World TB Day

{Photo Credit: Rui Pires}Photo Credit: Rui Pires

Tuberculosis (TB) kills more people each year than any other infectious disease. It severely strains health systems and local, regional, and national economies. And, like many health crises, the disease disproportionately affects vulnerable populations. Many families incur catastrophic costs, aggravating poverty in communities.

This World TB Day, we reflect on the progress we've made and the challenges we still face in the fight to end TB. The key moving forward is to work together to ensure we don't leave anyone behind.

VIDEO: Working to End TB in Uganda

“We have the medicines that actually cure tuberculosis,” said Raymond Byaruhanga, project director for the USAID-funded, MSH-led TRACK TB project in Uganda. “So the question is why? Why [do we still see] TB today, and why isn’t it being treated?”

In 2015, TB caused 1.8 million deaths around the world, and another 10 million people fell ill from the disease, according to the World Health Organization (WHO). Women and children are particularly vulnerable. TB causes between 6 and 15 percent of all maternal deaths, and childhood TB is too often not detected, diagnosed, or treated.

{Photo Credit: Warren Zelman}Photo Credit: Warren Zelman

MSH will host and support events in five countries this week to honor World TB Day.

Observed March 24, World TB Day raises awareness and mobilizes support for efforts around the world working to end tuberculosis (TB). The World Health Organization (WHO) has designated this year’s theme as “Unite to End TB: Leave No One Behind,” and many of the day’s activities will focus on addressing stigma, discrimination, and marginalization.

MSH has been a leader in strengthening health systems to fight against TB since 1999 and is working with partners in 22 countries to prevent the spread of the disease and improve the lives of those affected by it.

In Afghanistan, the Challenge TB project — funded by USAID  — will lead 20 awareness events in five cities and will deliver messaging about TB in schools and health facilities. The project will also lead conferences in three provinces, focusing on successful interventions like Urban Directly Observed Treatment and the TB Information System.

The Challenge TB project will also lead World TB Day activities in 11 districts in Bangladesh, ranging from orientations and discussions with workers, to programs at schools, to rallies, to a “sputum collection camp” at an outreach center.

{Photo credit: Warren Zelman}Photo credit: Warren Zelman

Tuberculosis (TB) claims a life every 15 seconds; it is the single largest infectious killer and is universally recognized as a global epidemic. Nearly 200 children die every day of TB.

The challenges of tackling TB are well known, particularly in settings with limited resources, crowded urban environments, and among high risk groups including people living with HIV, prisoners, and children. The emergence of multidrug resistant strains of the disease (MDR-TB), the result of incomplete or poor managed TB treatment, present further obstacles and add exponential costs to already burdened health systems. Furthermore, challenges with access to, affordability, and proper use of pharmaceuticals and laboratory materials can have devastating consequences on diagnosis and treatment.

The key to ending TB is to work together to strengthen health systems in high TB-burden countries to be able to effectively implement both proven and innovative strategies. Four approaches will help save lives by uniting stakeholders to collaborate, innovate, and end TB:

 {Photo credit: MSH Ethiopia}Atsede Tefera recalls three months of long delays in the diagnosis of tuberculosis for her daughter Nigist, who was eventually able to initiate treatment.Photo credit: MSH Ethiopia

When my daughter got sick, I took her to a clinic in my neighborhood. They gave her cough syrup for seven days.

I thought she was getting better, but it was apparent that she was still ill. After another examination, they referred her to St. Paul Hospital in Addis Ababa where they put her on oxygen and started taking blood sample after sample and injection after injection for a month. Her condition did not get better so they gave her another medicine. The doctors then decided to take blood from her back… only then did they know it was tuberculosis.

~ Atsede Tefera

Tuberculosis (TB) kills more people each year than any other infectious disease, causing over 1.5 million deaths globally. More than a quarter of cases are in Africa, the region with the highest burden of TB disease relative to population. Children are amongst the most vulnerable, and all too often children with TB remain in the shadows, undiagnosed, uncounted, and untreated. Today, more than 53 million children worldwide are infected with TB and over 400 die each day from this preventable and curable disease. 

{Photo credit: MSH staff/Afghanistan}Photo credit: MSH staff/Afghanistan

“I started feeling this coughing… so I went to the health center and got tested. It was positive for TB,” says Grace*, a young Ugandan woman. She started on medicines, but after two months, she stopped adhering to treatment.

They told me to continue with the drugs for five more months, but I stopped.

I thought I was ok.

She started coughing again, went to the hospital, and was diagnosed with multidrug-resistant TB (MDR-TB). MDR-TB cannot be treated with two of the most powerful first-line treatment anti-TB drugs. Her treatment regimen? Six months of injections and two years of drugs.

{Photo credit: Warren Zelman.}Photo credit: Warren Zelman.

Azmara Ashenafi, a 35-year-old woman from the Amhara region of Ethiopia, was diagnosed with tuberculosis (TB) and placed on treatment. She was fortunate. Many people with TB are missed by health systems altogether. But Azmara’a treatment wasn’t helping. Despite taking medicine for months, her symptoms persisted and became more severe.

In many places, her story would have a sad ending—TB is one of the top three leading causes of death for women 15 to 44 in low- and middle-income countries.

But Azmara went to the Muja Health Center—one of over 1,600 supported by USAID's Help Ethiopia Address Low TB Performance (HEAL TB) program, and where MSH has been training health workers to screen patients for multidrug-resistant TB (MDR-TB).

MDR-TB cannot be treated with the two most potent first line anti-TB drugs and infects 6,000 Ethiopians each year. To help curb the spread of the disease, health workers learn how to screen people in close contact with MDR-TB patients. All of Azmara’s family members were tested and both she and her three year old son Feseha were found to have MDR-TB.

 {Photo credit: MSH staff.}Dr. Jamie Tonsing, TB CARE I Project Director, preparing to release of balloons with the TB health education messages during 2013 WTD celebrations in Phnom Penh, Cambodia.Photo credit: MSH staff.

MSH staff are commemorating World TB Day through awareness-raising activities around the globe, including in Afghanistan, Cambodia, Ethiopia, Ghana, Indonesia, and Nigeria. Here are photos (some from 2013) with activities this year.

Afghanistan - TB CARE I

During this year’s World Tuberculosis Day (WTD) celebration in Afghanistan, MSH’s TB CARE I project team will reach more than 21,000 individuals with tuberculosis (TB) advocacy and awareness activities. The project staff plans to distribute over 8,530 banners, notebooks, and posters on TB control to politicians, health workers, and community members. Additionally, the TB CARE I Afghanistan team will travel to the 13 project-supported provinces to help field-based staff plan and facilitate WTD celebrations at health centers in their communities. The project staff will also support staff from the National TB Program (NTP) and other stakeholders in planning and participating in WTD celebrations at 26 schools and 600 and communities.

{Photo credit: KNCV/TB CARE I}Photo credit: KNCV/TB CARE I

TB CARE I Indonesia, The Global Fund to Fight AIDS, Tuberculosis and Malaria, and Indonesia’s National TB Program (NTP) organized a mass-mobilization World TB Day event on March 24, 2013, called "Run 4 TB".

This 5K race drew thousands of runners, bikers, walkers, and observers.

(Photo credits: KNCV/TB CARE I)

Voice of America Interviews Dr. Stephen Macharia: On Tuberculosis in South Sudan (Audio).Voice of America Interviews Dr. Stephen Macharia: On Tuberculosis in South Sudan (Audio).

On the eve of World Tuberculosis Day, Voice of America interviewed Dr. Stephen Macharia, the TB CARE I country director for South Sudan.

During the interview (transcript, PDF), Dr. Macharia discussed the TB epidemic in South Sudan, TB CARE I project achievements, and the way forward for improving funding for TB services and multi-drug resistant TB (MDR-TB) control in fragile states, like South Sudan.

TB CARE I is a USAID-funded project, led by KNCV TB Foundation with partners, including Management Sciences for Health.

Voice of America, the official external broadcast institution of the United States federal government, produces nearly 1,500 hours of news and programs each week for an estimated global audience of 123 million people.

{Photo credit: Katy Doyle / MSH.}Photo credit: Katy Doyle / MSH.

Stop TB in my lifetime.

This global call to action---the Stop TB Partnership's theme for March 24, World TB Day 2013---is as relevant now as it was over a hundred years ago.

Progress toward reducing the global burden of tuberculosis (TB) has been impressive in recent years: TB mortality has fallen by 41 percent since 1990.

Yet, TB remains one of the world’s leading causes of death, killing more than 1.4 million people per year, including 70,000 children. In 2011, 600,000 people died of TB in Africa alone---including many people with HIV.

Low detection rates, new strains of multidrug resistant TB (MDR-TB), high prevalence of HIV/TB co-infection, and risk of TB among diabetes patients---nearly 10 percent of TB cases are linked to diabetes, add to the challenge of TB control, especially among the poor and most vulnerable.

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