National tuberculosis and leprosy control stategic plan 2021-2025

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Date
2021-01-01
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Government of Malawi
Abstract
Despite significant progress in TB Control since Malawi adopted the WHO recommended TB DOTS strategy at the beginning of the 1990s, TB remains a major public health concern in the country. Over and above its direct impact on morbidity and mortality, TB continues to impact negatively on Malawi’s economic development. It continues exerting significant socio-economic burden on individuals, families and communities across the country. The high HIV prevalence and the resulting high prevalence of TB/HIV co-infection have exacerbated the situation. In 2013, 56% of the notified cases of TB were co-infected with HIV. Just as is the case in other countries in the sub-region, drug resistant TB cases have emerged and Malawi is already recording an increasing number of laboratory confirmed Multidrug Resistant TB (MDR-TB) cases. Recognizing the enormity of TB epidemic, the Government of Malawi (GoM) declared TB an emergency in 2007 in order to raise awareness and advocate for more resources and control actions by all stakeholders. One of the initiatives embarked on as a result of that declaration is Universal Access to TB diagnosis, treatment and care which entailed a shift from centralized institutional DOTS services to more innovative ways of reaching out to all target population groups with quality assured diagnosis and care regardless of socio-economic status and geographical location. Under this concept, community members, civil society groups, community based organizations (CBOs), governmental and non-governmental organizations are all called upon to participate in the fight against TB. The high levels of TB/HIV co- infection calls for integration of TB and HIV services at all levels of care to ensure widespread implementation of interventions which reduce the burden of TB among People Living with HIV (PLHIV) and those which reduce the burden of HIV among notified TB cases. Even though Malawi is one of the countries with low prevalence of MDR-TB, there is a need to put in place measures which prevent the development of drug resistant strains especially through attaining high treatment success rates for both new and previously treated TB cases. In order to respond effectively and efficiently to the TB epidemic there is an urgent need to strengthen Malawi’s health system. Human resources for health (HRH), infrastructure, transport, communication and logistic support, monitoring and evaluation systems, procurement and supply chain systems also remain major challenges for the health sector in Malawi. More efforts are needed to strengthen these in order to improve universal access to essential quality TB and TB/HIV diagnosis and treatment services through the Government of Malawi recommended primary health care approach. The development of this National TB & Leprosy Control Strategic Plan is, therefore, an opportunity to consolidate the significant gains that Malawi has made in the fight against TB and Leprosy. The Plan seeks to further decentralise quality assured TB diagnosis and treatment services to peripheral facilities and community levels in the public and private sectors; to consolidate programmatic management of drug resistant TB (PMDT); and roll out further implementation of TB/HIV collaborative activities and interventions as part of both TB and HIV Control strategies. In this context, this 5-year plan provides an outline of what the Ministry of Health & Population (MoHP) and its stakeholders would like to see implemented during the period 2021- 2025 in order to reduce the burden of TB in Malawi. This plan is aligned with the Malawi Growth and Development Strategy (MGDS) and the Malawi Health Sector Strategic Plan (HSSP). At a global level, it has been aligned with the End TB Strategy. At regional level, the document seeks to help align Malawi’s efforts with regional and sub-regional efforts to address emerging cross border challenges that include migrant populations due to political, social and economic reasons through regional commitments and declarations. It is this plan which will consolidate Malawi’s efforts towards achieving the UN High Level Meeting Resolutions and set Malawi going towards attainment of End TB targets as part of the UN Sustainable Development Goals (SDGs) aspirations. To achieve the country’s health aspirations and people level results specified in this strategic plan, increased human and financial resources and close collaboration between government ministries, agencies, departments, non-governmental organizations (NGOs), civil society, development partners and the communities themselves will be critical. I am confident that t his strategic plan will adequately guide all stakeholders in designing programs for TB and Leprosy control in Malawi. I call upon all stakeholders and citizenry to join government in its efforts to end the combined scourge of TB and TB/HIV which has the potential of derailing socioeconomic development of the country.
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