USAID/Mexico Tuberculosis Program

LAC PHN SOTA, March 2001

Tuberculosis

0

50

100

150

200

PE

BO

HA

DR

HO NI

BR

EC

GT

ES

MX

US

A JA

Cases/100,000

PAHO Health in the Americas, 1998

% TB Cases in LAC Presence Countries

BR

PE

ECDR HO NI GTES

J A

MX

BO

HA

PAHO Health in the Americas, 1998

Infectious Diseases - Funding Compared to Need % LAC TB Cases compared to %2000-2001 TB funding

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%B

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%oftotal TBcases

% TBfunding

USAID/MexicoTuberculosis Strategy

SO: A sustainable and effective institutional capacity developed to diagnose, control and monitor tuberculosis in target areas

IR1 Improved national and local political and administrative commitment to a tuberculosis control program

IR2 Increased use of laboratory-based diagnosis to identify tuberculosis cases

IR3 Improved directly observed therapy meeting strict case definitions

IR4 Improved mechanisms for monitoring program activities

Staffing andOther Support

USAID/Mexico: 1 full time USPSC, 1/2 FSN administrative assistant

SSA: 1 Tech. Project Coordinator, 1 Admin. Project Coord., 6 supervisors

USAID/W: LAC and Global Bureau technical backup, future global projects

USAID/ES: Technical, administrative, and legal support

USAID/Mexico Tuberculosis Strategy: Partners

Official Counterparts: Secretaría de Salud and USAID

Mexico partners: CVE, Mexico National TB Prev. and Control Program (including IMSS, IMSS-Solidaridad, and ISSSTE), INDRE, State Secretarías de Salud, NGOs

US partners: TATB, CDC, NGOs, Gorgas Institute, State Health Departments

Other donors: PAHO, Comité Nacional de Lucha contra la Tuberculosis

DIEZ CONTRA LA TUBERCULOSIS

TEN AGAINST TB

Baja California, Sonora, Chihuahua, Coahuila, Nuevo León and Tamaulipas

California, Arizona, New Mexico, Texas

Common Objectives

GOM HealthPromotion

Labs Epid.Surveillance

DiagnosisandTreatment

TATB HealthPromotion

Labs Epid.Surveillance

CaseManage-ment

USAID Commitment/HealthPromotion

Labs Epid.Surveillance

DiagnosisandTreatment

Tuberculosis Strategic Objective Grant Agreement

Signed August 21, 2000 by Mexico’s Secretary of Health and the US Ambassador to Mexico

Stipulates planned contribution of US and Mexican Governments through 2004

Obligates first tranche of funding ($3.7 million) Outlines program objectives, activities,

performance indicators, and standard provisions

Priority Areas

Baja California, Sonora, Chihuahua, Coahuila, Nuevo León and Tamaulipas

Chiapas, Jalisco, Veracruz, Michoacán, Guerrero, Oaxaca and San Luis Potosí

Phase I Activities

1) Development of educational campaign

2) Promotion of interinstitutional collaboration

3) Strengthening laboratory network

4) Operations research: eval. of program operation; sensitization of personnel and public; detection, diagnosis and treatment; specimen handling; studies of cases, contacts and deaths; information systems.

5) Development of National Tuberculosis Management Information System and Evaluation of Border Epidemiological surveillance systems

6) Management and operation of Program at national level

7) Supervision and impact evaluation

1) Priority municipalities

2) Laboratories performing sputum smear microscopy

3) Patients with respiratory symptoms to be identified

4) Expected cases of pulmonary tuberculosis

5) Contacts to be examined

6) Sputum smears to be processed

165

304

311,880

15,594

62,376

1’029,204

Tuberculosis Program in the 13 Priority States

100

75

50

25

2000 2001 2002 2003 2004

Year

PromotionPromotionPromotionPromotion

TrainingTrainingTrainingTraining

SupervisionSupervisionSupervisionSupervision

ControlControl

Funding/Activities

SSA/USAID

States

InfrastructureInfrastructure

DiagnosisDiagnosis

%

EvaluationEvaluation

U.S.-Mexico Binational Tuberculosis Card

43% of TB cases in the US are among the foreign-born (7553/ 17,531); and among the foreign-born, 23% of the cases are among the Mexican-born (1753/7553)

The U.S. Border States lead the nation in cases and incidence of TB

The six Mexican border states have TB case rates much higher than the U.S. border states

U.S.-Mexico Binational Tuberculosis Card

Collaboration between Mexico and the United States:– Ten Against TB– TB Net– Cure TB– The Binational Juntos Project – Migrant Health Core Group– USAID TB Program