Table 2– The World Health Organization (WHO) policy implementation package for rational introduction of new tuberculosis (TB) drugs
Minimum requirements for country preparedness and planningA set of basic health and programmatic capacities must be in place at the country level for the optimal introduction and implementation of a new TB drug or drug regimen according to WHO policy recommendations
Development of an implementation plan for introduction of new TB drugs or regimensThis national implementation plan must take into account the various operational models for introduction of new TB drugs or regimens, depending on the TB epidemics situation and level of preparedness in a country, and the type of drug or regimen of drugs to be introduced
Monitoring and evaluation of new drugs and regimens, including pharmacovigilance and drug resistance surveillanceIntroduction of new TB drugs or regimens requires careful monitoring of safety (particularly if drugs are being introduced following phase IIb trials), based on active pharmacovigilance, and of drug resistance.
Private sector engagementIntroduction of new TB drugs requires a set of best practice regulations from the local ministry of health to provide rational access and protection of new drugs, particularly in the context of substantial involvement of the private sector in TB care
Systems approach for ensuring uninterrupted supply of new and existing quality-assured medicinesThis describes the need for a clearly established procurement and supply chain management system at country level
Operational researchCan assist in the implementation and scale-up processes and help support evaluation of public health impact, through the collection of relevant information to measure feasibility, cost-effectiveness, acceptability and impact of the new drugs or regimens