VZCZCXRO6009
RR RUEHIK
DE RUEHAH #1400/01 3060938
ZNR UUUUU ZZH
R 020938Z NOV 09
FM AMEMBASSY ASHGABAT
TO RUEHC/SECSTATE WASHDC 3679
INFO RUCNCIS/CIS COLLECTIVE
RUCNMEM/EU MEMBER STATES COLLECTIVE
RUCNCLS/ALL SOUTH AND CENTRAL ASIA COLLECTIVE
RUEHAK/AMEMBASSY ANKARA 5833
RUEHBJ/AMEMBASSY BEIJING 3541
RUEHKO/AMEMBASSY TOKYO 3403
RUEHIT/AMCONSUL ISTANBUL 4075
RHMCSUU/CDR USCENTCOM MACDILL AFB FL
RHEHNSC/NSC WASHDC
RUEAIIA/CIA WASHDC
RHEFDIA/DIA WASHDC
RUEKJCS/JOINT STAFF WASHDC
RUEKJCS/SECDEF WASHDC

UNCLAS SECTION 01 OF 02 ASHGABAT 001400 
 
SIPDIS 
 
SENSITIVE 
 
STATE FOR SCA/CEN, EUR/ACE, F, OES/IHB 
AID/W FOR EE/EA 
 
E.O. 12958: N/A 
TAGS: PGOV PREL EAID EINV TBIO SOCI TX
SUBJECT:  TURKMENISTAN: USAID TUBERCULOSIS CONTROL 
PROGRAM CONCLUDES TEN YEARS OF COOPERATION 
 
REF:  STATE 95569 
 
ASHGABAT 00001400  001.2 OF 002 
 
 
¶1.  (U) Sensitive but unclassified.  Not for public 
Internet. 
 
¶2.  (U) SUMMARY:  On September 10, USAID and its 
implementer, Project HOPE, held a conference to mark the 
completion of their second five-year tuberculosis (TB) 
program.  From 2000 to 2009, this program cooperated with 
the Ministry of Healthcare and Medical Industry of 
Turkmenistan (MOHMIT) to strengthen Turkmenistan's 
National TB Program.  During the course of its work, 
USAID/Project HOPE supported expansion of the TB-Directly 
Observed Treatment Short Course (DOTS) program from a 
pilot stage to a national level. (NOTE: DOTS is the World 
Health Organization (WHO)-recommended approach to treat 
and control TB. END NOTE)  Additionally, the project 
strengthened coordination between specialized TB services 
and primary health care; provided recommendations to 
strengthen TB control and laboratory operations; helped 
develop a logistics management information system (LMIS) 
for TB drugs; and conducted advocacy, communication, and 
social mobilization activities among the Turkmen 
population.  Going forward, activities focused on 
combating multi-drug resistant (MDR) TB will continue 
under a new USAID five-year program, which is currently 
under procurement.  END SUMMARY. 
 
PROJECT PROMOTED NATION-WIDE DOTS ROLLOUT 
 
¶3.  (U) USAID Project HOPE's TB control program worked 
towards three overarching goals: to build political 
support for TB control, to build human and system 
capacity, and to improve community awareness, advocacy, 
and mobilization for TB prevention and treatment. 
USAID's partnership with Project HOPE dates to 2000 when 
it was awarded a regional agreement to support the 
MOHMIT's efforts to implement DOTS.  The DOTS strategy 
was introduced in Turkmenistan in 1999 and initially 
covered only 37% of the country.  Beginning with pilots 
in Ashgabat city that were followed by Mary city in 2003, 
USAID/Project HOPE supported the expansion of DOTS within 
the entire Balkan province from 2006.  With the support 
of USAID and Project HOPE, 100% nationwide DOTS coverage 
was achieved in 2007. 
 
THOUSANDS OF PERSONNEL TRAINED 
 
¶4.  (U) At the national level, USAID/Project Hope trained 
over 2,500 TB and primary health care personnel on the 
components of TB control, established and facilitated 
high level working groups on drug management and social 
mobilization, and assisted the MOHMIT in the development 
of the National TB Program for 2005-2009.  Project HOPE 
and USAID contributed microscopes, reagents, equipment, 
and other supplies for all laboratories throughout the 
country and renovated and equipped a training center at 
the TB Faculty of the State Medical Institute that is 
used to train medical students and retrain of TB doctors 
and family physicians. 
 
TECHNICAL ASSISTANCE COMPONENT 
 
¶5.  (SBU) The project provided technical assistance in 
developing applications for the Global Fund for AIDS, 
Tuberculosis and Malaria (GFATM) and communications with 
the Global Drug Facility (GDF) and other donors/partners. 
Due to USAID/Project HOPE's support on the application, 
Turkmenistan received a GDF grant for supply of first 
line TB drugs to cover the entire country's needs from 
2004-2010.  Turkmenistan has not been successful in 
previous GFATM applications, but its latest application, 
for the GFATM's Round 9, is currently under review. 
(NOTE: Parallel review comments for the Round 9 
 
ASHGABAT 00001400  002.2 OF 002 
 
 
application, were recently provided by post, per Ref A). 
 
¶6.  (U) In Balkan province, the project introduced a 
logistics management information system (LMIS) to ensure 
appropriate needs forecasting and rational use of TB 
drugs.  USAID/Project HOPE also rehabilitated the Balkan 
province TB laboratory and microscopy labs of 5 districts 
in the province.  Since 2000, USAID/Project HOPE sites in 
Balkan province, as well as in Ashgabat and Mary cities, 
helped to raise detection rates by 1.5 times and 
increased the treatment success rates by over 20 percent. 
 
STRONG WORKING RELATIONS WITH GOTX 
 
¶7.  (U) USAID has been able to develop strong working 
relations in the health sector of Turkmenistan due to its 
ability to demonstrate tangible results.  The Press 
Center of the MOHMIT has published articles in state-run 
newspapers highlighting the leading role of USAID/Project 
HOPE in TB prevention and treatment activities on 
numerous occasions.  It is important to build upon these 
relations with future USAID health projects. 
 
¶8.  (SBU) COMMENT:  USAID is currently procuring a new 
five-year regional Health Improvement Project (HIP), 
which will work with the MOHMIT to improve the quality of 
health services delivered, expand laboratories' ability 
to diagnose infections, and introduce and enforce 
stronger infection control measures in health facilities 
to help keep health workers and patients safe.  The 
project will work in maternal and child health, TB, HIV 
and evidence-based medicine areas. In TB, it will address 
further improvement of TB treatment success - with an 
added emphasis on multi-drug resistant TB (MDR-TB). 
 
¶9.  (SBU) COMMENT CONTINUED:  Currently under procurement 
review, this project needs to begin work in Turkmenistan 
soon.  The MOHMIT has requested a draft Memorandum of 
Understanding from USAID so that it can finalize its 
annual workplan for 2010 and ensure appropriate donor 
coordination.  In addition to taking advantage of the 
current goodwill towards USAID health programming among 
the MOHMIT and related structures, there are medical 
considerations to take into account as well.  A long gap 
between USAID health programs could lead to a shortage of 
medications and quality services for TB patients in 
Turkmenistan.  With the growing prevalence of MDR-TB, a 
form of TB which cannot be treated with a standard course 
of antibiotics, even a short gap between programs will be 
detrimental to TB treatment and control efforts.  END 
COMMENT. 
 
CURRAN