TB CARE I - Indonesia Year 3 Quarterly Report January-March 2013

The program is led by KNCV and involves collaboration with various partners, including ATS, FHI, JATA, MSH, The Union, and WHO. The program focuses on several technical areas, including universal and early access, laboratories, infection control, PMDT, TB/HIV, health systems strengthening, M&E, OR, and surveillance, and drug supply and management. The program has made significant progress in various areas. GeneXpert implementation has been speeding up, with seven new machines installed in different sites, bringing the total to 16 operational machines. The new sites include Labuang Baji hospital in Makassar, NHCR laboratory in Makassar, Sanglah hospital in Bali, Adam Malik hospital in Medan, Jayapura laboratory, Pengayoman hospital, and Kariadi hospital in Semarang. In this quarter, 1,039 cartridges have been used for screening of 1,004 suspects using Xpert, among which 714 were MDR-TB suspects and 290 were HIV patients suspects. A total of 218 Rif-resistant cases were detected, with 201 from MDR-TB suspects and 17 from HIV-TB suspects. TB CARE I has also assisted the National Health Research Institute (Litbangkes) in solving urgent bottlenecks potentially affecting the implementation of the National Prevalence Survey (NPS). This involved developing an NPS laboratory plan, training of laboratory technicians, and emergency procurement of equipment and consumables. The program has also contributed to the successful preparation and implementation of the Joint External Monitoring Mission (JEMM) through various forms of support, including providing interpreters, transportation, and technical assistance on PMDT, TB financing, logistics, and PPM. In addition, TB CARE I has supported the development and submission of the request for renewal of the Global Fund Single Stream Funding (GF SSF). The program has also made good progress in the preparation of regulation for private sector providers, with the National Guidelines for Medical Practice Standards for TB Care (PNPK) now in the finalizing stage. These guidelines are essential to ensure standardization of quality TB care delivered by private providers. The program has also facilitated the development and finalization of an assessment instrument that will help surveyors to evaluate the status of DOTS implementation in hospitals based on the accreditation standards for TB control. Furthermore, TB CARE I has facilitated the achievement of PMDT in prisons, with the Guideline for Management of MDR in the Prison Setting finalized and disseminated to 33 prisons from 6 provinces. The program has also established PPM teams in 8 districts in 2 provinces, with 2 teams established with local funding and are fully self-supportive. Overall, TB CARE I - Indonesia has made significant progress in various areas, including GeneXpert implementation, support to the National Prevalence Survey, TB financing, JEMM, GF grant renewal proposal writing, regulation of private practitioners, accreditation standards for TB control, achievement of PMDT in prisons, and increased local commitment for PPM implementation.