Dili, November 14: After two weeks of field visits to health facilities across multiple municipalities, an eight-member TB–HIV Joint Monitoring Mission (JMM) presented its findings to the Ministry of Health in a debriefing on Friday. The findings will help shape strategies to end tuberculosis and HIV as public health threats in Timor-Leste.
Held every three years by the Ministry of Health, with technical support from the World Health Organization (WHO), the JMM assesses how national policies are working on the ground and recommends steps to strengthen services.
During the visit, the expert mission, comprising of members from across the world, observed service delivery, checked whether national guidelines and protocols were being followed consistently, and spoke with health workers, community leaders, key populations and people affected by TB and people living with HIV. It also included interactions with key partners in HIV care - Estrela+, Key Population Association, Maluk Timor, Drop-in Centre etc., and TB care partners such as Bairo Pite Clinic, Klibur Domin, Hamnasa, among others.
In Dili, the team visited the National Health Laboratory and HNGV and met with monitoring focal points of the TB and HIV programmes. Outside Dili, they visited community health centres, laboratories and drop-in centres across Baucau, Aileu, Ainaro and Suai in Covalima.
Dr Arvind Mathur, WHO Representative in Timor-Leste, said the JMM is a crucial exercise because its findings will be translated into concrete actions feeding into the End TB Strategy 2026–2030 and Timor-Leste’s next Global Fund proposal for TB and malaria. “This mission, and the discussions today, are essential to align our plans, resources and partnerships for the next phase,” he said.
“With strong WHO support and national and international experts, we have reviewed our progress and clearly seen the gaps. If we act on these recommendations, more patients will be diagnosed early, families will be protected from catastrophic health costs, and we will move faster towards eliminating TB in line with the Sustainable Development Goals,” said Dr Florindo Pinto Gonzaga, National Director of Disease Prevention and Control.
The mission was led by a distinguished group of experts, including Dr Nicole Seguy (WHO Team Lead for HIV, STI and Hepatitis), Dr Rajat Adhikary (WHO India), Dr Sarabjit Singh Chadha (FIND), Dr Manoj Toshniwal (independent TB expert), Dr Arax (WHO Regional Office Europe), Dr Vineet Bhatia (WHO SEARO), Dr Siva Kumar Shanmugam and Dr Malaisamy Muniyandi from the WHO Collaborating Centre, India.
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The mission identified both key challenges and important improvements. New HIV infections are rising, with a concentrated epidemic among key populations and increasing prevalence among men who have sex with men. Hepatitis B remains prevalent in the general population, and syphilis rates are high among sex workers.
At the same time, there has been progress: antiretroviral therapy (ART) has been decentralised to improve access; most adults on ART have shifted to a one-pill-a-day regimen; TB GeneXpert machines are available across all municipalities; and syphilis testing has strengthened.
Experts recommended targeted interventions to reach “hidden” MSM through virtual networks, closing funding gaps, and stronger collaboration between institutions for consistent HIV messaging.
While TB burden is high, with an estimated 496 cases per 100,000 population, absolute numbers of drug-resistant TB remain low. The treatment success rate is 93% and care is increasingly people centered. The mission noted a strong rationale to expand active case finding and recommended more sustainable domestic financing for the TB response.