El Salvador

TB incidence of all forms has been decreasing from 1990 to 2006 from a rate of 100 to 50 / 100,000 population. Incidence for smear positive patients decreased in the same period from 44 to 22 / 100,000. HIV surveillance among TB patients is implemented in all cases since 2003. Co-infection arte in 2006 was 11%, reflecting an increase of TB/HIV co-infection (2005: 5.3%).

Role KNCV Tuberculosis Foundation

KNCV Tuberculosis Foundation has been involved in TB control activities since 2001 through the TBCTA project. That funding ended in 2006. The country still receives GFATM funding for the TB program approved in the second round (2001) as well as a HIV/AIDS grant in that same round. With Global Fund support the data of a Tuberculin Survey were analyzed in 2006.

Achievements

The national TB program is completely integrated in the general health system and accessible in the whole country. Community DOTS, with village health workers part of the health system, is practiced in the remote areas where geographical access to health facilities is limited. Quality of TB services has improved considerably during the TBCTA project financed by USAID and managed by PAHO. Specific achievements are an excellent Laboratory quality control system with decentralized supervision through the decentralized health system (SIBASIS), smooth collaboration between public sector and the Social Security Health System (16% of population), constant collaboration between Pre-service Training Institutions (Universities, Nurse Schools) and the national TB program, as well as continuous feedback from the SIBASIS. Case detection rate for new smear positive cases reached 61% with a treatment success rate of 91%.
  
Activities 2007

In 2005 KNCV Tuberculosis Foundation supported the program in the formulation of a 15 year strategic plan for elimination, being one of the recommendations of the evaluation mission of end 2004, in order to guarantee the sustainability of the program. Previous to this mission a study was carried out locally to get information on the disease load in each SIBASI and municipality and thus make a stratification of all municipalities and SIBASIS and their TB load. Together with poverty data of each municipality a specific strategy has been designed to prioritize the high loaded TB municipalities and with extreme poverty as well as vulnerable groups in society. This strategy should contribute to an accelerated reduction of TB. An external review mission of WHO/PAHO and KNCV Tuberculosis Foundation planned for 2007, had to be postponed because of an overcrowded agenda of WHO/PAHO. 

Next steps

In 2008 KNCV Tuberculosis Foundation will implement a workshop to introduce the Monitoring and Evaluation System Strengthening Tool of the Global Fund. The visit of the consultant will also be used to review progress of implementation of the Strategic Plan.