World TB Day 2014: Reaching the 3 Million

World TB Day 2014: Reaching the 3 Million

{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.

Thanks to effective detection, they were able to begin treatment immediately. Now both Azmara and Feseha are stable and in good health.

[Azmara and her son were found to have MDR-TB. Both are receiving treatment and in good health.] {Photo credit: Mr. Kinde Alamir/MSH Ethiopia}Azmara and her son were found to have MDR-TB. Both are receiving treatment and in good health.Photo credit: Mr. Kinde Alamir/MSH Ethiopia

The theme for this year’s World TB Day is reaching the 3 million–the number of people who are missed by efforts to find, treat and cure TB each year. The only way to reach the 3 million people is to go to where they are, find them in their communities, and help them gain access to life-saving care and treatment.

At MSH, we put people at the center of TB control efforts—building their capacity to manage TB efficiently and reaching those who are most vulnerable to TB. We expand and strengthen TB care and treatment, manage drug resistant TB, integrate TB and HIV care and treatment, improve pharmaceutical management and strengthen laboratory systems, and build human resources. We work with health leaders, train health workers, and improve detection, care, and control processes at all levels of the health system in over 30 countries to improve the lives of those affected by TB and prevent the spread of the disease.

In Ethiopia, health workers have referred more than 22,800 persons with presumptive TB to health centers with support from the HEAL TB program. Over 1,500 persons with presumptive MDR-TB have been tested, and over 200 like Azmara have been started on treatment.

In Afghanistan, MSH works with local leaders and health facility staff to expand TB services in densely populated areas. Between 2009 and 2013, the number of health facilities in Kabul using urban DOTS grew from 22 to  73, and health worker trainings helped to increase the number of TB cases identified from 1,934 to 3,215.

Similarly, in the Eastern Region of Ghana, the use of standard operating procedures for TB case detection at six hospitals resulted in a 46 percent increase in case detection in just one year.

Another way we’re reaching the 3 million is through the corner store (the "duka"). In Tanzania, community medicine shops (also referred to as accredited drug dispensing outlets or ADDOs) often serve as the first point of contact for people seeking care. MSH empowers shop owners and drug dispensers to offer safe, quality medicines, and to provide referrals to health facilities.

Accredited community medicine shops play an important role in identifying potential TB patients. Shop owners and medicine dispensers are trained to recognize the signs and symptoms of TB, and to refer people with these signs and symptoms for testing and treatment. Learn more about how community medicine shops are helping to reach the 3 million with support from the Systems for Improved Access to Pharmaceuticals and Services (SIAPS) program:

Today, on World TB Day, we recognize the global progress that’s been made in the fight against TB. We know that there is more to be done for those who still need to be reached. In 2012, 8.6 million people got sick with TB—and a third of them were missed by health systems. That’s three million reasons why our efforts to improve TB case detection, diagnosis and treatment are more important than ever. Today, we recommit to reaching the three million, and to stopping TB.

Here are some things you can do to help:

And join the World TB Day conversation on Twitter with " href="">, " href="">, " href=""> and more with hashtags , , and .

Chelsey Canavan, a research and communications specialist at MSH, and Andre Zagorski, principal technical advisor for SIAPS, contributed to this content.

Pedro Suarez, MD, is the MSH global technical lead on tuberculosis.