The Joint HIV-TB External Review Mission 2023

Overview

TB programme  Timor-Leste, with an estimated incidence of 486 cases per 100 000 population in 2021, is the seventh highest TB burden country in the world in terms of incidence rates and the second highest in WHO South-East Asia Region.  The Honourable Prime Minister’s pledge to accelerate the progress towards END TB in TimorLeste in September 2021 to achieve 2030 SDG targets by 2025–26 has increased the awareness and importance of TB programme performance at all levels.  Significant progress has been made in implementing the activities envisaged in the “National Plan for Accelerated Actions for Ending TB: 2021–2025”.  Almost all national guidelines are aligned with international guidelines. This is perhaps due to the collaboration between the National TB Programme (NTP) and its technical partner (WHO country office).  TB services are well integrated and provided through the existing health system consisting of the national hospital, referral hospitals (RHs), community health centres (CHCs), and health posts (HPs).  No drug stockouts or shortages were observed in the field. All diagnosed TB patients are initiated on TB treatment, and more than 90% of the TB patients are successfully treated.  Several new interventions, such as intensified case finding—triaging and fast tracking—at high patient load health care facilities (National hospital, referral hospitals), mobile van, and community outreach activities (especially in hard-to-reach areas), are providing a high yield of TB patients.  The number of patients tested with the latest state-of-the-art diagnostics (Xpert MTB/Rif test) and screening tools (such as X-ray machines with artificial intelligence software) has doubled in the last 1–2 years.  Nearly 90% of TB patients are being tested for HIV, and all those with HIV infection are linked to ART services.  The NTP has completed the drug resistance survey, piloted vulnerability mapping, and is now conducting the most important TB prevalence survey.