Forging Alliances Is Crucial to Fighting Tuberculosis

Today’s guest Blogger is Dr. Lasha Goguadze, Senior Health Officer, Global Tuberculosis Programme, International Federation of the Red Cross and Red Crescent Societies. He is based in Geneva.

On World TB Day, the world focuses on what yet needs to be done to stop this dreaded disease.  Equally important is taking stock of what has worked already in order to accelerate momentum.  At IFRC, it is clear that alliances, partnerships, and collaborations are more than ‘nice-to-haves.’ These represent a fundamental ‘must’ to achieving our objectives.

Before sharing our experience, let me describe the challenge:  TB remains the leading cause of death from an infectious disease together with HIV. Each year new cases of TB amount to 9 million while claiming 1.5 million lives – despite being preventable and curable!

Everybody is potentially at risk: one third of the world’s population already harbors the TB bacillus; of these, one in ten people will become ill with TB during their lifetime. This, in turn, ‘translates’ into an estimated 9 million new cases of TB every year, worldwide. But it is the vulnerable groups like poor, people living with HIV, drug users, sex workers, migrant populations, children, women and prison inmates who are disproportionately affected. According to the Stop TB Partnership, three million (out of the 9 million) are ‘missed’ – that is, they do not have access to diagnosis and treatment. Three million!  Add multidrug-resistant TB (MDR-TB) to the challenge and then it is clear that we need to act to stop this global epidemic

By far most cases of MDR-TB, which is significantly harder and more expensive to cure, are usually found in areas with least equipped to effectively handle this disease. Too often in these areas, people suffering from TB/MDR-TB either do not seek or stop treatment early for different reasons – some must travel long distances in order to access care, miss work, and lose  income. Others discontinue treatment when they begin to feel better and think it is no longer needed. For others, it is the side effects or difficulty of maintaining the routine in the midst of other problems — unemployment, addiction and lack of food.

So how can we overcome these challenges? First, the good news is that significant progress has already been made.  According to WHO, between 2000 and 2013, 37 million lives were saved through effective diagnosis and treatment of TB. During the same period, incidence rates fell by 1.5 percent annually. Despite these gains, TB remains a challenge.  So what is needed to further turn the tide?  I believe alliances are key to closing the gap between who does and does not have access to care. Well-crafted partnerships can help collectively raise awareness, ensure access to TB care and support, and provide often much-needed TB training to community health workers including Red Cross and Red Crescent volunteers and others.

The IFRC, including our National Red Cross and Red Crescent Societies volunteers, works with collaborations like the Lilly MDR-TB Partnership to achieve these goals. This alliance of international, national and local organizations from the public and private sectors aligns around key TB gaps in MDR-TB ‘hot spots.’ Each organization brings its own expertise to a common effort in hard-hit areas.  However, as mentioned, TB is a global issue – everybody is at risk. 

So, to ensure the work of these partnerships is translatable to other areas, communication and sharing of best practices are critical. In the Lilly example, this means: Research new models of care together, Report the findings and impact of the collaborative work, and then Advocate for broader adoption of proven practices by governments’ health systems.

The global TB community has made important progress since 2000, but on World TB Day 2015, much more collaborative work is needed to achieve equitable access to TB care. This requires forging partnerships within the health sector and beyond. TB can be ended by broadening the spectrum of partners’ engagement within the health sector (HIV and AIDS, nutrition, substance abuse, diabetes etc.) as well as by expanding alliances to include social development, urban planning and the private sector. Through the Lilly MDR-TB Partnership and other alliances, IFRC has been able to leverage its in-country presence and scale up its community-based programmes to fight MDR-TB in high burden countries. 

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