Last month, STREAM Community Advisory Boards (CABs) from 11 sites in seven countries joined the fifth webinar in the STREAM All-CAB webinar series. The webinar kicked off the STREAM CABs’ “Countdown to Sustainability” series, which aims to ensure STREAM CABs are able to continue their work after the STREAM trial ends. Dr. Fuad Mirazayev, Medical Officer for WHO Global TB Program, also led a discussion of the most recent revision to the World Health Organization (WHO) MDR-TB Guidelines and its impact on future TB research.

This installment of the Countdown to Sustainability series focused on results from CAB self-evaluations exploring the internal and relationship-building aspects of working as community groups.  Future sessions will examine how CABs build institutional relationships, are involved in political issues and policy change, and strengthen their financial viability. 

Natvarlal Pandya (left) and Birendra Kumar (right) at the Community Engagement Workshop in Hyderabad, India

Led by Dr. Ezio Tavora from REDE-TB, CABs shared their experiences of team building within the CAB and how members expect to be involved in future TB research. The Durban CAB highlighted the benefits of CAB member diversity (culturally, politically, and religiously), which permits members to effectively communicate with key decision-makers, including tribal leaders, political members, and government department heads in South Africa. This sentiment was echoed by many other CABs.

Participants also detailed how they will continue to ensure local communities are involved in future TB research. Birendra Kumar, CAB Coordinator at the STREAM site in Delhi, India, stated, “We are exploring how CAB members can further collaborate with government systems and organizations that are creating federal TB advocate networks.” Other CABs reported they are working to recruit the next generation of community advisory board members and creating mentoring programs to educate new members on the roles and responsibilities of CAB members.

Part two of the webinar was led by Dr. Fuad Mirazayev, Medical Officer for WHO Global TB Program, who discussed the most recent WHO treatment recommendations for treating MDR-TB and how they were developed.  He reported that, in its December 2019 Rapid Communication, the WHO announced its most recent change to MDR-TB treatment guidelines, now recommending that most MDR-TB patients receive an all-oral regimen containing bedaquiline. He also explained the WHO guideline development process, and how the WHO’s Guideline Development Group translates evidence into new recommendations and policy.  Updated WHO guidelines that incorporate the Rapid Communication recommendations are expected in April 2020. 

The new recommendations were based in part on South African TB program data, and Dr. Francesca Conradie, a STREAM principal investigator in South Africa, was therefore invited to share her insights on the WHO’s new recommendation.  Dr. Conradie expressed her support for the new guidelines, even though they are based principally on programmatic (rather than clinical trial) data, given the substantial benefits of an all-oral regimen.  However, she agreed that additional clinical trial evidence regarding the all-oral regimen remains necessary to strengthen and confirm the new recommendation.

Dr. Fuad Mirazayev closed by encouraging all STREAM CABs to continuing their participation in the development of future TB treatment guidelines.

Stay tuned for the next All-CAB webinar!

To read more about the STREAM CABs, click here.