We Are Stopping TB

Commonly overlooked in a world where modern diseases remain at the forefront, tuberculosis (TB) claims four lives every minute. With its reemergence in the past few decades, it is now considered a pandemic emergency.

The fight against TB is among MSH’s highest priorities. As a member of USAID’s Tuberculosis Control Assistance Program (TB CAP), the STOP TB Partnership, and the Global Fund, MSH works worldwide to ensure access to early case finding, diagnosis, and treatment. We provide technical leadership, training, and tools. And, by strengthening the capacity of health systems and TB service providers and program managers, MSH improves the lives of people affected by TB.

TB CAP in Malawi offers a window into how MSH is helping to improve lives. Malawi’s struggle with infectious diseases has taken a major toll on its economy and society. Complications are compounded because many who are diagnosed with HIV & AIDS are also susceptible to TB.

In close collaboration with Malawi’s National Tuberculosis Program, guidance from the USAID/Malawi Mission, and with our implementing partners (WHO, KNCV, FHI, and CDC), we are:

• developing a model of comprehensive integrated TB and HIV care, by ensuring that all levels of the health care system—individuals, families, and communities—are receiving the care and information they need to lead healthier lives, free of stigma and isolation;
   
• increasing access to TB diagnosis and treatment through the decentralization of laboratory services to selected health centers and developing standards and training staff to support this effort;
   
• improving the role of public providers in preventing, diagnosing, and treating TB, especially regarding high rates of TB/HIV co-infection; and
   
• developing a human resource development strategic plan for the TB program and supporting the implementation in pilot sites to improve supervision of integrated TB and HIV services.

The case detection rate (all cases) in the project target districts increased from 22% in 2006 to 29% in 2007, despite a reduction in the case detection rate at the national level. And the case detection rate (TB pulmonary sputum smear positive) picked up from 20% in 2006 to 27% in 2007. Improved case detection rates mean earlier treatment and improved chances of preventing further spread of the disease.

Similar successes are seen in MSH's work in the Dominican Republic, particularly around the TB drug supply system and drug treatment costs. The devaluation of the national currency and management issues led to a 384% increase ($32 to $155 per patient) in cost of TB treatments in only one year (2004-2005). By offering an alternative pharmaceutical procurement program, MSH and USAID saved $775,000. More significant, new-patient treatment costs were reduced to $20 per capital and retreatment costs to $40 per capital, reflecting prices significantly lower prior to the currency devaluation.