Adapting and piloting the integrated comorbid hepatitis test-treat-prevent care of MDR-TB Tuberculosis patients and PLHIV/key population in Pakistan and Malawi.

CONTEXT

Pakistan is the 2nd highest HCV burden country in the world, with China having the highest number of people suffering from HCV.

The integrated hepatitis care at the primary health care level in Punjab supported by The Hepatitis Fund was successfully implemented by ASD with excellent results and outcomes. It was adapted and expanded, through THF support, for integrated care at rural health centres.

In MDR-TB patients, identifying and managing hepatitis comorbidity (if found) is essential for their overall health/ well-being. Hepatitis screening and care has theoretically been a part of MDR-TB care, but not yet happening because of lacking comorbid care protocols and linkages for offering “test-treat-prevent” care. This leads to the missed opportunity to screen around 3,000 MDR-TB patients and manage comorbid hepatitis accordingly.

In PLHIV and key populations (i.e., sex workers, people who inject drugs, transgender people, MSM etc.), identifying and treating comorbid chronic HCV/ HBV is a known priority; and The Global Fund has recently created a window for assisting the programs to implement integrated comorbid hepatitis test-treat-prevent care for known PLHIVs and key populations.

ACTION

ASD will assist the three programmes (Hepatitis, TB and HIV/ AIDS) to adapt and pilot the integrated hepatitis comorbid care of MDR-TB patients and PLHIV/ key populations in Punjab.

ASD will also provide technical assistance and capacity building to a non-governmental organization in Malawi to adapt and pilot an integrated hepatitis comorbid care of PLHIV in primary settings in Malawi.

EXPECTED RESULTS

An adapted package for integrated comorbid hepatitis care (of DR-TB patients and PLHIV/ key populations) will be created. It will include adapted care products and care linkages for the patients to access ongoing public-funded HCV/HBV care at the ongoing Hepatitis Clinics.

Implementation of the comorbid hepatitis care of ≥1,300 MDR-TB patients at 13 MDR-TB sites and ≥1,000 PLHIV/ key population in a selected district of Punjab

Expansion of the integrated comorbid hepatitis care of MDR-TB patients at the GFATM-supported MDR-TB sites in Punjab and other provinces of Pakistan.

Partner and program enabling to implement integrated comorbid hepatitis care of PLHIV in other parts of Malawi (preferably through GFATM forthcoming work plans)

The results and the products will be shared with potential stakeholders within and outside Pakistan for the potential application of the pilot model in other settings.