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Overview

The World Bank’s role in the Stop TB Partnership

• The Bank is a financier of Stop TB and a permanent member of its Coordinating Board.  The Bank provides grant financing to the partnership (annual Development Grant Facility commitment of US$700,000). 
  
• The Bank administers the Stop TB Trust Fund, with cumulative transactions of about US$20 million to date. 
  
• Bank staff are active in several working groups of Stop TB which address strategic planning for the expanded use of the DOTS (Directly Observed Treatment, Short Course) approach recommended by WHO (and DOTS-Plus for multi-drug resistant TB).

Comparative advantages in relation to TB control

• Like the control of HIV/AIDS and malaria, TB control benefits from the Bank’s comparative advantage.  
  
• Much of the Bank’s comparative advantage is the combination of its cross-sectoral capacity for analytical work, advisory services, predictable financing on a medium- to long-term basis, operational support and convening power across multiple sectors.
  
• The Bank is working with Stop TB Partnership to assist countries to improve the integration of TB control into major tools of development planning, such as  PRSPs.
  
• The Bank has the operational experience and capability to assist countries in health systems that form the back bone of sustained improvements, including financing mechanisms, service delivery, human resources, logistics and supply, infrastructure for disease control,  monitoring and evaluation.

World Bank financing of TB control

• Cumulative commitments to TB control total about US$ 600 million in more than 30 countries (including Argentina, Bangladesh, Brazil, Cambodia, China, Eritrea, Ghana, Haiti, India, Kenya, Kenya, Kyrgystan, Uganda and Vietnam). 
  
• In addition to direct support for TB control, cross-cutting work on service delivery improves the systems for controlling TB. 
  
• Most MAP operations (as in Eritrea, Kenya and Uganda) include a TB component.

Some major examples

China

• Between 1991 and 2000, the prevalence of TB was reduced significantly in areas of China by use of WHO-recommended guidelines. WHO estimates that 2000, in a population of more than half a billion, there were 662,000 fewer cases than there would otherwise have been.
  
• The TB control effort was funded in part by a World Bank operation (Infectious and Endemic Disease Control Project, US$130 million, of which US$57 million was for TB).
  
• There is an ongoing project in China, the TB Control Project, US$104 million.

India

• India carries one fifth of the tuberculosis (TB) burden of the world. Controlling TB in India will be critical to reaching the worldwide MDG targets for TB.
  
• The Bank-financed India TB Control Project has provided credit support of about US$142 million since 1997.
  
• Through the Credit and resources from other donors (DANIDA, DFID, USAID, GFATM, Stop TB Partnership), the Government of India (GOI) hopes to implement the WHO-recommended TB treatment strategy of  DOTS in the entire country by December 2005.
  
• The expansion of DOTS in the India TB program is the fastest anywhere in the world. By March 2004, DOTS had become available to 805 million population with over 3 million cases treated under the program. A Joint Monitoring Mission found that due to the program, each day in India more than 10,000 symptomatic patients are examined, more than 2,500 patients placed on treatment, and nearly 500 lives saved. Treatment outcomes have consistently been high (over 85% compared to an estimated 40% under the old program) and the program is close to reaching the global target level for case detection of 70%.
  
• The Bank is responding to a request from the Government of India to prepare a new TB control project, with a potential World Bank contribution of about US$150 million.

Russian Federation

• The Bank is financing the TB & AIDS Control Project (US$150 million, of which US$100 million is for TB).
  
• The operation supports the country’s efforts to control TB and to stem the growing tide of multi-drug resistant TB.
  
• The Bank has also worked with WHO and Stop TB Partnership to help Russian pharmaceutical companies achieve Good Manufacturing Practice (GMP) standards.  This will enable them to produce drugs locally at a standard that will make the companies eligible as suppliers under the project.

Additional notes:

The Bank also provides DGF financing to the WHO/World Bank/ UNDP Special Program on Tropical Disease Research (TDR), based in Geneva. The work of TDR includes the development of new diagnostic tools for TB control.

Updated April 2005