World Tuberculosis Day: We Can Stop TB

It has been over six decades since tuberculosis (TB) was deemed a treatable and curable disease. Yet it still remains one of the leading causes of death across the world, killing more than 1.5 million people per year. Despite myths about its danger, misinformation about its breadth, and ignorance about its true burden on the world’s population, TB remains one of the deadliest epidemics in the world. From low detection rates to drug-resistant strains to the continued threat of co-infection with HIV, we need to recognize just how important this fight is. World Tuberculosis Day, observed on March 24, is one giant step in the right direction. Falling under this year’s theme of I am Stopping TB, the event marks the commitment of all those who are contributing to ending this disease. Management Sciences for Health (MSH) continues to play a critical role in the successes achieved thus far. Working in more than 30 countries across four continents, MSH programs are building technical and management systems to improve TB detection, diagnosis, and treatment; working with national TB programs to mobilize communities to prevent and control TB and reduce stigma and discrimination; promoting collaboration between TB and HIV & AIDS programs; improving laboratory systems and TB drug management; and providing technical assistance at the national, regional, and local levels. The USAID-funded Tuberculosis Control and Assistance Program (TB CAP) aims to decrease morbidity and mortality by increasing case detection and treatment success of [A group of community volunteers manning a sputum collection point with support from USG through TBCAP welcoming visitors from NTP and TBCAP who went to learn more about community based TB control activities. Photo by MSH staff.]A group of community volunteers manning a sputum collection point with support from USG through TBCAP welcoming visitors from NTP and TBCAP who went to learn more about community based TB control activities. Photo by MSH staff.pulmonary TB patients in USAID priority countries. Working with organizations such as the Royal Netherlands Chemical Society KNCV, the International Union Against Tuberculosis and Lung Disease, the World Health Organization, and the Centers for Disease Control, MSH provides technical assistance in areas such as TB control, pharmaceutical management, and laboratory strengthening. MSH is leading TB CAP efforts in Afghanistan, Ghana, and Malawi, while also working in 12 other countries. In Ghana, TB CAP developed a five-year strategic plan in collaboration with the national TB program. This comprehensive and innovative plan has been so well received in Ghana that the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) will be making funding decisions based on it. In addition, TB case notification in the country has increased by nearly 10 percent since TB CAP support to the national TB program began in 2008. In Malawi, working at the local level to improve patient care and health facility management, TB CAP is also incorporating nontraditional health care providers in their program to improve TB case detection rates and ultimately promote TB control. A traditional heale[A pharmacist in Ethiopia conducts practical training sessions of TB microscopy and external quality assurance (EQA) to produce new certified officers. Photo by Challa Negeri.]A pharmacist in Ethiopia conducts practical training sessions of TB microscopy and external quality assurance (EQA) to produce new certified officers. Photo by Challa Negeri.r in one of the program’s communities, for example, has recognized this new effort and begun to operate a sputum collection point at her herbal clinic, where she also provides disease screening and important information about TB. As a result of these efforts, inpatient death rates in two district hospitals in Malawi where MSH/TB CAP is working have fallen from 16.5 percent to 4.4 percent (2007-08). TB CAP’s effect can also be seen inside the laboratory. The program has trained numerous participants across 34 health facilities in Ethiopia on the newly developed national curriculum for acid fast bacilli (AFB) microscopy, a critical part of the TB drug management system recently implemented across the country. And working with MSH’s HIV/AIDS Care and Support Program (HCSP), staff have trained over 400 health care workers, leading to an HIV testing acceptance rate of 92 percent (compared to 34 percent previously) among TB patients. Microbiologist Paulos Reji recalls having difficulty visiting health centers and collecting slide samples. But, he says, “TBCAP has come into the picture at the right time, not only at the national level, but also at the facility level. I am glad that I am part of the first batch of trainers on the new national TB drug management system and ensure an uninterrupted drug supply for TB patients.” MSH specifically addresses commodity management and inventory control issues in laboratories in Ethiopia and other countries and has developed an electronic tool for laboratory commodity management and another tool to quantify TB laboratory supplies.

Worl[World TB Day in Afghanistan. Photo by MSH staff.]World TB Day in Afghanistan. Photo by MSH staff.d TB Day in AfghanistanThe TB CAP program in Afghanistan did its part for World TB Day by organizing the celebration of the event across 13 USAID-supported provinces. The activity was coordinated with WHO and the Stop TB Partnership, the Ministry of Education, Ministry of Culture and Information, Ministry of Haj, Ministry of Women’s Affairs, the National Congress, Provincial Congress, Parliament, and media organizations at the central and provincial levels. The provinces mobilized more than 150,000 children through marches, stage dramas, competitions, and football games. The aim of these efforts was to raise public awareness about TB prevention, care, and treatment in a country with one of the highest prevalence rates in the world—nearly 300 out of every 100,000 are burdened with the disease.

MSH is also committed to expanding pharmaceutical management of TB, specifically dealing with multidrug-resistant TB and increasing the use of DOTS, directly observed treatment. The Strengthening Pharmaceutical Systems (SPS) Program works in TB management in 10 countries and acts as a consultant to the Global TB Alliance in 19 nations. Programs like TB CAP and SPS have positioned MSH to be in the forefront of the global TB fight. By empowering people and communities across the world to ensure better TB prevention, care, and treatment, MSH is stopping TB. For more information about World TB Day, please visit the Stop TB Partnership website at http://www.stoptb.org/events/world_tb_day/2009/.

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