IMPLEMENTATION OF BERLIN DECLARATION - ESTONIA

UNCLAS TALLINN 000082

SIPDIS

COPENHAGEN FOR ESTH OFFICE

SIPDIS

E.O. 12958: N/A
TAGS: SOCI TBIO KHIV TBIO EN
SUBJECT: IMPLEMENTATION OF BERLIN DECLARATION - ESTONIA

REF: STATE 6989


1. As requested by REFTEL the following is Estonia's
report on the status of implementation of the Berlin
Declaration.


2. Estonia signed the Berlin Declaration on
Tuberculosis on October 22, 2007. On February 20, 2008
the Minister of Social Affairs approved the "National
Tuberculosis Response Strategy and Action Plan 2008-
2012" (NTRSAP). The NTRSAP addresses all commitments
taken by signatories under paragraph five.


3. By adopting the new strategy, the Government of
Estonia (GOE) demonstrates its political commitment to
rein in the problem of TB in Estonia. According to the
NTRSAP, the GOE continues to be the main coordinator and
financer of TB response activities in Estonia.
Furthermore, the NTRSAP provides new approaches to fight
against TB in Estonia, and requires that all functions
of the existing TB response system be adequately
implemented.


4. The main components of the Estonian TB Program are:

a. Implementation of a directly observed treatment
system (DOTS). Patients take their daily medicine under
the supervision of a nurse or social worker in a clinic
or at patient's home, in strict accordance with the
standardized treatment plan;

b. Public procurement of TB drugs to enable access to
free treatment for every patient;

c. Public procurement of drugs to reduce the side
effects of TB drugs and to reduce the number of drug-
resistance patients who drop out of the treatment
program;

d. Effective TB lab services to provide accurate and
economic microbiological TB diagnostics;

e. A well-functioning TB monitoring system including
maintenance of a TB registry that reflects the dynamics
of TB infection rates and enables analysis of the
effectiveness of treatment plans. This will also help
to ensure that patients continue to get treatment if
they move, or are released from prison;

f. Highly motivated personnel devoted to TB treatment
and cooperation both on a national and international
level.


5. The NTRSAP also focuses on possible problematic
areas that may impede the reduction of new TB cases in
Estonia. The Plan would provide new measures for
prevention and early diagnostics, such as screening of
TB risk groups, including the homeless, the HIV positive
population, and their close contacts. The NTRSAP is in
compliance with Estonia's National HIV Prevention
Strategy for 2007-2015, and with the National Strategy
on Drug Dependency for 2004-2012. Further, the NTRSAP
makes it possible to provide patients with coordinated
treatment plans, anti-retroviral treatment and drug
substitute treatment.

PHILLIPS