MISSION MARKS WORLD TB DAY

UNCLAS SECTION 01 OF 02 DJIBOUTI 000271 SIPDIS DEPARTMENT FOR AF/E AND OES/IHB CJTF-HOA FOR POLAD USAID FOR USAID/EAST AFRICA USAID/AFRICA/EA USAID/GH E.O. 12958: N/A TAGS: TBIO SOCI PREL EAID KPAO DJ SUBJECT: MISSION MARKS WORLD TB DAY ¶1. SUMMARY: Djibouti has the second-highest prevalence rate of tuberculosis (TB) in the world. Through coordinated USAID programming and Combined Joint Task Force-Horn of Africa (CJTF-HOA) civil affairs projects, Post continues to work closely with the GODJ as it implements a five-year plan to tackle this key health problem. Combating TB and other chronic diseases is a crucial part of the GODJs strategy to develop a healthier, more educated workforce, which is ready to take part more fully in Djiboutis recent foreign- investment-led growth. In recognition of World TB Day, USAID Representative spoke at a high-level event organized by the GODJ, while Ambassador joined regional officials on a visit to a USG-supported TB ward during a trip to the regional capital of Dikhil. END SUMMARY. ¶2. According to the World Health Organization, in 2008, Djibouti registered 1,300 cases of all forms of TB per 100,000 people. The estimated incidence of new smear positive cases is 356/100,000--up from 271/100,000--with a mortality rate of 128 per 100,000. Djiboutis Ministry of Health (MOH) has developed a five-year strategic plan (2006-2010) and has created a National TB Control Program in order to address this public health problem. ¶3. USAID health programming supports the GODJs National Control Program in several ways. Key areas of assistance include: --Strengthening the laboratory network in Djibouti: Fifteen labs are now operational, meeting international standards of serving an average population of 50,000 each; --Establishment of a quality assurance system and a laboratory manual with standard operating procedures. All 15 labs perform TB microscopy with over 95% correct microscopy results; --Training for key staff in the national TB recording and reporting system, which is now able to provide data in a timely manner; --Implementation of the decentralization of the TB program to improve diagnosis and treatment. ¶4. The majority of tuberculosis program funds in Djibouti are provided by the Global Fund (GF). The GF is positioned to cover the purchase of second line drugs, culture testing, drug sensitivity testing, and the conduct of a drug resistance survey. In 2009, USAID will complement the GF by continuing support to the National TB Program, providing technical assistance in multidrug resistant (MDR) TB management, training doctors on MDR management, and supporting infection control. USAID will also help Djibouti improve diagnostic capacity by constructing labs in four health posts operating as Diagnostic and Treatment Centers, thus helping maintain a strategic and comprehensive approach to addressing the high incidence of TB in Djibouti. ¶5. On World TB Da, March 24, USAID Representative made remarks at a high-profile event organized by GODJ officials. Her remarks, which were covered by local media, focused on the growing USG-GODJ partnership to fight TB. ¶6. On March 25, the Ambassadors trip to the region of Dikhil included a visit to a USG-supported TB ward at the districts main hospital. The Ambassador spoke with hospital personnel and local officials about what was being done to fight TB, and met with patients undergoing treatment. Dikhil Hospital serves approximately 70,000 people, and supervises six rural clinics. ¶7. USAID provided support to Dikhil Hospital through training for members of the District Health Management Team, and through significant improvements in the Health Information System (HIS). Training for the HIS focal point, along with the provision of a computer and other office equipment, now allows the HIS to collect key data and accurately transmit them to the central level. In late 2006, a CJTF-HOA civil affairs project renovated Dikhil Hospitals entire TB ward and installed a new cistern for the TB latrine, renovated the administration building, built a latrine in the general medicine building, and installed 15 air conditioners. DJIBOUTI 00000271 002 OF 002 ¶8. COMMENT. In his opening remarks at a mid-March National Health Symposium, President Guelleh noted that in the field of health in Djibouti, everything is a priority. However, he singled out management of chronic diseases--such as TB--as a particularly key area. END COMMENT. SWAN