The USAID Eliminating Tuberculosis in Central Asia Activity reduces the burden of tuberculosis (TB) in Central Asia, including Uzbekistan, by building local and regional capacity to improve the detection and treatment of drug-resistant TB (DR-TB)

The USAID Eliminating Tuberculosis in Central Asia Activity builds measurable, sustainable improvements in the quality and availability of DR-TB services by building the capacity of Uzbekistan’s institutions in TB leadership, management, financing, and information systems. The activity strengthens TB service delivery by improving the skills of medical providers in laboratories and health facilities, and promoting greater access to drugs, supplies, and services. The activity works with communities to reduce the stigma of TB and provides comprehensive support services to TB patients to ensure they complete treatment successfully. 

PROGRAM HIGHLIGHTS 

Uzbekistan has made significant progress in strategic planning and aligning clinical practice guidelines with international recommendations; however, improving TB outcomes cannot be achieved at the service level alone. Challenges in prevention, decreasing detection and treatment of both TB and DR-TB, implementation of an electronic TB database, and TB stigma remain. 

To overcome such challenges in Uzbekistan, the program intends to:

1. Increase detection of TB and DR-TB;
2. Increase treatment success for TB and all types of DR-TB; and
3. Improve the enabling environment and financial sustainability of TB and DR-TB programs.

 KEY RESULTS

• Supported the country in developing a strong National Strategic Plan (2020-2025) and National Laboratory Strategic Plan (2020-2025) through the provision of technical expertise on diagnostics, treatment, drug management and quantification/cost calculations, strengthening of the laboratory network, and TB outreach to at-risk populations including migrants; and contributed to the development of the country application to the Global Fund. 
• Provided 46 GeneXpert Systems with desktop computers and 31 GeneXpert calibration kits to the NTP.
• Through participation in national thematic working groups, supported revision of national guidelines and related documents for improved management of latent TB infection; guidelines for the Bacteriological Diagnosis of TB; protocol on video-supported treatment; development of 10 SOPs on the management of adverse events; translation of the national guidelines on latent TB infection management into Uzbek; update of the NTP diagnostic algorithm, taking into account the GeneXpert System primary TB diagnosis; and the introduction of Xpert MTB/XDR tests. 
• Developed the roadmap for the logistics network optimization in pilot regions: Ferghana, Syrdarya and Jizzakh. A sustainable and regular sample transportation system was launched in three pilot regions according to the routes and calculations developed by the program. 
• Provided technical support to prepare and pass the annual EQA (external quality assessment) conducted by NTP for culture laboratories. The Ferghana laboratory showed 100% compliance in panel tests obtained by NRL from the SupraNational Reference Laboratory of WHO-Gauting.
• Delivered medical equipment donated by the U.S. private sector to 43 district medical institutions of Ferghana, Syrdarya and Jizzakh regions. 
• Trained about 3,800 health and 1,000 non-health staff on service and quality related topics including diagnosis and management of TB, TB prevention, treatment of TB/DR-TB cases, and elimination of TB stigma and discrimination. 
• Introduced video-supported TB treatment, and provided 14 tablets for medical staff and 75 smartphones with mobile data plan for TB patients, delivering continued support to 420 patients during and after COVID-19 lockdowns.
• Procured and installed equipment and furniture to establish three regional branches of the Center of Distance Learning and Monitoring in Syrdarya, Tashkent and Kokand. 
• Through three USAID-created and supported multidisciplinary teams, improved the knowledge of about 28,252 at-risk individuals from target populations on TB and referred nearly 11,026 at-risk individuals for testing, resulting in detection of 308 TB cases and 62 people with latent TB infection. 
• Conducted various public awareness events to commemorate World TB Day 2021 and 2022, reaching around 6,000 people in pilot regions, and an additional 8 million through mass media channels with TB messaging. Printed and distributed more than 12,000 copies of communication products on TB information and education.
• Trained 54 reporters, bloggers, and influencers on effective approaches of drawing public attention to TB-related issues, which resulted in 900 media products about TB. 
• Organized study tour to Germany to learn about laboratory management practices, specimen logistics system, and functioning of LIMS in the Institute of Microbiology and Laboratory Medicine in Gauting, Germany.  
• Supported and actively participated in country and cross-country dialogues on the transition to insurance-based medicine in TB service. Supported the 5th and 6th International TB Conferences, 51 World Conference on Lung Health, Quality Management System training, in-person study tours to the Kyrgyz Republic for Health Insurance Fund staff to learn about the structure, function, activities of the MHIF Kyrgyzstan and to Georgia to learn about health system reforms.