Meaningful community participation to end TB

Nenet L Ortega, CNS Special Correspondent
Photo credit: Nenet Ortega/CNS
The theme for this year’s  45th Union World Conference on Lung Health, taking place in Barcelona, Spain, is focused on community driven solutions to address health challenges of the next generation. According to Jose Luis Castro, the Executive Director of the International Union Against Tuberculosis and Lung Disease (The Union), the conference  calls on everyone to  explore  the need of generating  health solutions that would address  health challenges  involving the different  stakeholders, policy makers and, most especially, the  people in the communities being served.

During the Global TB Symposium organized by the WHO, the Health Minister of India Dr Hashavardhan stated that governments should think about developing bold and ambitious strategies to address and put an to end to TB and this can only be done by having a strong collective partnership with civil society organizations (CSOs), people who are living with the disease, including TB survivors, international NGOs, and the private sector.

Ambassador Eric Goosby, Chair of the WHO Global TB/HIV Working Group on the other hand emphasized that partnerships and resources are available. There are engagement models that have been tested and proven and utilized in different health programmes, such as maternal and child care and HIV. It is only a matter of integrating and linking them to TB. TB communities that exist at local levels need to realize that they are part of a larger health dialogue, and that there is a need for them to align with National TB Programmes (NTPs) and other stakeholders, and piggy back on existing programmes to at least create demand and eventually link people most at risk of getting TB infection to local health services.

Highlighting community driven practices in addressing multidrug-resistant tuberculosis (MDR-TB), the European region shared their experiences.  Civil Society organizations are the drivers of community responses and solutions. In the European region, CSOs have played a key role in providing TB care by complementing NTPs in case detection and patient support. This pivotal and operational role of the CSOs was able to bring about structural changes in the way TB programmes were managed at the local levels in this region. CSO engagement has lead to the improvement in policy support for MDR-TB and drug-sensitive TB and resource mobilization.

As the saying goes, “no one can do it alone”, the government of Kazakhstan provided financial support to CSOs in order to run peer support initiatives and treatment groups aimed at treatment adherence by all TB patients until they were declared cured. 

In Armenia, Ukraine and Azerbaijan, CSOs are provided with non- financial support like access to skills and capacity building and information sharing and updates on latest development about TB/ MDR-TB.  Belarus is considering social procurement by CSOs working on MDR-TB. Joint activities between Ministry of Health and CSO is another example of community driven solution that is happening in Tajikistan.  CSOs there have been invited by the government to take part in development of the country’s annual operations plan to make sure that community tasks and activities are integrated and are funded. In Bulgaria, CSOs have been commissioned by their government to increase demand for TB services through community awareness and education and provision of care and support to TB patients enrolled in treatment.

However there are several concerns related to CSOs engagement too, like who will continue providing funds to sustain the existing efforts that have been bringing clients to diagnostic and treatment center; what are the target indicators for NTPs and governments on CSO engagement and community driven solutions?

These few small strides made by CSOs contributing to national and regional accomplishments are just the beginning of a meaningful and lasting engagement. National governments in the region still have to realize that they need to institute and establish inclusive national platforms and policies that will meaningfully recognize, include and engage CSOs in bringing about community driven solutions to end TB.

But there is hope, according to UK Parliamentarian Nick Herbert. Speaking at the WHO Global TB Symposium, he asserted that political will from governments is a must. It is very is crucial for CSOs to make a powerful call and expression of interest to work together  with governments to end TB. This action will push governments and ministers to support the need to make bolder and more effective actions to end TB.

Nenet L Ortega, Citizen News Service - CNS
29 October 2014
(WHO Global Tuberculosis Programme is supporting onsite CNS Correspondents Team's coverage of the Global TB Symposium organized around the 45th Union World Conference on Lung Health in Barcelona, Spain. Email: