19 October-1 December 2020
The 51st Union World Conference On Lung Health
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Channel 3
SP-31-Challenges and issues in ensuring continuum of care for migrants crossing borders with TB.
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SP-31-Challenges and issues in ensuring continuum of care for migrants crossing borders with TB.
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While it has been recognised that migrants are one of the key populations who are at greater risk of TB infection and disease, less attention has been paid to the risk of interrupting treatment among those who cross borders while still on TB treatment and the need to ensure continuum of care from one country to another. This symposium will introduce programmes from the US and Japan, as well as Southern African countries, that look to ensure migrants continue and complete their treatment after travelling to another country. It will look at the perspectives of both sending and receiving countries and discuss challenges and issues.

12:30 - 12:35: Introduction

12:35 - 12:47: CureTB-Transnational Continuity of CareIn the US, 2-4% of people diagnosed with active tuberculosis (TB), transfer out prior to treatment completion. The US Centers for Disease Control and Prevention’s Division of Global Migration and Quarantine provides linkage to destination countries and follow-up for TB patients that transfer out through the CureTB programme. This presentation will describe the work of CureTB, referral and outcome data, as well as elements that enhance success for mobile patients.
Kathleen Moser

12:47 - 12:59: Bridge TB Care: the first step in bridging care and support for foreign-born persons with TB who are returning to countries of originWhile in Japan, approximately 1 in 10 of its foreign-born tuberculosis (TB) patients are transferred out of the country prior to completing their treatment, there had been no coordinated support provided to such patients, to ensure continuum of care. Following a national survey on the state of 'transfer-out' of foreign-born TB patients, in May 2020, a project – Bridge TB Care - was launched by the Research Institute of Tuberculosis, to coordinate smooth transfer of TB treatment from Japan to countries patients are travelling to, and follow-up until the completion of TB treatment. This presentation will discuss the main findings of the national survey and present some of the early experiences of the Bridge TB Care.
Lisa Kawatsu

12:59 - 13:11: Building regional consensus on minimum standards for continuum of TB care in SADC regionCross-border migration is a challenge to tuberculosis (TB) control in Southern Africa Development Community (SADC), with an estimated five million documented and 20 million undocumented, migrants and 500,000 mine workers with high burden of TB, frequently migrating across countries. SADC member states endorsed political declarations and frameworks to harmonise TB management seven years ago, but there was insufficient implementation. A recent assessment revealed that patients crossed borders without formal referrals, minimal to no documentation, no feedbacks or re-initiation of multidrug-resistant TB treatment with country-specific regimens. The SATBHSS project facilitated consensus and development of regional standards for TB continuum of care among eight SADC countries including intercountry communication and monitoring and evaluation; cross-border referrals of drug-susceptible and drug-resistant TB; continuum of treatment with same regimens; integration of TB in existing cross-border surveillance platforms; and integration of  paper and electronic cross-border referral systems. This presentation will describe the process of development, the standards, training and pilot.
Ivandra Chirrime

13:11 - 13:47: Q&A session

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SS3-UN HLM TB goals – are we on track?
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SS3-UN HLM TB goals – are we on track?
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In 2018, heads of state committed to global TB targets in the United Nations High-Level Meeting’s Political Declaration on TB. Targets included: to treat 40 million people with TB, 3.5 million children with TB, 1.5 million people with drug-resistant TB and for at least 30 million to be put on TB preventive treatment – all to be achieved by 2022. At the half way mark to this deadline, it is prudent to assess our progress and evaluate the challenges to success.

12:30 - 12:33: Session introduction


12:33 - 12:43: Taking forward the commitments of the first United Nations high-level meeting on TB

Tereza Kasaeva

12:43 - 12:53: Successes and challenges driving country-level political commitment

Angelina 'Helen' Tan

12:53 - 13:03: How do we assess and demand accountability?

Tushar Nair

13:03 - 13:13: Grassroots voice

Blessina Kumar

13:13 - 13:28: Live moderated panel discussion


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SP-30-Towards a TB-free childhood: best practices to find, cure and prevent TB in children in Africa
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SP-30-Towards a TB-free childhood: best practices to find, cure and prevent TB in children in Africa
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An estimated 1.1 million children under the age of 15 become sick with tuberculosis (TB) each year of which 205,000 will die. However, children with TB rarely die once they receive standard treatment for TB disease. Child and adolescent TB case finding, treatment and the provision of TB preventive treatment are key strategies in ending TB. In this session, stakeholders of the Sub-Saharan Africa Regional Child and Adolescent TB Centre of Excellence will describe successful interventions for TB prevention and case finding among children/adolescents in high burden countries and explore best practices for clinical and laboratory-based TB diagnosis.  

12:30 - 12:35: Introduction

12:35 - 12:45: Finding missing paediatric TB cases through facility-based intensified case findings: lessons learned from CaP TB project in MalawiDiagnosis of paediatric tuberculosis (TB) remains challenging and results in a significant case detection gap. The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) partnered with the national TB control programme in Malawi to implement the Unitaid-funded CaP TB project, aimed at improving childhood TB diagnosis and prevention. The project rolled out a comprehensive case finding intervention in 16 purposively selected sites in six districts. Sites received training on screening and diagnosis of paediatric TB, support for paediatric-specific symptom screening of children in various entry points, increased access to Xpert MTB/RIF testing through strengthened sample collection, and transport and support for access to chest X-ray. Improvement of paediatric TB case finding has been assessed using a pre-post intervention design. Prospective data have been collected starting from first quarter 2019. The presentation will review early evidence generated by the project as well as key lessons learned that can inform successful implementation of childhood TB interventions.
Bhamu Yusuf

12:45 - 12:55: Household outreach and patient-centred engagement to increase child and adolescent TB and HIV case finding: HOPe project in south western UgandaIn a Ugandan district with the lowest tuberculosis (TB) case notification rate, we conducted household-based TB contact tracing. We evaluated TB and HIV case finding, and linkage. Community health workers and HIV testing volunteers screened household contacts for TB and HIV. Presumptive TB cases provided diagnostic specimens or were referred for specimen collection. Contacts <5yrs and people living with HIV without TB were offered isoniazid preventive therapy (IPT). Out of 1592 household members, 197 had a positive TB screen and 16 new TB cases (8.1%) were identified (4, 25% were children <15yrs). Ten (2%, 10/499) new HIV patients were identified (5, 50% were children <15yrs) and linked to antiretroviral treatment. Of the 429 contacts with negative TB screen, 375 were eligible for IPT, 279 initiated IPT (85.8%) and 195 (69.9%) completed IPT. Household-based contact tracing using low-cadre health workers is feasible and contributes to finding TB and HIV cases, especially among children who may otherwise be missed.
Pauline Amuge

12:55 - 13:05: Catalysing the introduction of child-friendly formulations of medicines for drug-resistant TB: lessons learned for new formulations and regimens in the pipelineThe presentation will focus on the key steps STBP/GDF took, in collaboration with implementing and technical partners, and lessons learned to catalyse adoption of child-friendly formulations of drug-resistant TB medicines by programmes. These key steps include identifying and consolidating demand from early adopter programmes, using the consolidated demand to negotiate price and supply terms for these formulations, funding the initial procurement for early adopter programmes and using a pooled procurement approach to meet minimum order quantities and batch sizes, and monitoring implementation and promoting sustainability. Globally, STBP/GDF provided more than 1000 treatment courses of child-friendly formulations, nearly double the estimated number of children less than 5 years old treated annually. Lessons learned on the benefits of an integrated approach to new tool introduction, from in-country demand generation through upstream supply security, and how these can apply to new child-friendly formulations and regimens in the pipeline will be shared.
Brenda Waning

13:05 - 13:15: Development of a DHIS-2 smart application for data collection and decision making for use by community health workers doing household-based TB contact tracing in UgandaContact tracing is an important way to find new cases of tuberculosis (TB) disease as well as identify household members who might qualify for TB preventive treatment (TPT). This is especially important for finding at-risk children in high burden countries (such as Uganda), where a significant number are otherwise 'missed'. Despite the importance of contact tracing, the reality is that contact tracing is challenging to implement and sustain due to the time, complexity and human resources required. This presentation will describe the development of a DHIS2-based smart application ('electronic TB contact tracing tool') to help address these barriers to contact tracing in Uganda. This application was developed to be a tool for community health workers to use while carrying out household-based contact tracing in resource-limited settings. We will describe the development process for this application, describe how it was used and offer some early end-user results and feedback.
Simon Robert Kununka

13:15 - 13:25: Improving paediatric and adolescent TB case detection in Mozambique through an Xpert MTB/RIF®- and spatial parameter-based stratified risk strategy (X-patialTB)The X-patial tuberculosis (TB) project aimed to increase the number of TB diagnoses in Manhiça district, a high TB-HIV burden area in Southern Mozambique. This study was funded by TB-REACH and embedded in routine TB surveillance of the National TB Control Programme in Mozambique. The main objective was to determine the impact of an active case finding strategy, based on Xpert MTB/RIF Ultra semi quantitative results (as a proxy of index case infectiousness) and spatial parameters, on TB case notifications in the district of Manhiça (intervention area) and compare it to a control area in the district of Magude. This descriptive cross-sectional study took place from March 2018 to February 2019 and the target population size was 16748 TB contacts. In this symposium, we will present the impact on the paediatric population, in whom a specific diagnostic algorithm was implemented to address the inherent difficulties of paediatric TB diagnosis.
Belén Saavedra

13:25 - 13:50: Q&A session

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SP-33-Role and contribution of algorithm and score for diagnosis of paediatric TB
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SP-33-Role and contribution of algorithm and score for diagnosis of paediatric TB
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While all efforts should be made to confirm diagnosis of tuberculosis (TB) in children, which includes the use of child friendly specimen collection and access to the most sensitive molecular testing methods, the decision to start a TB treatment will often rely on a high clinical presumption guided by several parameters without microbiological confirmation. Existing diagnostic algorithms have not been systematically properly evaluated, the main challenge being the absence of a robust TB reference standard in children. This session will review the recent evidence and future opportunities for more efficient diagnostic algorithm or score to guide the TB treatment decision in children.

12:30 - 12:35: Introduction

12:35 - 12:45: Overview of challenges in diagnosing TB in children and shortcomings of existing diagnostic algorithms and scoresTuberculosis (TB) is believed to be a 'hidden epidemic' in children, with approximately 65% of cases missed each year worldwide. Kenya TB prevalence survey (participants>15yrs) revealed 75% of TB cases had presented to health facilities with suggestive symptoms but were never diagnosed. The proportion of younger children undiagnosed in Kenya is presently unknown, but is presumably high. We explored TB diagnostic practices, among paediatric admissions, using a conceptualised care cascade based on Kenyan TB guidelines and found more than half of all admissions met the initial criteria of two or more suggestive signs of TB, but less than 3% got a TB differential diagnosis, and few had TB diagnostic tests done. We need a better understanding of which children may have TB and how they present, with clearer guidelines to help clinicians better select which patients to investigate, how to interpret test results and when to make a clinical diagnosis.
Jacquie Oliwa

12:45 - 12:55: New TB diagnostic algorithm/score for vulnerable children: children with HIV infection and children with severe acute malnutritionNumerous scoring systems have been developed to help standardise tuberculosis (TB) diagnosis in children but their heterogeneity, lack of validation and poor performance in HIV-infected children was a major limitation to their use in routine practice. PAANTHER was the first study developing a diagnostic score exclusively in HIV-infected children, using methods recommended for diagnostic prediction models. The score, based on clinical and chest-radiograph features, Xpert MTB/RIF results, and abdominal ultrasonography, has an overall sensitivity of 89%, and a specificity of 61%, and could enable standardised treatment initiation in most HIV-infected children with TB, used within a step-by-step algorithm. The PAANTHER TB treatment decision algorithm is currently being implemented and tested in an external validation study, the TB-Speed HIV study. The ongoing TB-Speed SAM study is also aiming to develop a similar score in hospitalised children with severe acute malnutrition, another vulnerable population at high risk of underdiagnosis.
Olivier Marcy

12:55 - 13:05: Performance of new screening and diagnostic tests in potential paediatric TB diagnostic algorithms: interim results from the RaPaed studyThe RaPaed tuberculosis (TB) study is evaluating a number of new, child–friendly candidate diagnostic tests, funded by the European and Developing Countries Clinical Trials Partnership. Samples used include (fingerprick) blood, urine and stool. The study completed 50% of recruitment (400 children) in February 2020, and interim analysis results will be presented. Using more than one new test, an algorithm of screening and confirmatory new test may be possible, with a low-cost and accessible screening test, and a confirmatory test that may be more complex.
Norbert Heinrich

13:05 - 13:15: Contribution of chest X-ray in the paediatric diagnostic algorithm?Chest X-rays (CXRs) are commonly used in the evaluation of children with suspected tuberculosis (TB) and yet, even after decades of use, it is unclear which children should be investigated with CXR and, if CXR is used, where it should be placed in the diagnostic algorithm. In many high TB-burden settings, access to CXR is challenging, the quality of the images is poor, interpretation is difficult and there is an associated cost for families. In this talk, there will be discussion of which children should be evaluated with CXR as well as the new developments that could make it easier to use CXR in high burden and resource-limited settings for the diagnosis of TB in children.
James Seddon

13:15 - 13:25: Methodological challenges and alternative in the evaluation of tuberculosis diagnostic algorithms in children
Luis Cuevas

13:25 - 13:50: Q&A session

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OA-26-Using digital technology for TB elimination
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OA-26-Using digital technology for TB elimination
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12:30 - 12:35: Introduction


12:35 - 12:43: OA-26-661-23-The use of geographic information systems technology and self-reported data to characterise congregate settings with high potential risk for TB transmission in an urban African area The use of geographic information systems technology, coupled with data provided by tuberculosis (TB) cases, can inform local public health interventions which target congregate settings with a high potential risk for TB transmission. In a retrospective cohort study conducted in an urban area in Uganda, we characterised and mapped these high-risk indoor congregate settings.

Maria Eugenia Castellanos Reynosa

12:43 - 12:51: OA-26-662-23-Bundling innovations for public-private mix: experience of artificial intelligence-augmented chest X-Ray screening and TrueLab for diagnosis To increase tuberculosis (TB) case detection in Nagpur slums, a public- private mix intervention was implemented with a novel Qure.ai software installed in private sector chest X-ray labs. Presumptive TB patients with abnormal chest X-ray results were confirmed microbiologically using TrueLab tests in a public sector hospital and linked for public sector treatment.

Shibu Vijayan

12:51 - 12:59: OA-26-663-23-Reducing turnaround time by transitioning from paper-based to digital signature certificate-based approval of direct benefit transfers under National Tuberculosis Elimination Programme, India In order to reduce catastrophic expenditure for various schemes under the National Tuberculosis Elimination Programme, end-to-end digital processing of benefits to various beneficiaries was assessed for feasibility, using Nikshay, the national tuberculosis (TB) patient management system. This demonstrated near real-time communication of process status to all stakeholders, resulting in increased transparency, accountability and process efficiency.

Manu Easow Mathew

12:59 - 13:07: OA-26-664-23-Improving TB patients treatment adherence via electronic monitors and an app vs usual care in Tibet: a pragmatic randomised controlled trial We report the interim analysis of the randomised controlled trial in Tibet, China, that is using electronic monitoring boxes to improve patient adherence to anti-tuberculosis medications. We find e-applications becoming better accepted by healthcare workers and patients during the COVID-19 pandemic period.

Xiaolin Wei

13:07 - 13:15: OA-26-665-23-Preliminary results of a randomised trial comparing traditional in-person directly observed therapy and video-based observed therapy for monitoring TB treatment We conducted a randomised, two-period cross-over trial in New York City tuberculosis (TB) clinics to determine if video-based observed therapy (VOT) is non-inferior to in-person, directly observed therapy (DOT) for assuring adherence to TB treatment. The non-inferiority margin was 10%. We report primary results using intention-to-treat, per protocol, and empiric as-treated approaches.  

Joseph Burzynski

13:15 - 13:23: OA-26-666-23-Assessing adverse events among patients using in-person and electronic directly observed therapy In a randomised cross-over trial comparing in-person directly observed therapy (DOT) with electronic DOT for tuberculosis treatment in New York City, we analysed the reporting and severity of adverse events and the time taken to access care for each DOT method.

Marco M. Salerno

13:23 - 13:50: Q&A


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OA-27-The social impact of TB in Europe
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OA-27-The social impact of TB in Europe
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12:30 - 12:35: Introduction


12:35 - 12:43: OA-27-667-23-Social risk factors for TB in England: a national point prevalence study 2019 A national point prevalence study in England identified that 25% of the study population had a wide range of social problems relevant to their tuberculosis diagnosis, higher than the 15% who reported to have problems with alcohol and drug misuse, homelessness and imprisonment.

Anjana Roy

12:43 - 12:51: OA-27-668-23-Country-specific approaches and effectiveness of latent TB screening targeting migrants to Europe Migrants in Europe are at an increased risk of active tuberculosis (TB) through reactivation of latent TB infection (LTBI). We did a systematic review and meta-analysis, as well as a survey of TB experts, in 32 European Union/European Economic Area countries and Switzerland, to explore current LTBI screening approaches among recently arrived migrants and the treatment outcomes.

Ioana Margineanu

12:51 - 12:59: OA-27-669-23-High TB and latent TB infection prevalence among minor Eritrean asylum seekers in the Netherlands: importance of travel history The tuberculosis (TB) prevalence rate among unaccompanied minor asylum seekers (UMAs) from Eritrea, who were travelling via Lybia to the Netherlands in 2018, was huge (8,526 per 100,000). In this presentation we show the results of our efforts to test the UMAs without TB for latent TB infection.

Bert A. Wolters

12:59 - 13:07: OA-27-670-23-Investigation of TB underreporting in the federal states of Germany Tuberculosis (TB) under-reporting is a major impediment for TB control efforts. We examined under-reporting of TB from 2009-2018 at the subnational level in Germany. We identified differences in under-reporting between federal states and a variation within states over time. These results will allow for targeted improvements in TB reporting.

Neil J, Saad

13:07 - 13:15: OA-27-671-23-Tuberculosis Source Investigation in the Netherlands – is it Effective? WHO recommends tuberculosis (TB) source investigation (SI) for all children identified with TB. SI aims to detect unidentified source patients or co-infected TB patients and prevent further transmission. As there is limited published evidence on the effectiveness of SI, we present the TB yield of SI in the Netherlands.

Ineke Spruijt

13:15 - 13:23: OA-27-672-23-Evaluating TB transmission in a penitentiary system using customised MIRU-VNTR typing Our study focuses on customising reduced loci set of MIRU-VNTR (mycobacterial interspersed repetitive units–variable tandem repeats) typing for the Georgian population and gives an insight on transmission predictors of tuberculosis (TB) in the penitentiary system, representing as one of the main sources of drug-resistant TB in Georgia.

Nino Maghradze

13:23 - 13:50: Q&A


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P3-Striving for Universal Health Coverage
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P3-Striving for Universal Health Coverage
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Universal health coverage (UHC) is built on the principles that all people have access to the health services they need, without financial hardship. This includes the availability of and access to a full range of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.  Currently, at least half of the people in the world do not receive the health services they need. About 100 million people are pushed into extreme poverty each year because of out-of-pocket spending on health. This must change.
To move toward the goal of Universal Health Coverage it is necessary to develop resilient, responsive and inclusive health systems based on strong, people-centred primary health care, informed by the best available evidence and civil society and vulnerable communities at the heart of the response.
As the largest health profession in the global health workforce, nurses are intrinsically linked and well placed to play a key role in achieving Universal Health Coverage and the Sustainable Development Goals. Working across the life course and in all settings nurses are often the first and only point of care in their communities. They work to uphold human rights, fight to reduce inequalities and empower people and communities.  Civil Society similarly has a key role to play in achieving the goal of Universal Health Coverage: to ensure that the community’s needs in relation to access to, and the delivery of health services are met.  Community voices need to be amplified as they have a critical leadership role in decision making and accountability for UHC.
(UHC- "Empower individuals, families, communities, local providers and civil society organisations to be at the centre of UHC, especially by strengthening and enhancing community capacity to get involved in decision-making and accountability processes")

14:00 - 14:03: Session introduction


14:03 - 14:18: PL3A-The multifaceted role of nurses in universal health coverage

Elizabeth Iro

14:18 - 14:33: PL3B-Access to care: how do we tackle the gaps?

Erika Mohr-Holland

14:33 - 14:43: PL3C-A personal tale

Prachi Kathuria

14:43 - 14:53: PL3D-Moderated panel discussion


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SP-34-Human rights and tobacco: progress and next steps for protecting populations from tobacco industry interference in child health
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SP-34-Human rights and tobacco: progress and next steps for protecting populations from tobacco industry interference in child health
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This session will focus on how stakeholders in health and human rights can use a human rights based approach to protect children’s rights and accelerate the implementation of tobacco control measures at national level. We will provide practical examples of how to use human rights mechanisms and human rights treaties as well as coordinated campaigns around national reporting obligations to human rights treaties.
 

15:00 - 15:05: Introduction

15:05 - 15:17: Human rights-based approach as the pathway for protecting populations from tobacco industry: global progress and next stepsA human rights approach to ending the tobacco epidemic is unique. It frames the freedom from smoking addiction, and the health harms from tobacco use, as a human right and requires governments to advance human development by implementing measures that decrease use. The Framework Convention on Tobacco Control (FCTC) has brought significant progress in advancing health, but lacks enforcement mechanisms. Using human rights obligations forces the hands of governments, empowers tobacco control advocates, brings new allies and suggests innovative policy solutions. This presentation will discuss both top-down and bottom-up approaches and illustrates the progress that is being made by advocates around the world. Bottom-up approach involves human rights mechanisms to advance tobacco control by engaging in the reporting processes associated with national human rights treaty obligations. The global top-down approach integrates tobacco control objectives among global human rights bodies as well as collaboration among health and human rights mechanisms.
Laurent Huber

15:17 - 15:29: Human rights reporting and campaigning on tobacco use and imported tobacco in GermanyGermany has not implemented key tobacco control policies and politicians often portray tobacco as an individual lifestyle choice rather than an issue that needs government regulation. By framing tobacco control as a human rights and children‘s rights issue and by using human rights reporting mechanisms, civil society puts pressure on the German government to implement regulatory measures. In 2018, Unfairtobacco started to build the German Network for Children‘s Rights and Tobacco Control, bringing actors from different backgrounds together that had no links to each other before: organisations in public health, human/children‘s rights and development. Because human rights treaties have enforcement mechanisms that are lacking in the FCTC, this angle advances tobacco control advocacy in Germany. With this presentation, we aim to share our experience and, thereby, build the capacity of colleagues on how to use human rights arguments and reporting processes to advance tobacco control in their countries.

Laura Graen

15:29 - 15:41: Reclaiming child rights to health by preventing the tobacco industry from using disruptive tactics to deny rights to be tobacco-freeThe denial of children’s rights is at the heart of the tobacco industry’s interference in health policies. Five of the largest tobacco companies control 80% of the global market, and mergers and acquisitions have solidified interference on an industrial scale. Driven by shareholder demand for profits, the industry needs children to replace the sick, the dying and those that have quit. With no apparent intention of ending their marketing of addictive, lethal products, which kill 8 million people a year, the industry is aggressively releasing new products and using front groups, corporate social responsibility and philanthropy to disrupt tobacco control. While the interference tactics of Big Tobacco are well documented, their misleading concerns about children (while simultaneously denying their rights) demands a more strategic response, with integrated use of treaties and frameworks to protect children.
Anne Jones

15:41 - 15:53: Child labour in tobacco: a violation of human rights and national law in BangladeshThe exploitation of children as labour in tobacco manufacturing is a major problem as both a violation of human rights and the national law in Bangladesh. Avenues to counter child labour exist and will be reviewed along with challenges and opportunities to do more to protect children from tobacco and tobacco industry interference. 
Syed Mahbubul Alam

15:53 - 16:20: Q&A session

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TBS3A-What is new in drug-resistance detection: plenary session
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TBS3A-What is new in drug-resistance detection: plenary session
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Multiple active anti-mycobaterial drugs are required to cure tuberculosis. Monotherapy or treatment with insufficient active drugs accelerates the development of mycobacterial resistance resulting in treatment failures and, ultimately, undermining elimination strategies. For this reason, understanding the detailed mechanisms of resistance, as well as interactions between the host and different drugs, is important as it allows in vivo activity to be predicted. This session aims to discuss recent findings with respect to our understanding of anti-mycobacterial drug resistance and the prediction of susceptibility, notably based on genome sequence data.

15:00 - 15:03: Introductory note


15:03 - 15:23: Sequencing to support DR TB treatment decisions: a new landscape of options

Timothy Rodwell

15:23 - 15:43: From MoR to MoA to new drugs

Thomas Dick

15:43 - 16:03: The role of M. tuberculosis within-host heterogeneity. Can it inform TB patient care?

Maha Farhat

16:03 - 16:22: Live Q&A


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OA-29-Who pays the cheque? The economic burden of TB
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OA-29-Who pays the cheque? The economic burden of TB
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15:00 - 15:05: Introduction


15:05 - 15:13: OA-29-680-23-Assessing the economic impact of TB mortality in 165 countries: what it will cost if we don’t achieve the End TB targets Tuberculosis (TB) elimination leads to colossal health and development returns. However, evidence on the economics of ending TB remains disparate. We estimate the economic dividend of achieving the End TB mortality target by 2030 and the cost of inaction - the welfare penalty - of not meeting the target until 2045.

Sachin Silva

15:13 - 15:21: OA-29-681-23-First national survey of the costs borne by households with TB in the Democratic Republic of the Congo 2019 The Democratic Republic of the Congo tuberculosis (TB) programme conducted its first national TB patient cost survey in 2019 to establish a baseline for monitoring the progress towards elimination of catastrophic costs, in line with World Health Organization methods. National health and social policy interventions, geared to mitigate newly evidenced economic burden borne by TB patients, require crafting.

Inés Garcia Baena

15:21 - 15:29: OA-29-682-23-Determinants of household catastrophic costs for TB care in Kenya Despite the significant burden of drug-sensitive tuberculosis (DS-TB) cases, little is known about the predictors for catastrophic costs among them. This presentation will share results on the determinants for household catastrophic costs among DS-TB patients in Kenya. This could be the first step in designing tailor-made social interventions.

Beatrice Kirubi

15:29 - 15:37: OA-29-683-23-Economic burden of TB in Tanzania: a national survey of costs faced by TB-affected households Despite free provision of tuberculosis (TB) care, TB-related costs can be overwhelming and sometimes catastrophic for patients and their households, leading to poor treatment adherence and patient outcomes. We conducted a national survey to assess the economic burden of TB on patients and their households in Tanzania in 2019.

Andrew Martin Kilale

15:37 - 15:45: OA-29-684-23-Direct medical costs and out-of-pocket expenditures on TB treatment in three regions of China Although tuberculosis (TB) treatment is free of charge in China, medical costs during the inpatient treatment period still resulted in more than 10% of TB-affected families facing catastrophic costs. During outpatient treatment, the proportion of out-of-pocket expenditures reached almost 50% of direct medical costs because of additional medicines for drug-induced adverse effects.

Xubin Zheng

15:45 - 15:53: OA-29-685-23-Catastrophic costs associated with diagnostic cascade and treatment of TB among patients treated at a public health centre in Rio de Janeiro, Brazil Poor socioeconomic conditions increase the risk for tuberculosis (TB) infection, reactivation and maintenance of TB in the community. We conducted a study involving patients undergoing TB treatment in a municipal health centre in Rio de Janeiro aiming to assess the direct, indirect and catastrophic costs incurred for patients with TB.

Adriana da Silva Rezende Moreira

15:53 - 16:01: OA-29-686-23-Why Cepheid Xpert MTB/RIF and SARS-CoV-2 cartridges should not be sold to low- and middle-income countries at more than $5 per test An independent cost-of-goods analysis of Cepheid’s GeneXpert MTB/RIF and HIV viral load cartridges, currently priced at $9.98 and $14.90 for low- and middle-income countries, indicates that one cartridge can be produced below $5 and can be sold, with profit, for between $5 and $7, including service and maintenance.

Stijn Deborggraeve

16:01 - 16:09: OA-29-687-23-The cost of TB contact investigation in Uganda Tuberculosis (TB) contact investigation has been recommended for a long time. However, it is not being fully implemented in most low- and middle-income countries. One of the main issues raised for this is the cost. We set out to find the cost relative to GDP and we found it to be high.

Michael Kakinda

16:09 - 16:20: Q&A


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