Quarterly Monitoring Report: Challenge TB - Core Bedaquiline Coordination Year 2, January-March 2016

The project's work plan was approved in November 2015, with a timeframe of October 2015 to September 2016. The reporting period for this quarterly monitoring report is January to March 2016. The project team consists of Fraser Wares as project coordinator, Susan van den Hof leading operational research and pharmacovigilance, Antonia Kwiecien leading procurement, supply chain management, and Agnes Gebhard providing regional and country-level overview and training. The team has been actively engaged in various activities to support the introduction of Bedaquiline. A "Challenge TB Bedaquiline (Bdq) core project workshop" was held in The Hague, The Netherlands, from March 31st to April 1st 2016. The workshop aimed to ensure a coordinated, efficient, and effective approach towards the rapid introduction of Bedaquiline in CTB project countries. The workshop summary report is attached as Annex 1. The team has also compiled an inventory of available training and supportive materials, which will be completed in Q3 of APA 2 (April – June 2016). Progress in countries since the project approval is notable. In Ukraine, all critical steps for the introduction of Bedaquiline have been completed, with expected enrollment of first patients on Bedaquiline-containing regimens in August 2016. In Tajikistan, optimized diagnostic algorithms and clinical protocols for the treatment of non-complicated MDR-TB cases and pre-XDR-TB and XDR-TB patients with new drugs and shorter regimens have been developed. Vietnam has started treatment of patients on Bedaquiline as from December 2015, with 80 patients expected to be on treatment by the end of September 2016. The team has also been supporting the programmatic introduction of Bedaquiline in Kazakhstan. Following discussions in Cape Town, South Africa in December 2015, further in-country discussions have been held between the regional USAID mission, the regional KNCV office, and the NTP in relation to possible CTB core project support to the introduction of Bedaquiline in Kazakhstan. A workplan for the period April to September 2016 has been developed to provide technical assistance to both the national and regional levels of NTP in three main activities: programmatic preparations for implementation of new drugs, build programmatic capacity for initial scale-up of Bedaquiline treatment, and systematic M&E for implementation of Bedaquiline. Technical and administrative challenges have been identified in the introduction of Bedaquiline and other new drugs. A thorough review of each country's APA2 workplan with the lead technical partners is required, with reprogramming of funds to Q3-4 activities where appropriate. Discussions which feed into the APA3 planning cycle are also required to obtain CTB country buy-in, prioritization of this work area in discussions with NTP, and inclusion of essential steps into the APA3 work plans. To facilitate this, the core project team has reached out to all CTB coalition partners to organize a series of discussions with the respective lead technical partners and country teams in the coming weeks.