On behalf of EXPANDx-TB, FIND CEO signs MOU with India Ministry of Health
From left to right: Dr. L.S. Chauhan, National TB Control Programme Manager; Mr. M.K. Mishra, Under Secretary Ministry of Health and Family Welfare, and Dr. Giorgio Roscigno, FIND CEO
In 2007, FIND opened an office in New Delhi, India for the purpose of collaborating closely with the Government of India (GOI) to conduct diagnostics studies in liquid culture and line probe assay (LPA) and to identify and allocate new technologies in state level laboratories. In 2010, the US$ 31 million EXPANDx-TB project funded by UNITAID will expand diagnostic capacity and services for the detection of tuberculosis (TB) and multidrug-resistant (MDR) TB by providing laboratory instruments and related reagents/supplies for liquid culture/speciation and LPA, instrument installation, training, and project monitoring and evaluation. The costs involved for these activities will be spent through the three core recipient partners, namely, WHO-GLI (Global Laboratory Initiative), FIND, and GDF (Global Drug Facility), under the specific terms of reference described in the Memorandum of Understanding that was signed between FIND/EXPANDx-TB and the Government of India on 8 March 2010.
The EXPANDx-TB project aims to serve as a catalyst for attracting funding from existing donors and/or technical agencies to cover additional laboratory costs related to implementation of the new diagnostic tests for TB and MDR-TB. These funds will cover the extra costs incurred for infrastructure development, laboratory renovation, ancillary laboratory equipment and supplies, generators, and laboratory human resources.
With the support of WHO’s laboratory strengthening team at the GLI, FIND will provide technical assistance to India to facilitate capacity to effectively diagnose and manage MDR-TB through rapid culture, species identification and drug susceptibility testing while adhering to WHO standards. This will also allow project sustainability through cost reduction over the years, with increasing economies of scale and greater access to patient-technology interface in programmatic settings (patients in need). The funded scale-up of laboratories also contains a significant treatment component to cover the needs of up to 15,000 MDR-TB patients annually.
Several partners are committed to supporting the various provisions and components needed to scale-up TB diagnostic services in India, including: the Government of India, the World Bank, WHO, USAID, and other NGOs. Many laboratories will benefit from additional government investment in further upgrades, such as generators to assure uninterrupted power supplies and additional human resources. Furthermore, the GOI will cover recurring costs for basic laboratory services including culture and DST on solid media (which will continue to be needed as a back-up for liquid culture and line probe assay). The WHO, with support from USAID, allocated US$ 1.5 million to procure additional laboratory equipment in 2009. DfID and PATH are planning to provide additional human resources and technical support for 2-3 laboratory sites each.
"EXPANDx-TB shows how governments, technical partners, and donors joining forces for a common goal can quickly and effectively address one of the major barriers in MDR-TB control - that of diagnostics access - in a best-practice, 'learning-by-doing' approach, using state-of-the-art technologies in modernised laboratories," says Karin Weyer, Coordinator: TB Laboratory Strengthening & Diagnostics, Stop TB Department, WHO. "The India project is the single most ambitious laboratory strengthening activity ever undertaken in a high-burden TB setting, and lessons learnt will be invaluable as we scale up the global response to MDR-TB."