Pakistan ranks fifth in terms of Tuberculosis (TB) burden, at an alarming figure of 620,000 TB patients out of a total population of 177 million people (World Health Organization Regional Office for the Eastern Mediterranean). It is the world’s fourth highest multidrug-resistant tuberculosis (MDR-TB) burden country in the world (United Nations Pakistan).
Luckily, TB is a treatable disease, but requires a reliable access to anti-TB medications. In Pakistan, pharmacies frequently have stock outs of these precious drugs. As people wait for the pharmacies to be re-stocked they become sicker and sicker, spread the disease to more people and cannot work. With so many Pakistanis unable to work, economic activity plummets. The economic burden of TB in Pakistan is astounding—75 percent of people with TB in Pakistan are between the ages of 15 and 45 years (World Health Organization).
In 2012, the National Tuberculosis Control Program (NTP) approached JSI through the USAID | DELIVER PROJECT’s Pakistan office to provide technical assistance in addressing the TB epidemic. The NTP is implemented by the Government of Pakistan and the USAID Pakistan Mission and procures anti-tuberculosis drugs and works to strengthen the drug management system. In addition, the NTP supports the successful implementation of the Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund’s) consolidated Round 8 & 9 award, and supports the TB Control Program’s continued efforts towards the global Stop TB target of 85 percent treatment success.
The NTP wanted to prevent shortages of anti-TB drugs, so they asked DELIVER for support in enhancing the scope of the web-based Logistics Management Information System (LMIS) and warehouse management system (WMS) for TB Drugs (defined as a “functional TB-DMIS”). The LMIS was originally developed for contraceptives, but would now be updated to include anti-tuberculosis drugs.
In addition to the development of the TB-DMIS, the USAID | DELIVER PROJECT would lead a training of trainers that included the training of relevant staff on the use of the “pipeline software” that is used for supply planning of TB/MDR drugs. The team also nominated 25 relevant staff from Greenstar Social Marketing (GSM) and the TB Control Program to be trained on the enhanced TB-DMIS so that they could provide roll-out training up to the district level. In March 2013 the NTP launched the TB-DMIS.
The TB-DMIS, as well as corresponding reports and graphics, are now up and available to the public on the Government of Pakistan’s website .
To date, the NTP has successfully implemented the TB-DMIS in 57 districts in Pakistan. Next, the USAID | DELIVER team will train NTP staff and implement the Warehouse Management System to track the drug supply chain in real time. The districts are reporting real-time TB drugs data regularly into the system which is being used for policy and operational level decisions. The Program intends to scale up the TB-DMIS to all 140 districts of the country in the coming months by scaling up the trainings of TB-DMIS across the country in order to make the TB drugs data 100 percent available for analysis and monitoring purposes.
Under the stewardship of National TB Control Program Ministry of Health Services Regulations and Coordination, the journey to completely eradicate TB in Pakistan will be a long one. With USAID | DELIVER PROJECT’s support, along with other stakeholder support, valuable milestones have been achieved.
- World Health Organization Regional Office for the Eastern Mediterranean. Stop Tuberculosis. n.d. http://www.emro.who.int/pak/programmes/stop-tuberculosis/Print.html (accessed February 28, 2014).
- United Nations Pakistan. “A Monthly Newsletter of the United Nations-Pakistan.” March 2013. http://unic.org.pk/pdf/0313NL.pdf (accessed February 28, 2014).
- World Health Organization. “World Tuberculosis Report 2013.” 2013. http://www.who.int/tb/publications/global_report/en/ (accessed March 3, 2014).
- NTP | National TB Control Program | Pakistan. n.d. http://www.ntp.gov.pk/ (accessed March 3, 2014).