TURKMENISTAN: LAUNCH IN BALKAN PROVINCE BRINGS NATIONAL

UNCLAS SECTION 01 OF 02 ASHGABAT 001285 SIPDIS SIPDIS SENSITIVE STATE FOR SCA/CEN, EUR/ACE E.O. 12958: N/A TAGS: PGOV PREL EAID SOCI TX SUBJECT: TURKMENISTAN: LAUNCH IN BALKAN PROVINCE BRINGS NATIONAL TB-DOTS COVERAGE TO 90% ¶1. (U) Sensitive but unclassified. Not for public Internet. ¶2. (U) SUMMARY: On November 16, USAID's implementing partner Project HOPE organized a ceremony in Balkanabat city marking the expansion of DOTS, the internationally recognized approach to control tuberculosis (TB),to three new towns and five new districts in Balkan province. With the new expansion, USAID and Project HOPE, together with the Ministry of Health and Medical Industry of Turkmenistan (MOHMIT),have ensured that the entire population of Balkan province will have access to high quality services in the prevention and treatment of TB. This ongoing cooperation supports the ministry's implementation of the National TB Program, which calls for nationwide DOTS implementation by 2009. As a result of the expansion in Balkan province, over 90% of Turkmenistan's population is currently covered by the TB-DOTS approach. END SUMMARY. LONG-TERM COOPERATION ON TB-DOTS ¶3. (U) Since 2000, USAID's implementing partner Project HOPE has been supporting the MOHMIT to implement the World Health Organization-recommended DOTS strategy in Turkmenistan. Under a Memorandum on Mutual Understanding and Cooperation between USAID and MOHMIT signed in 2000, Project HOPE is implementing a multi-component program to assist the government of Turkmenistan in strengthening political commitment and public awareness, upgrading clinical capacity, and improving the quality and availability of TB services. The project has three overarching objectives: building political support; building human and systems capacity for TB control; and raising community awareness of the risks and symptoms of TB while encouraging positive care-seeking behavior. ¶4. (U) In preparation for the expansion, the project, together with the State Medical Institute and the National TB Program specialists, conducted training on DOTS for TB doctors, laboratory specialists, and primary health care doctors and nurses, and provided supplies to local laboratories. Project HOPE's specialists, together with the MOHMIT TB Prevention Center, visited districts and towns in Balkan province to provide technical assistance for local specialists involved in TB control. In addition, TB drugs have been supplied for this region by the Global Drug Facility and will be provided to patients free of charge. CEREMONY DEMONSTRATES MINISTRY SUPPORT FOR USG PROGRAMS ¶5. (U) The ceremony was attended by the Balkan province healthcare department head, the National TB Prevention Center Deputy Director, and hospital directors and TB doctors from districts across Balkan province. In addition, USAID/Turkmenistan's Country Representative and Health Management Specialist joined Project HOPE's regional technical director and other Project HOPE representatives in attendance. The deputy provincial head sent last minute regrets due to a priority request to participate in preparations related to upcoming local elections scheduled for December 9. An article on the expansion appeared in the state-run Neutral Turkmenistan newspaper on November 17 and made positive references to the USG contribution through USAID and Project HOPE. ¶6. (U) At the ceremony, Project HOPE and USAID handed over five binocular microscopes for use in Balkan province. The new equipment will enable laboratory specialists to carry out quality tests for the diagnosis of tuberculosis. Project HOPE/USAID has already provided training for laboratory specialists who will be using the equipment and plans to follow up with additional education and technical support to ensure optimal use of the equipment. Additional microscopes were recently delivered to laboratories in five districts in Lebap and Mary regions where DOTS is implemented by MOHMIT. ¶7. (SBU) COMMENT: The Government of Turkmenistan is pursuing a policy of rapid expansion of DOTS without devoting sufficient funds or technical expertise to the expansion. Experience in the region has shown the potentially harmful impact of DOTS implementation ASHGABAT 00001285 002 OF 002 without proper preparation and support: one result is increased prevalence of multi-drug resistant TB, as has occurred in neighboring Kazakhstan. The USG is currently the main donor active in TB control in the country, and USAID plans to devote a portion of supplemental FY07 funds to expand its successful program of preventing and treating TB in Turkmenistan. ¶8. (SBU) COMMENT CONTINUED: Although the previous political environment in Turkmenistan limited opportunities to pursue much-needed health reforms, USAID has been able to develop strong working relations in the sector due to its ability to demonstrate tangible results. The positive impact of these programs on the Turkmen population also promotes USG objectives by bringing communities together around health issues. The government's recognition of the USG contribution in a state-run newspaper reflects a gradually increasing willingness to highlight USG cooperation in non-political sectors. END COMMENT. CURRAN