both public and private TB careprovidersFunded by : Japan International Cooperation Agency• Strategy 4: Promote and strengthen positive
behavior of communities53

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Project Sites

Engagement of NGOs
Canossa
POPULATION
2013

Sto De Tondo Charity Clinic

405, 125

Urban poor
population

193, 746(47.8%)

Land Area

5.64 sq km

Population
density(sq. Km2)

71,831

German Doctors

10 Health Centers
2 NGO DOTS Facilities
14 NGO Referring Facilities

PAOFISaint Luigi Orione

POPULATION

2013

700

120, 633

NGO DOTS’ Contribution‐ Tondo,
2007 ‐ 2012600

Urban poor
population

108, 063(90%)

LAND AREA

3.21 sq km

Population
density(sq. Km2)

37,580

500

LGU

400

NGO
300
District I‐ Tondo, Manila
200

100

3 Health Centers
3 NGO DOTS Facilities
1 Referring Facility

0
LGU

2007
407

2008
374

2009
406

2010

2011

449

2012

464

512

NGO

146

152

169

155

157

133

District I‐ Tondo, Manila

553

526

575

604

621

645

NGO DOTS’ Contribution ‐Payatas
250

200

Interventions

150

LGU
100

NGO
Payatas, Quezon City

50

0

54

2007

2008

2009

2010

2011

LGU

85

75

109

117

101

NGO

45

46

90

92

107

2012
105

Payatas, Quezon City

130

121

199

209

208

230

125

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Capacity Building
Basic TB DOTS Training

Infection Control Training

Orientation of CHV on Basic
STI HIV and AIDS Education

CHV Assembly

Appreciation Course for CXR
Basic DSSM Training for Medical Technologist

Network and Linkage (ACSM Activities)
Interpersonal Communication and Counselling

Orientation of CHV in NTP Program

Development of Recording Forms

Basic DSSM Training for Lab Assistants

Monitoring Tool

55

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CHVs’ Contribution to DOTS Facility‐
Tondo, 2010‐2012

Development of Policies/Guidelines

2000
1800
1600
1400

DOTS
FacilityNGO
Referring

1200
1000
800
600
400
200
0

2010
1014
43

DOTS Facility
NGO Referring

2011
1599
28

2012
1846
42

Operational Researches Conducted

CHVs’ Contribution to DOTS Facility –Payatas, 2010‐2012
1000
900
800
700
600
500
400
300
200
100
0

• Effectiveness of Training Course on Quality
Assurance of Chest Radiography

DOTS Facility• Health Care Seeking Behavior of Pulmonary TB
Patients• Research on Tuberculosis Diagnostic
Committee (TBDC)

NGO
Referring

DOTS Facility
NGO Referring

2010
454
6

2011
898
22

2012
846
16

Monitoring and Evaluation Visits

Accomplishment in the two project sites• Engagement of NGOs (combined in both sites):
oNumber of NGOs from 3 (2008) to 5 (2010)
oNumber of NGO referring facilities: 4 (2008) to 15 (2012)• Percent contribution (combined in both sites) :oPercent contribution of NGO DOTS to TB Cases ranged
from 27. 9 % to 41.6 % (2007 to 2012)
oPercent community contribution to TB Cases ranged
from 2.1 % to 3.3 % (2010 to 2012).

56

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Project Areas
TECHNICAL ASSISTANCE SERVICES TO CAPACITATECOMMUNITY BASED ORGANIZATIONS (CBOs) AS RURALHEALTH UNITS ( RHUs) PARTNERS IN TUBERCULOSIS CONTROL
January 15, 2015 – April 30 2016
Funded by : Philippine Business for Social
Progress/Innovations on Multi‐Sectoral Partnership toAchieve Control of TB (PBSP/IMPACT)

Province of Bulacan

RIT/ JATA (RJPI)Technical Assistance(Initial)

PBSP‐IMPACT

Criteria for Project site selection

Establish Network /linkage with
RHO/PHO/MHO/
RHUs/ CBOs

• Low TB performance ( LGU ) because of low
utilization of DOTS services by the target clients– Low awareness of the TB disease– Stigma– Distance and cost in going to the facility– Lack of public involvement

Capacitybuilding
Training

Recording andReporting• Strong political support• Presence of CBOs

Joint Monitoringand Evaluation(PHO/MHO/RHU/BHS)

Roles of CBOs

Project Goal

• Identify and refer presumptive TB to Rural
Health Units (RHUs)• To increase the case detection rates and to
improve or maintain Cure Rates in the six
municipalities of Bulacan.

• Provide TB education• Supervise TB treatment of patients

57

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Challenges
Roles of CBOs

• Health financing: reduce financial burden amongclients• Encourage contacts of TB cases undergo TB
screening at health centers• Health Resources for Health: deployment of support
systems and enabling environment; keep the
motivation of Community Health Volunteers• Follow‐up presumptive TB (who were not able
to access RHUs) and interrupters of treatment• Essential medical products and technologies:
Balanced diagnostic and treatment supplies

Contribution of CBOs to the 6municipalities of Bulacan

Municipalities

RHU
Accomplishment
1130

Challenges• Service delivery: Patient‐ centered approach
care; improvement of access to quality TB
services• Lack of funding support to continue ourcommunity‐based TB activities

No. of TB All Forms
CBO% contribution by
Accomplishment
CBO to RHU
83
7%

Challenges

Future Directions• Leadership and Governance– Continuity of adherence to policies (municipal
ordinance) and make necessary amendments ifneeded;– Continuity of supportive supervision among
NGOs.

• TB and Universal Health Care
• TB and Tobacco• TB and Diabetes (?)• Health Information system• Promote gender equality (?)– Utilization of data to inform policy change

58

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。

59

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2016/9/13

Wei-Wen, Chen (Sally)

Presentation and discussion ofactivities of partnership㻳㼞㼕㼒㼒㼕㼠㼔㻌㼁㼚㼕㼢㼑㼞㼟㼕㼠㼥㻘㻌㻽㼡㼑㼑㼚㼟㼘㼍㼚㼐㻘㻌㻭㼡㼟㼠㼞㼍㼘㼕㼍㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻹㼍㼟㼠㼑㼞㻌㼛㼒㻌㻳㼑㼞㼛㼚㼠㼛㼘㼛㼓㼥㻌㻺㼡㼞㼟㼕㼚㼓㻌㻌㻞㻜㻜㻟㻙㻞㻜㻜㻡Á 㻯㼔㼍㼚㼓㻙㻴㼡㼍㻌㼀㻮㻌㻯㼍㼞㼑㻌㻭㼟㼟㼛㼏㼕㼍㼠㼕㼛㼚㻹㼑㼙㼎㼑㼞㻌㻌㻞㻜㻝㻠㻌㻙㼜㼞㼑㼟㼑㼚㼠Á 㻯㼔㼍㼚㼓㻙㻴㼡㼍㻌㻴㼛㼟㼜㼕㼠㼍㼘㻘㻌㻹㼕㼚㼕㼟㼠㼞㼥㻌㼛㼒㻌㻴㼑㼍㼘㼠㼔㻌㼍㼚㼐㻌㼃㼑㼘㼒㼍㼞㼑㻘㻌㻯㼔㼍㼚㼓㼔㼡㼍㻘㻌㼀㼍㼕㼣㼍㼚㻿㼑㼏㼞㼑㼠㼍㼞㼥㻌㼍㼚㼐㻌㼞㼑㼟㼑㼍㼞㼏㼔㻌㼍㼟㼟㼕㼟㼠㼍㼚㼠㻘㻌㻹㻰㻾㻌㼀㻮㻌㻰㼑㼜㼍㼞㼠㼙㼑㼚㼠㻌㻞㻜㻝㻠㻌㻙 㼜㼞㼑㼟㼑㼚㼠Á

Chang-Hua TB Care Association
TaiwanGeographic Position

Chang-Hua TB Care Association
Taiwan㻼㼞㼑㼟㼑㼚㼠㼑㼐㻌㼎㼥㻌㼃㼑㼕㻙㼃㼑㼚㻌㻯㼔㼑㼚㻌㻔㻿㼍㼘㼘㼥㻕Ἀ⤥ 㻩ƜǜƴƪƸ㻩㻴㼑㼘㼘㼛

Geographic Position

Chih Yun, Lin (Vicky)㻲㼡㻌㻶㼑㼚㻌㻯㼍㼠㼔㼛㼘㼕㼏㻌㼁㼚㼕㼢㼑㼞㼟㼕㼠㼥㻘㻌㻺㼑㼣㻌㼀㼍㼕㼜㼑㼕㻌㻯㼕㼠㼥㻘㻌㼀㼍㼕㼣㼍㼚㻌㻰㼑㼜㼍㼞㼠㼙㼑㼚㼠㻌㼛㼒㻌㻸㼕㼒㼑㻌㻿㼏㼕㼑㼚㼏㼑㼟㻌㻞㻜㻜㻝㻙㻞㻜㻜㻡Á 㻯㼔㼍㼚㼓㻙㻴㼡㼍㻌㼀㻮㻌㻯㼍㼞㼑㻌㻭㼟㼟㼛㼏㼕㼍㼠㼕㼛㼚㻌㻿㼡㼜㼑㼞㼢㼕㼟㼛㼞㻌㻌㻞㻜㻝㻞㻌㻙㼜㼞㼑㼟㼑㼚㼠Á 㻯㼔㼍㼚㼓㻙㻴㼡㼍㻌㻴㼛㼟㼜㼕㼠㼍㼘㻘㻌㻹㼕㼚㼕㼟㼠㼞㼥㻌㼛㼒㻌㻴㼑㼍㼘㼠㼔㻌㼍㼚㼐㻌㼃㼑㼘㼒㼍㼞㼑㻘㻌㻌㻯㼔㼍㼚㼓㻙㼔㼡㼍㻘㻌㼀㼍㼕㼣㼍㼚㻌㻌㻞㻜㻜㻤㻙㼜㼞㼑㼟㼑㼚㼠㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌㻌• Capital: Taipei

Á•The total area of
Taiwan :36,193 km2(13,974 sq mi)• Population: 23 million

60

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Geographic Position

First meeting in 2009

Chang-Hua county
Area: 1,074 km²
Population: 1.3 millions

HistoryÁPresent Director 2015~㼀㼔㼑㻌㼒㼕㼞㼟㼠㻌㼚㼛㼚㻙㼓㼛㼢㼑㼞㼚㼙㼑㼚㼠㼍㼘㻌㼍㼚㼐㻌㼚㼛㼚㻙㼜㼞㼛㼒㼕㼠㻌㼙㼍㼗㼕㼚㼓㻌㼢㼛㼘㼡㼚㼠㼍㼞㼥㻌㼛㼞㼓㼍㼚㼕㼦㼍㼠㼕㼛㼚㻌㼑㼟㼠㼍㼎㼘㼕㼟㼔㼑㼐㻌㼕㼚㻌㻯㼔㼍㼚㼓㻙㻴㼡㼍㻌㻯㼛㼡㼚㼠㼥㻌㼕㼚㻌㻹㼍㼞㼏㼔㻌㻞㻜㻜㻥㻌㼎㼥㻌㻰㼞㻚㻌㼅㼕㻙㼃㼑㼚㻌㻴㼡㼍㼚㼓㻌㻔㻹㻰㻘㻌㻯㼔㼕㼑㼒㻌㼛㼒㻌㻼㼡㼘㼙㼛㼚㼍㼞㼥㻌㼍㼚㼐㻌㻯㼞㼕㼠㼕㼏㼍㼘㻌㻯㼍㼞㼑㻌㼁㼚㼕㼠㻘㻌㻯㼔㼍㼚㼓㻙㻴㼡㼍㻌㻴㼛㼟㼜㼕㼠㼍㼘㻘㻌㻰㼑㼜㼡㼠㼥㻌㼏㼛㼙㼙㼍㼚㼐㼑㼞㻌㼛㼒㻌㻯㼑㼚㼠㼞㼍㼘㻌㼞㼑㼓㼕㼛㼚㻌㼏㼛㼙㼙㼡㼚㼕㼏㼍㼎㼘㼑㻌㻰㼕㼟㼑㼍㼟㼑㻌㻯㼛㼚㼠㼞㼛㼘㻌㻹㼑㼐㼕㼏㼍㼘㻌㻺㼑㼠㼣㼛㼞㼗㻕㻌㼣㼕㼠㼔㻌㼍㻌㼢㼕㼑㼣㻌㼠㼛㻌㼞㼍㼕㼟㼕㼚㼓㻌㼜㼡㼎㼘㼕㼏㻌㼍㼣㼍㼞㼑㼚㼑㼟㼟㻌㼍㼓㼍㼕㼚㼟㼠㻌㼀㼡㼎㼑㼞㼏㼡㼘㼛㼟㼕㼟㻌㻔㼀㻮㻕㻌㼍㼚㼐㻌㼍㼐㼛㼜㼠㼕㼚㼓㻌㼜㼞㼑㼢㼑㼚㼠㼕㼢㼑㻌㼍㼚㼐㻌㼏㼡㼞㼍㼠㼕㼢㼑㻌㼙㼑㼍㼟㼡㼞㼑㼟㻌㼠㼛㼣㼍㼞㼐㼟㻌㼠㼔㼑㻌㼏㼛㼚㼠㼞㼛㼘㻌㼛㼒㻌㼠㼔㼑㻌㼐㼕㼟㼑㼍㼟㼑㼟㻚㻌

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ÁÁThe First Director 2009-2014

Membership㻺㼍㼙㼑㻦㻌㼅㼕㻙㼃㼑㼚㻘㻌㻴㼡㼍㼚㼓㻹㻰㻘㻌㻷㼍㼛㼔㼟㼕㼡㼚㼓㻌㻹㼑㼐㼕㼏㼍㼘㻌㼁㼚㼕㼢㼑㼞㼟㼕㼠㼥㻌㻝㻥㻣㻡㻙㻝㻥㻤㻞Á 㻰㼑㼜㼡㼠㼥㻌㼏㼛㼙㼙㼍㼚㼐㼑㼞㻌㼛㼒㻌㼏㼑㼚㼠㼞㼍㼘㻌㼞㼑㼓㼕㼛㼚㻌㼏㼛㼙㼙㼡㼚㼕㼏㼍㼎㼘㼑㻌㼏㼛㼚㼠㼞㼛㼘㻌㼙㼑㼐㼕㼏㼍㼘㻌㼚㼑㼠㼣㼛㼞㼗㻘㻌㻯㻰㻯㻘㻌㻹㼕㼚㼕㼟㼠㼞㼥㻌㼍㼚㼐㻌㼣㼑㼘㼒㼍㼞㼑㻌㼟㼕㼚㼏㼑㻌㻞㻜㻝㻟㻙㼚㼛㼣Á 㻯㼔㼕㼑㼒㻌㼛㼒㻌㻼㼡㼘㼙㼛㼚㼍㼞㼥㻌㼍㼚㼐㻌㻯㼞㼕㼠㼕㼏㼍㼘㻌㻯㼍㼞㼑㻌㼁㼚㼕㼠㻘㻌㻯㼔㼍㼚㼓㻙㻴㼡㼍㻌㻴㼛㼟㼜㼕㼠㼍㼘㻌㼟㼕㼚㼏㼑㻌㻞㻜㻝㻜㼪㼚㼛㼣Á 㻯㼔㼕㼑㼒㻌㼛㼒㻌㻱㼙㼑㼞㼓㼑㼚㼏㼥㻌㻰㼑㼜㼍㼞㼠㼙㼑㼚㼠㻘㻌㻯㼔㼍㼚㼓㻙㻴㼡㼍㻌㻴㼛㼟㼜㼕㼠㼍㼘㻌㼟㼕㼚㼏㼑㻌㻞㻜㻜㻤㼪㼚㼛㼣Á 㻯㼔㼕㼑㼒㻌㼛㼒㻌㼀㼡㼎㼑㼞㼏㼡㼘㼛㼟㼕㼟㻌㻰㼑㼜㼍㼞㼠㼙㼑㼚㼠㻘㻌㻯㼔㼍㼚㼓㻙㻴㼡㼍㻌㻴㼛㼟㼜㼕㼠㼍㼘㻌㼟㼕㼚㼏㼑㻌㻞㻜㻜㻣㼪㼚㼛㼣Á 㻯㼔㼕㼑㼒㻌㼛㼒㻌㻯㼑㼚㼠㼞㼍㼘㻌㻾㼑㼓㼕㼛㼚㻌㻹㻰㻾㻙㼀㻮㻌㼠㼑㼍㼙㻘㻌㼟㼕㼚㼏㼑㻌㻞㻜㻜㻠㼪㼚㼛㼣㼃㼑㻌㼜㼡㼞㼟㼡㼑㻌㼛㼡㼞㻌㼙㼕㼟㼟㼕㼛㼚㻌㼕㼚㻌㼜㼍㼞㼠㻌㼠㼔㼞㼛㼡㼓㼔㻌㼍㼚㻌㼛㼜㼑㼚㻌㼙㼑㼙㼎㼑㼞㼟㼔㼕㼜㻌㼜㼛㼘㼕㼏㼥㻘㻌㼍㼚㼥㻌㼕㼚㼐㼕㼢㼕㼐㼡㼍㼘㻌㼕㼚㼢㼛㼘㼢㼑㼐㻌㼍㼚㼐㻌㼕㼚㼠㼑㼞㼑㼟㼠㼑㼐㻌㼕㼚㻌㼠㼔㼑㻌㼛㼎㼖㼑㼏㼠㼕㼢㼑㼟㻌㼛㼒㻌㼠㼔㼑㻌㻭㼟㼟㼛㼏㼕㼍㼠㼕㼛㼚㻌㼙㼍㼥㻌㼍㼜㼜㼘㼥㻌㼒㼛㼞㻌㼙㼑㼙㼎㼑㼞㼟㼔㼕㼜Á 㼀㼔㼑㻌㻱㼤㼑㼏㼡㼠㼕㼢㼑㻌㻯㼛㼙㼙㼕㼠㼠㼑㼑㻌㼟㼔㼍㼘㼘㻌㼐㼑㼏㼕㼐㼑㻌㼍㼟㻌㼠㼛㻌㼠㼔㼑㻌㼍㼏㼏㼑㼜㼠㼍㼚㼏㼑㻌㼛㼞㻌㼚㼛㼠㻌㼛㼒㻌㼍㼚㼥㻌㼍㼜㼜㼘㼕㼏㼍㼠㼕㼛㼚㻌㼍㼚㼐㻌㼟㼕㼙㼕㼘㼍㼞㼘㼥㻌㼏㼍㼚㼠㻌㼟㼔㼍
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TB incidence rate in Chang-Hua2009 -2014

Aim/Purpose㻤㻜㻿㼡㼜㼜㼛㼞㼠㻌㼐㼕㼟㼍㼐㼢㼍㼚㼠㼍㼓㼑 㼍㼚㼐㻌㼟㼜㼑㼏㼕㼍㼘 㼓㼞㼛㼡㼜㼟㻌㼠㼛㻌㼏㼛㼙㼜㼘㼑㼠㼑㻌㼀㻮㻌㼠㼞㼑㼍㼠㼙㼑㼚㼠㻌㼠㼔㼡㼟㻌㼞㼑㼐㼡㼏㼑㻌㼠㼔㼑㻌㼏㼔㼍㼚㼏㼑㻌㼠㼛㻌㼜㼞㼛㼓㼞㼑㼟㼟㻌㼠㼛㻌㻹㻰㻾㻙㼀㻮Á 㼃㼑㻌㼍㼞㼑㻌㼍㻌㼏㼛㼘㼘㼍㼎㼛㼞㼍㼠㼕㼢㼑㻌㼚㼑㼠㼣㼛㼞㼗㻌㼛㼒㻌㼜㼛㼘㼕㼏㼥㻌㼙㼍㼗㼑㼞㼟㻘㻌㼔㼑㼍㼘㼠㼔㻌㼣㼛㼞㼗㼑㼞㼟㻘㻌㼞㼑㼟㼑㼍㼞㼏㼔㼑㼞㼟㻘㻌㼜㼑㼛㼜㼘㼑㻌㼍㼒㼒㼑㼏㼠㼑㼐㻌㼎㼥㻌㼀㻮㻌㼍㼚㼐㻌㼍㼐㼢㼛㼏㼍㼠㼑㼟㻚㻌
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㻞㻜㻜㻥
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2016/9/13

MissionÁMission㻲㼡㼚㼐㼞㼍㼕㼟㼕㼚㼓㻌㼒㼛㼞㻌㼜㼍㼠㼕㼑㼚㼠㼟㻌㼣㼔㼛㻌㼕㼟㻌㼍㼠㻌㼘㼛㼣㻌㼑㼏㼛㼚㼛㼙㼕㼏㼍㼘㻌㼟㼠㼍㼠㼡㼟㻌㼛㼞㻌㼡㼚㼝㼡㼍㼘㼕㼒㼕㼑㼐㻌㼠㼛㻌㼞㼑㼠㼞㼕㼑㼢㼑㻌㼓㼛㼢㼑㼞㼚㼙㼑㼚㼠㼍㼘㻌㼟㼡㼜㼜㼛㼞㼠㻘㻌㼕㼚㼏㼞㼑㼍㼟㼑㻌㼜㼍㼠㼕㼑㼚㼠㼟䇻㻌㼙㼛㼠㼕㼢㼍㼠㼕㼛㼚㼟㻌㼍㼚㼐㻌㼍㼐㼔㼑㼞㼑㼚㼏㼑㻌㼠㼛㻌㼏㼛㼙㼜㼘㼑㼠㼑㻌㼠㼞㼑㼍㼠㼙㼑㼚㼠㻚Á 㼀㼔㼑㻌㼡㼚㼐㼑㼞㼠㼍㼗㼕㼚㼓㻌㼛㼒㻌㼠㼔㼑㻌㻾㼑㼟㼑㼍㼞㼏㼔㻌㼍㼚㼐㻌㻵㼚㼢㼑㼟㼠㼕㼓㼍㼠㼕㼛㼚㻌㼛㼚㻌㼟㼡㼎㼖㼑㼏㼠㼟㻌㼏㼛㼚㼏㼑㼞㼚㼕㼚㼓㻌㼠㼡㼎㼑㼞㼏㼡㼘㼛㼟㼕㼟㻚Á 㻵㼙㼜㼛㼞㼠㻌㻒㻌㼙㼛㼚㼕㼠㼛㼞㻌㼚㼑㼣㻌㼀㻮㻌㼐㼞㼡㼓Á㻭㼟㼟㼕㼟㼠㻌㼣㼕㼠㼔㻌㼐㼕㼟㼍㼐㼢㼍㼚㼠㼍㼓㼑 㼍㼚㼐㻌㼟㼜㼑㼏㼕㼍㼘 㼓㼞㼛㼡㼜㼟㻔㼑㼓㻚㻌㼔㼛㼙㼑㼘㼑㼟㼟㻘㻌㻴㻵㼂㻘㻌㼐㼞㼡㼓㻌㼍㼎㼡㼟㼑㼐㻘㻌㼜㼟㼥㼏㼔㼕㼍㼠㼞㼕㼏㼟㻘㻌㼍㼘㼏㼛㼔㼛㼘㼕㼏㼟㻘㻌㼜㼑㼛㼜㼘㼑㻌㼘㼕㼢㼕㼚㼓㻌㼍㼘㼛㼚㼑㻕㻌㼣㼔㼛㻌㼔㼍㼟㻌㼟㼡㼒㼒㼑㼞㼕㼚㼓㻌㼣㼕㼠㼔㻌㼀㻮㻌㻔㻹㻰㻾㻌㻒㻌㼜㼞㼑㻌㼄㻰㻾㻌㼀㻮㻕㻌㻦㻌㼕㼙㼜㼞㼛㼢㼑㻌㼠㼔㼑㼕㼞㻌㼘㼕㼢㼑㼟㻌㼠㼔㼞㼛㼡㼓㼔㻌㼒㼕㼚㼍㼚㼏㼕㼍㼘㻌㼟㼡㼜㼜㼛㼞㼠㻘㻌㼑㼐㼡㼏㼍㼠㼕㼛㼚㻘㻌㼍㼚㼐㻌㼑㼚㼏㼛㼡㼞㼍㼓㼑㼙㼑㼚㼠㻚

MissionActivities㻴㼛㼙㼑㻌㼢㼕㼟㼕㼠㼟㻌㼎㼥㻌㼏㼘㼕㼚㼕㼏㼍㼘㻌㼟㼠㼍㼒㼒㻌㼛㼞㻌㼢㼛㼘㼡㼚㼠㼑㼑㼞㼟Á 㻿㼠㼞㼑㼚㼓㼠㼔㼑㼚㼕㼚㼓㻌㼏㼘㼕㼚㼕㼏㼍㼘㻌㼑㼐㼡㼏㼍㼠㼕㼛㼚㻌㼒㼛㼞㻌㼏㼘㼕㼚㼕㼏㼍㼘㻌㼀㻮㻌㼟㼠㼍㼒㼒㻌㻾㼑㼓㼡㼘㼍㼞㻌㼙㼑㼐㼕㼏㼍㼘㻌㼍㼘㼘㼛㼣㼍㼚㼏㼑㻌㼛㼞㻌㼒㼛㼛㼐㻌㼟㼡㼎㼟㼕㼐㼕㼑㼟Á 㻼㼞㼛㼢㼕㼐㼑㻌㼠㼛㼕㼘㼑㼠㼞㼕㼑㼟㻌㼒㼛㼞㻌㼔㼛㼙㼑㼘㼑㼟㼟㻌㼏㼍㼟㼑㼟㻌㻌㻌ÁÁ

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Challenges㻯㼔㼍㼚㼓㻙㻴㼡㼍㻌㼏㼛㼡㼚㼠㼥㻌㼕㼟㻌㼙㼍㼕㼚㼘㼥㻌㼞㼑㼘㼥㻌㼛㼚㻌㼡㼞㼎㼍㼚㻌㼍㼓㼞㼕㼏㼡㼘㼠㼡㼞㼑㼟㻙 㻸㼍㼏㼗㻌㼛㼒㻌㼀㻮㻌㼕㼚㼒㼛㼞㼙㼍㼠㼕㼛㼚㻌㼍㼚㼐㻌㼗㼚㼛㼣㼘㼑㼐㼓㼑㻙 㼁㼚㼍㼎㼘㼑㻌㼠㼛㻌㼞㼑㼏㼛㼓㼚㼕㼦㼑㼐㻌㼀㻮㻌㼟㼥㼙㼜㼠㼛㼙㼟㻌㻌㻌㻙 㼀㻮㻌㻩㻌㻿㼕㼚㻌Á 㻰㼑㼘㼍㼥㻌㼔㼛㼟㼜㼕㼠㼍㼘㼕㼦㼍㼠㼕㼛㼚㻌Á 㻿㼔㼛㼞㼠㻌㼛㼒㻌㼒㼡㼚㼐㼕㼚㼓
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THRF-HISTORY ( 2 )PARTNERS
RS• 1995 The Research Institute of Tuberculosis, Japan AntiTuberculosis Association (RIT/JATA) set up “TB/HIV Research Project”• 2002 TB/HIV Research Foundation” (THRF) was officiallyregistered as a non-profit, non-government organization

THRF BOARD MEMBERS (NON-PAID)• President Jintana Ngamvithayapong-Yanai, B.N. (Hons.), M.A., Ph.D.
• Vice President Pathom Sawanpanyalert, M.D. (Hons.), Dr.PH.
• Members• Treasurer• Secretary)XQGLQJ3ROLF\• 1RIXQGLQJIURPWREDFFRDQGDOFRKROUHODWHG
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Pacharee Kantipong, M.D.

Petchawan Pungrassami, M.D.,Ph.D.
Supalert Nedsuwan, M.D., M.P.H.
Surakameth Mahasirimongkol, M.D., M.Sc.,Ph.D.
Oranuch Nampaisan, B.Sc. (Statistic),
M.Sc.(Biostatistics)

Piyanoot Chatchawarat, B. Econ., M.Ed.,(Admin.)Sarmwai Luangjina, B.A.

14 Fulltime paid staff

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affected by tuberculosis, HIV/AIDS and otherdiseases of poverty (for the people) by meansof epidemiology, bio-medical, social science,
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66• Improvement of diagnosis by using urine test of detecting DNA
fragment of Mycobacterium tuberculosis (RIT/JATA)• Impact of isoniazid preventive therapy on TB morbidity andmortality: A cohort study of people living with HIV (JATA)• Pharmacogenomic study of anti-tuberculosis side effects:K\UHVHDUFKDQGFKDULW\"• 0RVW7%SDWLHQWVDUHSRRU• 3RYHUW\FDXVHWUHDWPHQWLQWHUUXSWLRQDQG
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Association)• Interventions for reducing sodium intake among patients withhypertension (Thailand Health Promotion Foundation)• Workshops on TB in risk groups (JATA-seal funding)

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poor TB patients for transportation andliving expenses. (initial 3,000 US$ fundfrom StopTB Partnership, Geneva)• 2009: THRF and JATA established

Volunteer Ladies Against TB to sustain
the patient-fund and to support TB care

universities in Thailand and School of Public Health University ofAlberta, Canada

67

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70

Appendix 5Group Discussion 1: 15 March 2016 (10:15 – 11:45)
Topic: Challenges of NGO to End TB and role of women
Moderator:

Nobukatsu Ishikawa

Rapporteur: Jintana Ngamvithayapong-Yanai
The moderator started the discussion by showing a list of roles of NGOs/CSOs to cover for
End TB, as following:

hard to reach groups/poor patientscare/support to catastrophic costSocial protection (e.g., Stigma, discrimination)

Universal health coverage (UHC)

Use of community health volunteersEngage TB

Social linkage

local authorities



Advocacy voice for the voicelessCommunity empowerment

Communicate/coordinate stakeholder

Conducting researchand Non-TB sectors

The moderator then requested each NGO to write a top three challenges in three pieces ofpost-it note paper. One piece for one challenge which they think are challenges for NGO to
End TB.

All NGOs posted their lists on a big board. Later, the moderator createdcategories based on the lists presented in the Table 1. Table 2 presents challenges
classified by NGO/country as discussed in the country presentations and in the document
for End TB.
Table 1: The top-three free listing of perceived challenges to NGOs/CSOs to end TB

Categories of Challenges (Number)

List of challenge (country)

Challenges related to community - How to maintain and keep volunteers
health volunteers (5)actives?
(Indonesia, Thailand)- Need of resource and incentives forvolunteers (Indonesia, Myanmar, Philippines)
1971

- Case findings still low in remote area andvolunteers can do more (Cambodia)
Challenges related to funding (4)- Budget sustainability (Korea)-

Limitedresources, funding (Cambodia,

Nepal, Philippines)
Challenges related to support to TB patients and poor patients (4)Addressing

inequality

inTB

patient(Philippines)- Advocacy voice for vulnerable people(Thailand)- Need of nutrition support to patients(Myanmar)- Patient confidentiality (Taiwan)

Challenges related to patients and -Need to increase TB awareness amongcommunity awareness about TB (3)community people (Taiwan, Thailand,
Myanmar)

Challenges related to stakeholders - Lack of consensus between government and(3)

NGO (Korea)- Satisfaction for donors or satisfaction ofpatients? (Korea)- High expectations from stakeholders (Nepal)

Challenges related to professional care providers (2)Difficultyin

implementing

International

Standard of TB care among the providers(Indonesia)- Less capacity in conducting research anddevelopment (Nepal)

Other (1)-Migration (Cambodia)

Table 2: Challenges of NGO to End TB classified by country

Organization, Country

Challenges of NGO to End TB

Stop TB Partnership, - Budget sustainability
Korea- Lack of consensus between government and NGO- Satisfaction for donors or satisfaction of patients?

Chang-Hua Hospital / - Awareness of TB among community and society
TATA, Taiwan- Stigma and discrimination- Confidentiality of patient side, Privacy
20
72

Stop

TB

Partnership - Difficulty keeping the volunteers active

Indonesia- Need resources to support the volunteers- Difficulty implementing International Standard of TB careamong the providers

THRF, Thailand- TB awareness among general people- Advocacy voice for vulnerable people- Sustainability of volunteers

JANTRA, Nepal- Limited resources- Less capacity in research and development- High expectations from stakeholders

CATA, Cambodia- Limited fund
- Case finding is still low- migration

MMWA, Myanmar- To increase community awareness by providing more IE&C
materials and community health talk
- Funding for nutrition and transportation support for patients- Volunteer incentive is not enough for the targeted 330
townships for providing psycho-social support to complete
treatment

RIT/JATA, Philippines- Provision of incentive- Funding support- Addressing patients’ inequality

The challenges related to “funding” was not included in this discussion session because theafternoon session will specifically discussed about fundraising. The group members shared
their experiences and participated in discussion of the following issues:
1. Challenges related to community health volunteers
Turnover rate of the volunteers is common in most countries because of lack of incentives,lack of recognitions by community people, particularly recognition from people with highsocial and economic status. The following strategies may motivate volunteers to stay longer
and increase volunteers’ dignity or recognitions:
1.1 Provision of incentives including- special right to access free health service,- organize periodic meetings and let the volunteer to report their performance- organize “exchange visit” so that the volunteers open their eyes to expose to other21
73

sites- organize training to increase TB knowledge- provide transportation fee, award ceremony for outstanding volunteers
1.2 To enhance dignity, the volunteers should be selected by community people
Despite provision of these incentives and motivation, several participants felt the turnoverrate of the volunteer is still high and require additional interventions. JUNTRA Nepal
proposed “Trust fund” as an intervention motivating volunteers to actively work with dignity.

2. Enhancing TB awarenessParticipants shared their opinion on enhancing TB awareness as followings:-

Means and message to convey TB information to people living in remote area
should be cultural sensitive.

-

TB patients and their family should be involved in providing TB education to thecommunity-

It is important to repeat TB education to every level-

Enhancing the role of peer group (TB patients group)

The moderator concluded summarizing the sessions that the roles and challenges ofNGOs/CSOs are diverse and varies according to the country and organization, but key
common issues such as community and patient oriented approach were discussed andshared, and this kind of sharing is a most useful to promote the spirit of stop TB partnership.
For that, documentation of the success stories is important. A term of human dignity wasraised particularly for community health volunteers’ motivation, but the concept could apply
to all aspect of the work by NGOs/CSOs.

22
74

Appendix 6
Session 2: 15 March 2016 (13:00 – 14:30)
Topic: Fundraising for the community activities
Moderator:

Jintana Ngamvithayapong-Yanai

Rapporteur: Ram Sharan Gopali
The moderator started the session by showing a short video clip on “Japan hosts‘Touch-a-boob’ fundraising event” https://www.youtube.com/watch?v=pUi-FIfzHIw This is
the second most viewed video clip in the YouTube for a searching keyword of “fundraising”.
The video shows how Japanese Foundation for AIDS Prevention (a Japanese NGO) raised
US$50,000 within 24 hours with the objectives to raise HIV awareness in Japan and raisefund to support HIV prevention, treatment and care. Several Japanese porn queens
voluntarily contributed to this fund raising. The participants discussed how they felt andwhether or not this fundraising methodology can be applied in their countries. All participants
reported this fundraising method cannot be applied because it is against law and culture in
their respective countries.
Following this introductory video, the moderator presented topics for the discussion.
All participants agreed with the topics. Results from the discussion are summarized asfollows: Current community TB activities requiring fund include:
1. Activities directly related to patient supports include; supporting patients’transportation, providing foods to complete TB treatment, and home visit
2. Activities related to community volunteers include; support for meetings, training
and allowance for volunteers
3. International community TB activities
Table 1:

Current funding sources of the participants’ NGOs

Organization, Country

Funding sources

Stop TB Partnership, The operational cost is funded by the government of Korea
Korea

and programmatic budgets are from several funding sources
such as Koica, Korean Anti-TB Association

Chang-Hua Hospital / For TATA, 80% of funding are from the president, Christmas
TATA, Taiwan

seal. As for Chang Hua, funding are from membership,
donation of members, pharmaceutical companies

Stop

TB

Partnership Entire fund is from the Chairperson (owner of oil company)
23
75

Indonesia
THRF, Thailand

Research funding for research activities For charity, mostly
come from the volunteer ladies’ fundraising

JANTRA, Nepal

For

regularfunding

is

from

RIT/JATA.

For

project

implementations are from Global Fund, Stop TB partnership,
TBREACH
CATA, Cambodia

JATA, USAID, TBREACH

MMWA, Myanmar

For regular fund are from membership fee, properties (renting
lands/building), running pre-school. For project are fromseveral sources such as UNICEF

RIT/JATA, Philippines

JATA, MOFA, JICA, USAID

Participants learnt that MMWA has 12 million members and each member pay about 0.2
US$ for life-long membership and they receive a pin and a certificate to be a member.

Table 2:Fund raising methods of NGOs participating in the meeting

Organization, Country

Methods of fund raising

Stop TB Partnership, - Developing proposal for funding
Korea- Putting donation box in department store, post office andbank (obtained very small amount)

Chang-Hua Hospital / - Annual donation by people (Taiwanese people like
TATA, Taiwan

donation)- Donation from pharmaceutical companies (cash andmedicine) -selling

Stop

TB

Christmas seals

Partnership - Organizing charity events such as cultural night, sport

Indonesia

competition to high income people

THRF, Thailand- Developing proposal for research funding- For charity: The volunteer ladies raise the fund by
self-donation, organizing gala dinner, donation from othersources

JANTRA, Nepal- Developing proposal for funding

CATA, Cambodia- Organizing field visit for Japan Women Anti-TB Association- Developing proposal for funding

MMWA, Myanmar- Donation from donors- Selling calendar and magazine

RIT/JATA, Philippines- Developing proposal for funding
24
76

Funding from tobacco, alcohol and pharmaceutical companies
All participants recognized tobacco and alcohol as risk factors for TB. Therefore, theirorganizations do not accept funding from tobacco and alcohol related business. Particularly,
Stop TB partnership Indonesia’s mission also includes stop tobacco. Cambodia
implemented TB prevention project in tobacco factory but does not receive funding from thecompany. As for funding from pharmaceutical companies, participants from Korea, Taiwan
and Thailand reported that they accepted donation with conditions. For examples, thepharmaceutical companies can donate money to support TB activities as if they are an
individual donor. Therefore, the company’s logo must not appear in the product or the
events funded by the pharmaceutical companies. JUNTRA, CATA and RIT/JATA Philippines
have never been approached by pharmaceutical company. In addition to pharmaceuticalbusiness, Myanmar MMWA also reject funding from some baby products such as baby
talcum, milk or baby food. The senior participants from RIT shared the information thatpharmaceutical companies are also members of Stop TB Partnership Japan. Accepting
funding from this business sector should be considered based on the conditions and context
of funding proposal.
The moderator closed the session by concluding that funding is important for running NGO
and implementing community activities. The discussion shows that integrity to accept or toraise funding is priority for all participants.

25
77

78

Appendix 7

Tokyo Statement on Community Engagement in End TB Strategy
Asian National Stop TB Partnership Forum 2016
The Asian National Stop TB Partnership Forum 2016 was held on March
14-15, in Tokyo, Japan, with the participation of a total of 18 delegates from
8 Asian countries / territories (Cambodia, Indonesia, Korea, Myanmar,
Nepal, Philippines, Taiwan, and Thailand). These participants represented
the non-governmental organizations (NGO) and other civil society
organizations (CSO) engaged in tuberculosis control.
The missions of the Forum were;-

To enhance people’s awareness of the importance of their ownership forand commitment to tuberculosis control activities,-

To promote the effective collaboration between governmental andnon-governmental sectors in the fight against tuberculosis, with specialreference to the potentiality of women’s roles,-

To clarify the problems and challenges of tuberculosis control of eachtarget area or community to be addressed in their action plans, and-To advance cooperation between partners of different groups beyond
country borders.

During the two-day meeting the participants shared their experiences andviews of their groups, as well as those of the Women’s anti-TB Associationand Western Pacific Region of WHO, and had discussions over the ways toenhance respective groups’ activities in the perspective of End TB Strategy.
Following are the summary findings of presentations, discussions, andproposals from the forum, as agreed upon by all the participants.
Background: Paradigm shift in the fight against tuberculosis
Along with the paradigm shift from the Millennium Development
Goals to Sustainable Development Goals, the global TB program has turned
to End TB Strategy as endorsed in 2014. In this strategy, tuberculosis is
recognized more clearly than ever as a socio-economic challenge, not merely
as a medical issue, to which more engagement of communities, or
non-governmental organizations, is badly needed, as claimed throughout thepillars of the strategy. Specifically, integrated, patient-centered TB care and26
79

prevention is claimed as the fundamental element in Pillar 1. This is alsostressed in the Regional Framework developed by WPRO, adapting the End
TB Strategy to its regions.
Roles of NGOs in End TB Strategies: Missions, Opportunities, and Challenges
In country presentations and group discussions, the following four points
were highlighted as important roles of NGOs / CSOs, each with special
emphasis as supplemented in numbers 1, 2, …. . Although the roles andchallenges of NGOs/CSOs are diverse and variable according to the countries
and organizations, the key issues such as community and patient-oriented
approach were common, and this sharing was felt as most critical inpromoting the spirit of the stop TB partnership.

1) Cooperation with the government in implementing NTP
1. Supporting TB case detection through urging symptomatic subjects, or
TB suspects, to visit health facilities.
2. Encouraging patients to take medications regularly.
3. Increasing the awareness and knowledge of TB among community people
on various occasions to reduce the stigma, discrimination andsuperstition, and to take proper action against illnesses.

2) Social support of patients and families
1. Supporting, educating, and empowering patients and their family facing
financial barriers through forging UHC.
2. Providing patients with food, transport, housing, etc., as important areasof patient support.

3) Advocacy
1. Advocating voices of patients and vulnerable people.
2. Increasing awareness of TB among the community.
3. Creating patients’ groups, so that they have a stronger voice for claiming
better service and protection, and also enhancing community awarenessof TB.
4. Creating peer support groups with high capacity to support vulnerable
groups (e.g., the very poor, women, children, HIV-infected or elderly
persons, etc.).
5. Advocating research for TB control, especially operational researches
2780and researches involving community activities.
6. Engage other areas of the society/community with TB, such as education,
agriculture and MCH, etc..
7. Empower health activists and volunteers o set up networks at grass-root
level involving other community members

4) Women’s roles and potentials
1. Gender equity should be addressed in TB care, including access to healthservices and knowledge of TB.
2. Women’s potential in community activities should be fully recognized.
Fund raising issues
Many groups suffer from inadequate budgets, but few of them use
specific schemes of their own for fund raising, e.g., Christmas-seal campaign,
Calendar sales, donation box (in shops, etc.), and charity events, in addition
to donations from individuals (group members and others) and companies.
Other funding sources include government programs, the Global
Fund, WHO, Union, Stop TB Partnership, UNICEF, other bilateral plans(e.g., JATA, USAID, TBREACH), and charitable foundations.
Apart from the inadequacy of funds, possible concern may exist forreceiving donations from pharmaceutical industries (in some countries, also
other health-related businesses), to say nothing of donations from tobaccoand alcohol industries.
Challenges
1. The high turn-over rate of volunteers is common, possibly due toinadequate incentives and lack of community recognition, or volunteers’
dignity.
2. Incentives for volunteers may include privileged free access to healthservices, periodic meetings for reporting volunteers’ activities,
opportunities of training and exchange with other groups, awarding foroutstanding performance, and provision of travel allowances.
3. Addressing patient’s confidentiality or privacy.
4. In some cases, consensus between government and NGOs is not enough,and some care providers have difficulty in implementing International
Standards of TB Care.
5. Low capacity of research activities, when NGO’s operational research is
28
81expected as very significant, especially in UHC and social protection
schemes.
6. Documentation of success stories of community activities may be
important in sharing recognition of bases of TB control such as UHC andpatient-centered care.
Forum slogan
The forum decided to adopt a following slogan to be shared by member organizations asa priority message of activities.
-

Women are creators of community health through family health.

Acknowledgement
The Forum acknowledges the contribution and efforts of the following individuals andorganizations that made the meeting possible and successful. The Forum also expresses
deep thanks to the observers for their kind interest in the meeting.
Participants[Organization] Cambodia: National Center for TB and Leprosy control (CENAT), Cambodia
Anti‐Tuberculosis Association (CATA). Indonesia: Headquarthers of Forum Stop TB PartnershipIndonesia and Stop TB Partnership Cimahi City, Korea: Korean National Tuberculosis Association(KNTA), Stop TB Partnership Korea, Myanmar: Myanmar Maternal Welfare Association (MMWA),
National Tuberculosis Program, Kachin State, Nepal: Japan‐Nepal Health & TB Research Association(JANTRA), Philippines: RIT/JATA, Philippines Inc. (RJPI), Taiwan: Taiwan Anti‐TB Association (TATA),
National Chang‐Hua Hospital MDR TB Department, Thailand: TB/HIV Research Foundation (THRF),
Chiang Rai Volunteer Ladies against TB[Member] Cambodia: Khloeung Phally, Monyrath Chry, Chharvy Ringsey Keo, Indonesia: Mariani
Reksoprodjo, Fitriani Manan, Korea: Seungjoon Chang, Kanghee Kim, Hong Jo Choi, Myanmar: Tha
Zin Nwｅ, Ei Ei Chaw, Nepal: Ram Sharan Gopali, Jamuna Panthi, Philippines: Aurora G Querri,
Leonardo G. Parungo Jr, Taiwan: Chih‐Yun Lin, Wei‐Wen Chen, Thailand: Sarmwai Luangjina, Jintana
Ngamvitayapong‐Yanai

Staff[Organization] Stop TB Partnership Japan, Japan Anti‐Tuberculosis Association (JATA), ResearchInstitute of Tuberculosis, JATA, Council of Japanese Women’s Anti‐Tuberculosis Associations,Western Pacific Regional Office of World Health Organization
29
82

[Member] Ram Sharan Gopali, Makiko Goto, Yumi Ishikane, Nobukatsu Ishikawa, Shoji Kudo, Ayako
Miyamoto, Toru Mori, Nobuyuki Nishikiori, Jintana Ngamvitayapong‐Yanai Kosuke Okada, Kintaro
Shibuya, Noriko Shirasu, Noriyo Shimoya, Keiji Tanaka, Tomoko Tsuji, Takeko Yamashita

30
83

84

アジア・ナショナル・ストップ結核パートナーシップフォーラム 2016

日
場
主程：2016 年 3 月 14 日・15 日

所：国連大学、結核予防会結核研究所

催：認定特定非営利活動法人ストップ結核パートナーシップ日本
協

賛：公益社団法人全国結核予防婦人団体連絡協議会
協 力：公益財団法人結核予防会

85

86

報  告
アジア・ナショナル・ストップ結核パートナーシップフォーラム 

アジア・ナショナル・ストップ結核パートナーシップフォーラム  は、 年  月 、 日東京で開催された。下記は、フォーラムにおける発表、討論の総括である。

メインテーマ
アジアの「結核早期根絶戦略」における住民の役割

会議の目的
アジアの各国・地域のストップ結核パートナーシップ（ないし相当組織、例結核予防会）が一堂に会して、それぞれの国・地域におけるより早期の結核根絶達成のための、住民による（非政府組織としての）現在の活動、今後の計画、およびそれらを強化する可能性、加えて各国・地域の間の協力や連携について討議する。アジアの「結核早期根絶戦略」の早期目標達成に向けて、特に、女性の役割、国境を越えた
パートナーシップ間の連携の可能性に重きを置く。

期待される成果
１．結核対策への住民の主体的な取り組みの重要性に対する自覚を強化する
２．結核予防・ケアにおける政府と民間セクターの効果的な協力を向上させる
３．参加国・地域の状況の比較に基づく、それぞれ特有の問題点、優先課題を明らかにし、それらに対する民間セクターとしての対策行動計画案を作成する
４．住民活動における女性の取り組みの可能性への理解を深める
５．各国・地域のパートナーシップ間の協力や連携を強化する日 程 年  月  日、 日会 場
国連大学 東京都 渋谷区（ 月  日）
（公財）結核予防会 結核研究所 東京都 清瀬市 （ 月  日）

参加者 ヶ国地域の非政府組織を代表する  人が招待された（付録 を参照）。
加えて、外務省、-,&$ を含む様々な政府、非政府組織、グループから  人のオブザーバが出席した。



87

会議内容と成果
 開会挨拶と参加者、スタッフの紹介：  月  日（国連大学）
座長： 森 亨（ストップ結核パートナーシップ日本 代表理事）

 基調講演 ：  月  日（国連大学）
テーマ： 日本における結核予防婦人団体の活動
講師： 山下武子（結核予防婦人団体協議会 事務局長）
概要：付録  を参照 基調講演 ：  月  日（国連大学）
テーマ： アジアにおける今日の結核問題の課題
講師：錦織信幸（世界保健機関（:+2）西太平洋地域事務局ストップ結核・ハンセン病対策調整官
概要：付録 を参照 結核予防婦人団体協議会表敬訪問・交流： 月  日（結核予防婦人団体協議会総会 会場 ホテル・ニューオータニ ）
 各参加国・地域の活動の発表：  月  日、 日（結核研究所）
座長： 岡田耕輔（結核予防会国際部 部長）概要：付録  を参照 グループ討議 ：  月  日（結核研究所）
テーマ： 民間結核対策活動の課題と女性の役割
モデレーター： 石川信克（結核予防会 結核研究所 所長）  概要：付録  を参照 グループ討議 ：  月  日（結核研究所）
テーマ：住民活動の資金造成の計画作成
モデレーター：ジンタナ・ヤナイ（タイ結核+,9 研究財団）
概要：付録  を参照 フォーラム宣言文の採択：  月  日（結核研究所）
座長：森 亨（ストップ結核パートナーシップ日本 代表理事）
概要：付録 ；東京宣言 アジア・ナショナル ストップ結核パートナーシップフォーラム 
を参照
 懇親会： 月  日（結核研究所）
特別ゲスト：渋谷金太郎（清瀬市 市長）88

付録 
東京宣言 「結核早期根絶戦略」におけるコミュニティの参加
アジア・ナショナル・ストップ結核パートナーシップフォーラム 

アジア・ナショナル・ストップ結核パートナーシップフォーラム  は、アジアの国・地域（カンボジア、インドネシア、韓国、ミャンマー、ネパール、フィリピン、台湾、タイ）を代表する合計  名の参加により、 月 ～ 日に東京で開催された。参加者は、結核対策に関わる 1*2、&62 を代表する。
フォーラムのミッション；
 結核対策における住民の主体的な取り組みの重要性に対する自覚を強化する 特に女性の役割の可能性に関連した結核予防・ケアにおける政府と民間セクターの
効果的な協力を促進する 参加国・地域の状況の比較に基づく、それぞれ特有の問題点、優先課題を明らかにし、それらに対する民間セクターとしての対策行動計画案を作成する
 各国・地域のパートナーシップ間の協力や連携を強化する
 日間の会議の中で、参加者たちは、結核予防婦人団体協議会や :+2 西太平洋地域事務局（:352）、そして各グループの経験や視点を共有し、「結核早期根絶戦略」の見地に立ち、それぞれの活動強化について話し合った。下記は、参加者全員の合意によるフォーラムでの発表、討論の総括と提言である。
背 景：結核終息へ向けた戦いの枠組みの転換（パラダイムシフト）
 「ミレニアム開発目標」から「持続可能な開発目標」へのパラダイムシフトに伴い、:+2 のグローバ
ル結核対策計画も  年に承認された「結核終息戦略」へ移行した。この戦略において、結核は単な
る医学的な問題としてではなく、明確に社会経済的な課題と認識され、住民や非政府組織による取組み
が戦略の柱として今まで以上に重要視されている。特に、統合された患者中心の結核治療（ケア）と予防は、第  の柱の基本的な要素である。これは、「結核終息戦略」を地域別に適合させた :+2 西太平洋
地域事務局（:352）による「地域フレームワーク」においても強調されている。
「結核終息戦略」における 1*2 の役割：ミッション、機会、課題
国ごとの発表、グループ討議の中で、1*2、&62 の重要な役割として以下の  つの点とその中で特に強調すべき点がそれぞれ補足 …として挙げられた。 それぞれの 1*2、&62 の役割や課題は、国や組織によって多種多様であるが、住民と患者中心のアプローチなどの重要な論点は共通であり、このことはストップ結核パートナーシップのスピリットを促進するのに最も重要と感じられた。

） 国の結核対策計画（173）の現場における政府との協力
 結核の疑い患者や有症状患者を医療施設への受診をの促進して結核の早期発見を支援する。
 患者の定期的な服薬を働きかける。
 地域住民の結核に対する知識や認識を向上させ、偏見、差別、迷信をなくし、病気に対して適切な89

行動がとれるようにする。
） 患者と家族に対しての社会的な支援 経済的困難に直面する患者やその家族に対して、全国民医療サービス（8+&）推進を通して患者を支援し、教育し、エンパワーする。
 患者支援の重要な要素として、患者に食物、交通手段、住居を供給する。
） アドボカシー 患者や弱者の声を代弁する。
 地域社会での結核への認識を向上させる。
 社会保障やサービスについて要求し、それによって地域社会の結核に対する意識を高める声を大きくするために、患者団体をつくる。
 弱者（貧困者、女性、子供、+,9 感染者、高齢者など）を支援するピアサポートグループ（相互支援グループ）をつくる。
 結核対策に係る調査、特にオペレーショナル・リサーチや住民活動を含む調査を提唱する。
 教育や農業、母子保健など結核とは異なる領域と連携する。
 結核領域以外の住民を巻き込み、草の根レベルのネットワークをつくるべく、健康問題関連の活動
家とボランティアの能力を高める。） 女性の役割と可能性 保健サービスの利用や結核の知識を含め、結核のケアにおいても両性の平等について強調されるべきである。
 住民活動における女性の可能性を十分に認識するべきである。

資金造成
多くのグループで予算は不十分であるが、いくつかのグループでは、独自の方法で資金造成をしている。個人（グループのメンバーやその他）や企業からの寄付に加え、例えば、クリスマスシールキャン
ペーン、カレンダ販売、募金箱（店頭で）、チャリティーイベントなどがあげられる。
 政府のプログラムを含め、グローバルファンド、:+2、国際結核肺疾患予防連合、ストップ結核パー
トナーシップ、また二国間援助（-$7$、86$,'、7%5($&+）や寄付財団などがその他の資金造成としてあげられる。
 資金不足の見地から離れるが、タバコやアルコール産業からの寄付は言うまでもなく、製薬企業（国によっては、健康関連ビジネスも）からの寄付についての懸念も存在している。
課 題 おそらく不十分なインセンティブや地域社会での認識不足、尊厳の認識不足によるボランティアの離任率の高さは共通である。
 ボランティアへのインセンティブは、保健サービスの無償化、ボランティアの活動報告の定例会議

90やトレーニング、他のグループとの意見交換の機会の提供、優秀な活躍に対する褒賞の授与や交通費の提供も含まれる。
 患者の機密保持やプライバシーについて重視する。
 政府と 1*2 間の共通認識が十分ではないことがある。いくつかの結核ケア提供者は、「結核ケアの国際標準」によるサービスを提供する事が困難である。
 1*2 によるオペレーショナル・リサーチ特に 8+& や社会的保護についての研究が重要とされるに関わらず、1*2 の研究実施能力が低い。
 8+& と患者中心のケアなど、結核対策の基本認識を共有するために、住民活動の成功事例を文書化することは重要と思われる。
フォーラムスローガン
活動の優先メッセージとして、参加者によって下記のスローガンが採択された。


女性はコミュニティの健康の創造者
謝 意
このフォーラムの開催を可能にし、成功に導いてくださった下記の個人や組織にお礼を申し上げます。
またフォーラムはこの会議に興味を持ってくださったオブザーバの方に深い感謝を示します。

参加者
[Organization] Cambodia: National Center for TB and Leprosy control (CENAT), Cambodia Anti-Tuberculosis
Association (CATA). Indonesia: Headquarthers of Forum Stop TB Partnership Indonesia and Stop TB Partnership
Cimahi City, Korea: Korean National Tuberculosis Association (KNTA), Stop TB Partnership Korea, Myanmar:
Myanmar Maternal Welfare Association (MMWA), National Tuberculosis Program, Kachin State, Nepal: JapanNepal Health & TB Research Association (JANTRA), Philippines: RIT/JATA, Philippines Inc. (RJPI), Taiwan: Taiwan
Anti-TB Association (TATA), National Chang-Hua Hospital MDR TB Department, Thailand: TB/HIV Research
Foundation (THRF), Chiang Rai Volunteer Ladies against TB[Member] Cambodia: Khloeung Phally, Monyrath Chry, Chharvy Ringsey Keo, Indonesia: Mariani Reksoprodjo,
Fitriani Manan, Korea: Seungjoon Chang, Kanghee Kim, Hong Jo Choi, Myanmar: Tha Zin Nwｅ㻘㻌Ei Ei Chaw, Nepal:
Ram Sharan Gopali, Jamuna Panthi, Philippines: Aurora G Querri, Leonardo G. Parungo Jr, Taiwan: Chih-Yun Lin,
Wei-Wen Chen, Thailand: Sarmwai Luangjina, Jintana Ngamvitayapong-Yanaiスタッフ
[Organization] Stop TB Partnership Japan, Japan Anti-Tuberculosis Association (JATA), Research Institute ofTuberculosis, JATA, Council of Japanese Women’s Anti-Tuberculosis Associations, Western Pacific Regional Officeof World Health Organization[Member] Ram Sharan Gopali, Makiko Goto, Yumi Ishikane, Nobukatsu Ishikawa, Shoji Kudo, Ayako Miyamoto,
Toru Mori, Nobuyuki Nishikiori, Jintana Ngamvitayapong-Yanai Kosuke Okada, Kintaro Shibuya, Noriko Shirasu,
Noriyo Shimoya, Keiji Tanaka, Tomoko Tsuji, Takeko Yamashita

91

92

JAPAN

Asian National Stop TB Partnership Forum 2016
Date： 14-15, March, 2016
１：1F HALL
Nations University,
AsianVenue
National
StopUnited
TB Partnership
Forum 2016
Venue ２：Hotel New Otani
Venue
３：ResearchInstitute
Date：
14-15, March,2016 of Tuberculosis (RIT)
Venue １：1F HALL United Nations University,
Venue ２：Hotel New Otani
Venue ３：Research Institute of Tuberculosis (RIT)

93

JAPAN

94

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討 論

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The Asian National Stop TB Partnership Forum 2016

Date:

November, 2016

Published by:

Stop TB Partnership Japan
Kekkaku-Yobokai, Misaki-sho 1-3-12,
Chiyoda-ku, Tokyo 101-0061 Japan
Tel 03-5282-3010 Fax 03-5980-8267
www.stoptb.jp

Funded by:

Japanese Council of Women’s Anti-TB Associations

アジア・ナショナル・ストップ結核パートナーシップフォーラム 2016

発行：

2016 年 11 月

発行者:

認定特定非営利活動法人 ストップ結核パートナーシップ日本〒101-0061 東京都千代田区三崎町 1-3-12 結核予防会内
Tel 03-5282-3010

Fax 03-5980-8267

www.stoptb.jp
協賛:

公益社団法人 全国結核予防婦人団体連絡協議会

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