The 2017 Annual National Tuberculosis (TB), Leprosy and Buruli Ulcer Control Programme (NTBLCP) review meeting with the central unit, State Tuberculosis, Leprosy and Buruli Ulcer Control Officers and representatives of donor Agencies and partners was held at Giginya Hotel, Sokoto, Sokoto State from 28th to 30th November, 2017. It was organised by the Federal Ministry of Health (FMOH) with support from Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and other Partners.
The meeting was attended by the National Coordinator of the NTBLCP, and 21 State Tuberculosis and Leprosy (TBL) Control Officers (STBLCOs). Other participants include the representatives of State TBL Control Officers of, Enugu, Borno, Plateau, Yobe, Nasarawa, Kogi, Rivers, Ekiti, Imo and Taraba states, WHO, ILEP (NLR, GLRA and TLMN), Institute of Human Virology, Nigeria (IHVN), Association of Reproductive and Family Health (ARFH), KNCV/Challenge TB Project, National TB and Leprosy Training Centre (NTBLTC), Zaria, FHI360, Civil Society for the Eradication of TB in Nigeria (TB Network), Catholic relief Services (CRS), Management Sciences for Health (MSH) and APIN Public Health Initiative. Other dignitaries present at the meeting were the former Minister of Health, Dr Khaliru Alhassan.
The Sokoto State Governor was ably represented by the Honorable Commissioner for Health, Dr. Balarabe Kakale, who gave the welcome address on behalf of State Government and declared the meeting open.
The overall goal of the meeting was to review the performance of the NTBLCP and its activities at all levels of implementation for the year 2017, share best practices and chart the way forward for 2018.
1. Domestic funding for TB is very low (9% of the TB funding in 2016).
2. The removal of some key activities in the new 18-month extension period like capacity building, reduction in frequency of supervisions and meetings from quarterly to Bi-annually may have negative implication on programme performance.
3. Supervision register has been developed and currently being printed. This will serve as evidence for supervision by relevant stakeholders.
4. Solar panel has been included in Gene-Xpert Machine installation package by NTBLCP yet to rolled out.
5. Launching of Wellness on Wheel project by the Hon. Minister of Health aimed at accelerating TB case finding.
6. Burnt Xpert site in General Hospital Wudil, Kano is yet to be re-activated since October 2016.
7. Delay in reporting problems by GeneXpert sites for immediate response by relevant authorities/stakeholders.
8. Provision of seed stock for Rifabutin at the Zonal store was not strictly followed as agreed in the last annual review meeting.
9. Integration of TB services into other public health services like OVC and Nutrition services was noticed to have shown increase in childhood TB case notification in Benue and Jigawa states.
10. The country has adopted the new paediatric anti-TB drug formulation for use in the National TBLCP at all levels.
11. There are declining skills on Leprosy diagnosis and management amongst Programme Officers and health workers in the country.
12. Low awareness on Leprosy and BU in communities.
13. Suboptimal performance of the Third-Party Logistics (3PL) system in some states (Akwa-ibom, Benue, Plateau, Adamawa, Nasarawa, Niger, Delta, Bayelsa and Rivers).
14. Inverters at GeneXpert sites break down more frequently due to damage from thunder storm as most health facilities don’t have lightening conductors.
15. Sub-optimal utilisation of GeneXpert Machines across the country.
16. There is funding gap between projected number of DR TB patients (8,733) and those to be supported (2,500) by GF during the extension period (1st January 2018 to 30th June 2019).
17. Nine of the 27 states trained on DR TB Shorter regimen are yet to commence implementation.
1. NTBLCP and relevant stakeholders (WHO, ARFH, IHVN, USAID, KNCV, STOP-TB PARTNERSHIP, TB Network, Health Alive Foundation etc.) to bring the issue of low domestic TB funding to the attention of the HMH for urgent action.
2. Government at all levels and stakeholders should look for opportunity to fill the existing gap and maximally utilise the available resources.
3. NTBLCP should ensure printing and distribution of supervision register to all DOTS facilities by first quarter of 2018.
4. NTBLCP to ensure that all new GeneXpert sites should have the minimum package which includes solar panels. Resources should be sourced to provide solar panels to old GeneXpert sites with power challenges.
5. Stakeholders are encouraged to adopt this strategy and ensure scale up to other States in the Country so as to enhance TB case detection
6. Kano State Government and partners are requested to ensure replacement of the burnt GeneXpert accessories.
7. NTBLCP Laboratory Unit to initiate urgent action in instituting monthly update on the status of GeneXpert Machines functionality at all levels. There should also be prompt escalation of faults from GeneXpert sites as well as sending necessary documents (IQR, run files and system error log) to KNCV Cepheid Nigeria and other stakeholders by service providers for timely fixing of faults.
8. Reversal of the current system of stocking of Rifabutin from IPs stores to Zonal Stores.
9. NTBLCP, STBLCPs and all relevant partners in TB Control in the Country to ensure that TB services are integrated into other Public Health services like OVCs, Nutrition, Malaria, Immunization etc.
10. NTBLCP and STBLCPs to ensure the dissemination and implementation of the new Paediatric Anti-TB drug formulation in all facilities offering TB services in the Country.
11. NTBLCP in conjunction with ILEP Partners and WHO to organise capacity building for State, LGAs and facility staff on leprosy diagnosis and management at all levels as soon as possible.
12. NTBLCP in conjunction with ILEP Partners and WHO to develop and distribute communication materials on Leprosy and BU to States and Media Houses before the end of second quarter 2018.
13. NTBLCP and other relevant Stakeholders to strengthen the performance of 3PL in the affected states.
14. NTBLCP, STBLCPs and partners should conduct advocacy visits to hospital management for installation of lightening conductors in affected GeneXpert sites.
15. NTBLCP, STBLCP and partners should ensure maximisation of GeneXpert machines through demand creation and maintaining functionality of the machines.
16. The FGN and partners to fill-up the funding gap of 6,233 DRTB patients not covered by the 18 months GF extension period funding plan
17. States trained on shorter regimen should ensure that DRTB patients commence implementation before the end of 2017.
1. Mr. Alobu Isaac - Chairman
2. Dr. Atiku Abubakar - Secretary
3. Dr. Nkiru Nwokoye - Member
4. Dr. Nura Musa Shuaib - Member