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Suggested Citation:"Appendix A: Agenda." Institute of Medicine. 2011. The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa: Global and Local Challenges and Solutions: Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africa. Washington, DC: The National Academies Press. doi: 10.17226/12993.
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Appendix A
Agenda

With the development of antibiotics in the twentieth century, tuberculosis gradually lost its central position as a global health concern—it was considered a disease of the past or one that was only associated with the extreme poverty of the developing world. However, this view of tuberculosis is out of date.

Tuberculosis is today one of the leading causes of death in the world—4,500 people die daily from the disease. Although many cases of TB can be cured by available antibiotics, multidrug-resistant TB (MDR TB) is a major and growing threat worldwide. Strains of TB resistant to even the second-line therapies (XDR TB) are documented in over 50 countries, including the United States, and we are seeing the emergence of strains that are fully resistant to treatment. And while the epidemic of TB is still primarily centered in the developing world, the reach of MDR extends to every continent, including both rich and poor countries. The global battle against TB, once thought won, is today very real.

The Institute of Medicine (IOM) Forum on Drug Discovery, Development, and Translation is conducting a series of workshops in the United States and in high-burden countries—including South Africa, Russia, China, and India. The first workshop, held in November 2008, included experts from around the world, and was framed by a commissioned paper developed by Partners in Health that provided new data on the nature and spread of MDR TB. In addition, in February 2009, the Forum held a public briefing on MDR TB for Congressional staff in Washington, DC. Details of both meetings, including the agendas and speaker presentations, are available on the Forum’s website (www.iom.edu/drug).

Suggested Citation:"Appendix A: Agenda." Institute of Medicine. 2011. The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa: Global and Local Challenges and Solutions: Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africa. Washington, DC: The National Academies Press. doi: 10.17226/12993.
×

IOM is partnering with the Academy of Science of South Africa (ASSAf) to convene a 2-day workshop on MDR TB. The workshop will bring together disease experts, community leaders, policy makers, and patient advocates to examine the state of MDR TB in the South Africa region, to learn from the experiences of the South African public health community in its fight against MDR TB, and to draw lessons regarding best practices and novel approaches that can be applied both within and beyond the region. Proceedings of the workshop will be published and disseminated globally.

The South Africa meeting will focus on various aspects of MDR TB:

  1. Epidemiology. The latest information on the spread of MDR/XDR TB in Africa and globally, including the nature of the coinfection with HIV, will be presented and discussed.

  2. Diagnostics and Preventive Therapies. The challenges associated with rapid diagnosis of TB and resistance testing in resource-constrained environments will be explored, as well as opportunities for expansion of laboratory capacity and point-of-care diagnosis.

  3. Treatment. The limitations of current treatment, including the capacity of current health systems to address the needs of TB patients, the limited numbers of patients receiving appropriate treatment, and challenges in treating migrant workers, will be examined.

  4. Transmission and Infection Control. The meeting will explore our growing understanding of the modes of transmission of MDR TB, and the strategies needed to address them.

  5. Pediatric TB. The devastating spread of MDR TB among children and the unique challenges they pose for prevention and treatment will be explored.

  6. Policy. The workshop will analyze the effects of MDR TB beyond patients in order to highlight areas for improved policy and next steps.

Suggested Citation:"Appendix A: Agenda." Institute of Medicine. 2011. The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa: Global and Local Challenges and Solutions: Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africa. Washington, DC: The National Academies Press. doi: 10.17226/12993.
×

The Emerging Threat of Multidrug-Resistant Tuberculosis: Global and Local Challenges and Solutions Pretoria, South Africa


Day 1

March 3, 2010

8h30-9h00

Registration

 

Breakfast and coffee will be served at this time.

9h00-9h30

Welcome and Opening Remarks

 

Roseanne Diab, ASSAf

 

Lerole David Mametja, Ministry of Health, South Africa

9h30-9h45

Perceptions vs. Realities: Summary of 2008 MDR TB Workshop in Washington, DC

 

Gail Cassell, Eli Lilly and Company

9h45-11h45

Session 1: A Realistic Assessment of the Spread of MDR/ XDR TB in Sub-Saharan Africa with an Emphasis on South Africa

 

Moderator: Gerald Friedland, Yale School of Medicine

 

Capacity for Health Care Across Southern Africa and MDR/XDR TB

Tomas Zimba, Maputo Central Hospital, Mozambique

 

Evolution of XDR TB in KwaZulu-Natal

Willem Sturm, Nelson Mandela School of Medicine, University of KwaZulu-Natal

 

Prevalence of Drug Resistance at the Initiation of Second-Line Drugs and Existence of Totally Drug-Resistant TB

Martie van der Walt, Medical Research Council of South Africa

Suggested Citation:"Appendix A: Agenda." Institute of Medicine. 2011. The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa: Global and Local Challenges and Solutions: Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africa. Washington, DC: The National Academies Press. doi: 10.17226/12993.
×

 

Putting Resistance in Perspective: The Korean Experience and Polymorphisms Associated with Resistance and Cross Resistance

Clifton Barry, National Institutes of Health

11h30-11h45

Discussion with Audience

11h45-12h45

LUNCH

12h45-13h45

Keynote Address

 

Moderator: Janet Tobias, Ikana Media

 

Epidemiology and Management of MDR TB in Children

Simon Schaaf, Department of Paediatrics and Child Health, Stellenbosch University

13h30-13h45

Discussion with Audience

13h45-15h15

Session 2: Coinfection with HIV/AIDS: Clinical Outcomes and Consequences

 

Moderator: Richard Chaisson, Center for Tuberculosis Research, Johns Hopkins University

 

Tugela Ferry Experience in a Community Hospital

Neel Gandhi, Tugela Ferry Care and Research Collaboration (TF CARES) Albert Einstein College of Medicine

 

Outcomes from TB Referral Hospitals, KwaZulu-Natal

Nesri Padayatchi, University of KwaZulu-Natal

 

Outcomes from the Eastern Cape

Charlotte Kvasnovsky, Medical Research Council

 

Mortality and Causes of Death in South Africa

Maletela Tuoane-Nkhasi, Statistics South Africa

15h00-15h15

Discussion with Audience

15h15-15h30

BREAK

Suggested Citation:"Appendix A: Agenda." Institute of Medicine. 2011. The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa: Global and Local Challenges and Solutions: Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africa. Washington, DC: The National Academies Press. doi: 10.17226/12993.
×

15h30-17h00

Session 3: Alternative Strategies

 

Moderator: Robin Wood, University of Cape Town

 

Community-Based Care

Kristina Wallengren, Medical Research Council

 

ART for the Prevention and Treatment of MDR TB

Stephen Lawn, University of Cape Town

 

Intensified TB Case Finding Among HIV-Infected Patients

Sabine Verkuijl, International Center for AIDS Care and Treatment Programs (ICAP-SA), Mailman School of Public Health, Columbia University

 

South-to-South Assistance to Initiate MDR TB Care in Ethiopia (Note: via phone)

Anne Goldfeld, Harvard University

16h45-17h00

Discussion with Audience

17h00

ADJOURN

18h00

Group Dinner for Speakers

Day 2

March 4, 2010

8h00-10h00

Session 4: Transmission and Strategies for Infection Control

 

Moderator: Neel Gandhi, Tugela Ferry Care and

Research Collaboration (TF CARES)

 

Proof of Principle: Transmission of MDR TB in the AIR Facilities

Matsie Mphahlele, Medical Research Council

Suggested Citation:"Appendix A: Agenda." Institute of Medicine. 2011. The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa: Global and Local Challenges and Solutions: Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africa. Washington, DC: The National Academies Press. doi: 10.17226/12993.
×

 

Epidemic in Tugela Ferry: Transmission and Impact of Infection Control

Gerald Friedland, Yale School of Medicine (in place of Anthony Moll, Church of Scotland Hospital)

 

Household Contacts

Claudio Marra, Church of Scotland Hospital

 

Careworkers

Karen Shean, University of Cape Town

 

Migrant Workers in Lesotho

Maketekete Thotolo, Adventist Development and Relief Agency

 

An Evaluation of Infection Control Infrastructure and Health Worker KAP in MDR/XDR TB Care Settings

Jason E. Farley, Johns Hopkins University

9h45-10h00

Discussion with Audience

10h00-10h30

BREAK

10h30-12h15

Session 5: Application of Molecular Biology to Shape Policy

 

Moderator: Elaine Gallin, Doris Duke Charitable Foundation

 

Drug-Resistant Genotypes: Implication for Point-of-Care Detection of Resistance in Different Geographies

Paul van Helden, Stellenbosch University

 

Genetic Analysis of Drug-Resistant Strains in South Africa

Robin Warren, Stellenbosch University

 

Bench to Bush in Biomarker Studies in Africa: Implications for MDR TB Treatment and Drug Development

Shreemanta Parida, Max Planck Institute for Infection Biology, Berlin, Germany

Suggested Citation:"Appendix A: Agenda." Institute of Medicine. 2011. The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa: Global and Local Challenges and Solutions: Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africa. Washington, DC: The National Academies Press. doi: 10.17226/12993.
×

12h00-12h15

Discussion with Audience

12h15-13h00

LUNCH

13h00-14h15

Session 6: How Close Are We?

 

Moderator: Martie van der Walt, Medical Research Council of South Africa

 

Current Status of Diagnostics Globally for the Detection of Drug Resistance with Emphasis on Point of Care

William Jacobs, Einstein School of Medicine

 

Challenges in Laboratory Capacity in Diagnosing Drug-Resistant TB in South Africa

Gerrit Coetzee, National Health Laboratory Services, South Africa

 

Information Solutions to Enhance Laboratory Capacity in Evaluation of New Diagnostics and Therapies

Dale Nordenberg, Novasano Health and Science

14h00-14h15

Discussion with Audience

14h15-15h15

Session 7: Research Gaps, Priorities, and Opportunities— Report from NIH Workshop

 

Valerie Mizrahi, National Health Laboratory Service

 

Barbara Laughon, National Institutes of Health

15h00-15h15

Discussion with Audience

15h15-15h30

BREAK

15h30-16h45

Session 8: Convergence of Science and Policy to Create a Blueprint for Action

 

Moderator: Queta Bond, Burroughs Wellcome Fund (retired)

 

Where Are We and Where Do We Go from Here?

Salim Abdool Karim, University of KwaZulu-Natal

Suggested Citation:"Appendix A: Agenda." Institute of Medicine. 2011. The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa: Global and Local Challenges and Solutions: Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africa. Washington, DC: The National Academies Press. doi: 10.17226/12993.
×

 

Panelist Response:

 

Gail Cassell, Eli Lilly and Company

Norbert Ndjeka, Department of Health, South Africa

Sidney Parsons, Council for Scientific and Industrial Research

16h30-16h45

Discussion with Audience

17h00

ADJOURN

Suggested Citation:"Appendix A: Agenda." Institute of Medicine. 2011. The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa: Global and Local Challenges and Solutions: Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africa. Washington, DC: The National Academies Press. doi: 10.17226/12993.
×
Page 95
Suggested Citation:"Appendix A: Agenda." Institute of Medicine. 2011. The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa: Global and Local Challenges and Solutions: Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africa. Washington, DC: The National Academies Press. doi: 10.17226/12993.
×
Page 96
Suggested Citation:"Appendix A: Agenda." Institute of Medicine. 2011. The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa: Global and Local Challenges and Solutions: Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africa. Washington, DC: The National Academies Press. doi: 10.17226/12993.
×
Page 97
Suggested Citation:"Appendix A: Agenda." Institute of Medicine. 2011. The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa: Global and Local Challenges and Solutions: Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africa. Washington, DC: The National Academies Press. doi: 10.17226/12993.
×
Page 98
Suggested Citation:"Appendix A: Agenda." Institute of Medicine. 2011. The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa: Global and Local Challenges and Solutions: Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africa. Washington, DC: The National Academies Press. doi: 10.17226/12993.
×
Page 99
Suggested Citation:"Appendix A: Agenda." Institute of Medicine. 2011. The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa: Global and Local Challenges and Solutions: Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africa. Washington, DC: The National Academies Press. doi: 10.17226/12993.
×
Page 100
Suggested Citation:"Appendix A: Agenda." Institute of Medicine. 2011. The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa: Global and Local Challenges and Solutions: Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africa. Washington, DC: The National Academies Press. doi: 10.17226/12993.
×
Page 101
Suggested Citation:"Appendix A: Agenda." Institute of Medicine. 2011. The Emerging Threat of Drug-Resistant Tuberculosis in Southern Africa: Global and Local Challenges and Solutions: Summary of a Joint Workshop by the Institute of Medicine and the Academy of Science of South Africa. Washington, DC: The National Academies Press. doi: 10.17226/12993.
×
Page 102
Next: Appendix B: Report from the National Institute of Allergy and Infectious Diseases (NIAID) Workshop »
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Tuberculosis (TB) kills approximately 4,500 people worldwide every day. While most cases of TB can be treated with antibiotics, some strains have developed drug resistance that makes their treatment more expensive, more toxic and less effective for the patient. The IOM Forum on Drug Discovery, Development, and Translation and the Academy of Science of South Africa held a workshop to discuss ways to fight the growing threat of drug-resistant TB.

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