The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the... 3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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Timor-Leste’s vulnerability to natural hazards means if particular care is not taken in the development of the country’s infrastructure, it will remain at risk to disruption.
Timor-Leste developed the 2008 National Disaster Risk Management Policy, which lays out the government’s vison of ...its disaster management process from the national to the village level. Additionally, through the United Nations Development Program (UNDP), they have conducted national hazards, vulnerability and risk assessments. Through Plan International they have initiated the integration of disaster management education into public schools. Although the Government of Timor-Leste considers DRM as a priority and supports the dissemination of DRM policy to the district levels, the current Strategic Development Plan 2011-2030 of Timor-Leste has not explicitly reflected nor integrated DRM as one of its development priorities. Disaster Management is included in the Strategic Plan Document of MSS 2009-2012.
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The development of water, sanitation and hygiene (WASH) in schools guidelines for TimorLeste is a landmark moment in our quest to make every school child-friendly – a place where every child can learn, play and grow with pride and dignity. The overarching goal is to improve health, boost education... achievement and promote gender equity in our schools.
The guidelines set clear levels of acceptable standards for water supply, provision of sanitation facilities and hygiene promotion in schools and provide a common framework and policy direction for all sub-sector actors. Therefore, all implementing agencies, managers, planners, architects, water and sanitation technicians, teaching staff, school directors, school boards, district WASH committees, local authorities and other relevant bodies should consult these guidelines, when making implementation plans.
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World Health Organization. Country Office for Timor-Leste. (2020). National strategic plan for ending TB 2020--2024. World Health Organization. Country Office for Timor-Leste.
In the last decade, Timor-Leste has made remarkable progress in strengthening its health system and improving the health status of its population. This has resulted in an increased life expectancy, and the achievement of Millennium Development Goals such as a reduction in infant and under-five morta...lity, an improvement in maternal and child health outcomes, and an increase in immunization coverage. Further, the country has successfully eliminated infectious diseases such as polio, measles, and maternal and neonatal tetanus. There is full political commitment to reducing the incidence of tuberculosis (TB) by 80% and the number of deaths due to TB by 90% by 2030. The country has made great progress in the context of the pandemic, having established numerous quarantine facilities/isolation centres; trained health-care workers; streamlined the procurement and supply of medicines, consumables, personal protective equipment and other equipment; and strengthened the capacity in critical care across secondary and tertiary health care, to better respond to future pandemics and other disaster situations.
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Antimicrobial resistance (AMR) is described as a situation when bacteria, viruses, fungi and parasites
change over time and no longer respond to medicines, making infections harder or impossible to treat,
and increasing the risk of disease spread, severe illness and death.1 AMR in recent years has... become
a global priority in public health due to its widespread consequences and increasing occurrence from
time to time. AMR has a formidable impact where the existing antibiotics and other antimicrobial
medicines become ineffective, and infections become increasingly difficult or impossible to treat.
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This publication outlines public health aspects of alcohol use and harm in WHO South East Asia Region Countries. It summarizes Global Regional and country specific data and also discusses aspects of alcohol control that are important in the context of the Region. The possible future trend of alcohol... use in the Region is also analysed and current and future barriers to effective alcohol control in countries of the Region are discussed.
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The Report describes the evaluation of WHO's contribution to the Maternal Health Program in South-East Asia Region. This was an independent evaluation conducted in 2015 by Amaltas, a Delhi based organization. The evaluation highlights the progress in five countries, namely Bangladesh, Indonesia, Mya...nmar, Nepal and Sri Lanka and provides specific recommendations for Organizational Learning and Development. This report will be useful for all those interested in WHO's work on Maternal Health Program in the Region.
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The publication conveys the quantitative surveillance results focusing on tobacco use and noncommunicable disease (NCD) related behaviours among youth (13–15 years) in Member States of the WHO South-East Asia Region, namely, the Global School-based Student Health Survey (GSHS) and the Global Youth... Tobacco Survey (GYTS). This publication contains selected indicators relating to tobacco use and other related risk behaviours of youth (aged 13–15 years) in Member States of the WHO South-East Asia Region. The tobacco indicators are mainly taken from GYTS and other indicators relating to risk behaviours (dietary behaviours, physical activity, alcohol use, drug use, mental health, violence and unintentional injury, sexual behaviours, protective factors and hygiene) are taken from GSHS. The latest findings from surveys conducted in Member States are presented in the publication.
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The publication conveys the most recent quantitative surveillance results focusing on noncommunicable disease (NCDs)-related risk behaviours among adults from the WHO STEPwise approach to NCD risk factor surveillance (STEPS) and tobacco use among adults from the Global Adult Tobacco Survey (GATS) in... Member States of the WHO South-East Asia Region. This publication contains selected indicators relating to tobacco use and other related risk behaviours of adults in Member States of the WHO South-East Asia Region. The tobacco indicators are taken from GATS or STEPS and other indicators relating to risk behaviours (history– dietary behaviours, physical activity, alcohol use, cervical cancer screening; physical measurements – body mass index, blood pressure, waist circumference; biochemical measurements – fasting blood glucose level, blood glucose level 2 hours after glucose load, total blood cholesterol, urine sodium and urine creatinine) are taken from STEPS. The latest findings from surveys conducted in Member States are presented in the publication.
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At the threshold of Sustainable Development Goals (SDG) era, this document captures the remarkable achievements by Member States towards achieving MDGs 4 and 5. It acknowledges new opportunities in the post-2015 phase shaped by the SDGs and the Global Strategy for women’s, children’s and adoles...cents’ health and presents an advanced state of preparedness in the Region. This also highlights the region’s renewed commitment for a more inclusive and more dynamic flagship action for ending preventable maternal, newborn and child mortality as well as to improve women’s, children’s and adolescents’ health and wellbeing in the South-East Asia Region.
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The workshop aimed to support countries in the prioritization and acceleration of NCD prevention and management with a specific focus on accelerating the prevention and control of hypertension and diabetes, identifying the most impactful NCD interventions within their context, closing the gaps in ca...ncer care services through regional collaboration and integrating NCD services in when responding to emergencies.
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The WHO Framework Convention on Tobacco Control (WHO FCTC) is an evidence-based treaty that reaffirms the right of all people to the highest standard of health and was developed in response to the globalization of the tobacco epidemic. Member States of the WHO South-East Asia Region have made... attempts to implement the demand and supply reduction strategies for tobacco control as recommended by the treaty. While recognizing the need to accelerate implementation of the WHO FCTC in the Region, this document has been developed to support the Member States in implementing the treaty using a ‘PRACTICAL’ Approach which pertains to identified demand and supply reduction strategies under the treaty.
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The availability of controlled medicines is crucial for patients requiring palliative care, pain relief and symptom management. Many individuals worldwide, especially in low- and middle-income countries, continue to experience limited access to these essential medicines. Enhancing access to controll...ed medicines is paramount in promoting universal health coverage. This report offers a detailed situational analysis of policies and programmes aimed at improving access to affordable, high-quality controlled medicines for pain management in the WHO South-East Asia Region. The report identifies the existing barriers, challenges and possible solutions to facilitate access to such medicines across all Member States.
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This South-East Asia Regional Strategy for Primary Health Care: 2022-2030 aims to accelerate progress in all countries of the Region towards universal health coverage (UHC), health security and the health-related Sustainable Development Goals (SDGs). It is intended to provide Member States with guid...ance on facilitating PHC-orientation through the identification of seven values and 12 strategic actions that collectively embody the philosophy and practice of PHC, enunciated in the 1978 Declaration of Alma-Ata and reaffirmed in the 2018 Declaration of Astana.
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The WHO End TB Strategy aims to end the global TB epidemic by 2030, in alignment with Goal 3 of the United Nations (UN) Sustainable Development Goals (SDGs). Member States of the World Health Organization (WHO) and the UN committed to ending the TB epidemic through adoption of WHO’s End TB Strateg...y and the UN SDGs in 2014 and 2015, respectivel
Almost half of the deaths worldwide caused by TB in 2019 occurred in the WHO South-East Asia Region, home to around a quarter of the global population. Maintaining robust progress in this Region is therefore essential if the global goal of ending the TB epidemic is to be realized. Despite substantial gains made in the Region, the threat to
health worldwide posed by the COVID-19 pandemic has the potential to reverse these gains and eclipse the focus on the global TB emergency.
While continuing to tackle COVID-19-related challenges, countries will need to rapidly and urgently deploy supplementary measures to address the large numbers of missed cases, poor treatment outcomes and, potentially, a higher TB burden.
The Regional Strategic Plan towards Ending TB in the Region 2021–2025 clearly articulates priority interventions, analyses the challenges, bottlenecks and opportunities, and focuses on implementation considerations in the Region.
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The current SEARVAP (South-East Asia regional vaccine action plan) describes a set of regional goals and objectives for immunization and control of vaccine-preventable diseases for 2016 – 2020 and highlights priority actions, targets and indicators that address the specific needs and challenges of... countries in the Region.
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The WHO South-East Asia (SEA) Region bears a high burden of tuberculosis (TB) and MDR-TB. In 2015, the Region accounted for nearly 200 000 or 35% of the global estimated new RR/MDR-TB cases eligible for treatment. Extensively drug-resistant TB (XDRTB) has also been reported from s...ix countries of the SEA Region. MDR-TB could potentially replace drug-susceptible TB, and constitutes a threat to global public health security. The South- East Asia Regional Response Framework for DR-TB 2017–2021 complements the Ending TB in the South-East Asia Region: Regional Strategic Plan 2016–2020” and outlines key strategies for reducing morbidity, mortality and transmission of DR-TB.
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