Conquering TB is everybody's business

Tuberculosis (TB) is still the most common opportunistic infection and cause of death among people living with HIV. While TB is curable and HIV is treatable, too often people do not access services quickly enough. More has to be done to fight these two diseases, and community organisations have an important role to play.

Delegates are preparing to meet in Paris at the end of this month for the 44th Union World Conference on Lung Health. There they will discuss the latest research and programme developments in tuberculosis (TB) and lung disease.

Present will be Zahedul Islam, Alliance Ukraine’s director responsible for HIV and TB integration programmes. He will present details of Alliance Ukraine’s transition from being an HIV-focused organisation, to one that now integrates TB programming alongside its HIV work – something he says has not come about quickly or easily:

“Tuberculosis is an acute and complex problem for people living with HIV in Ukraine. Sufficient time and a holistic approach are needed for TB service integration, which we pioneered back in 2004 under our Global Fund Round 1 programme.

Once it was made a strategic approach, momentum grew. We pursued partnerships and funding in order to be able to provide direct services, and played a significant role in catalyzing the active participation of civil society in HIV and TB service integration.”

However, there is still much to be done. By the end of 2012, only 54.8% of those with both TB and HIV had received treatment for both infections.

The role of community organisationsGiven their vital role in strengthening formal health systems, there is an urgent need for other HIV focused community-based organisations to actively engage in providing TB services.

Dr Gitau Mburu, senior advisor on health systems and services, says: “Community-based organisations are a vastly under-utilised resource that can help take the fight against TB to the next level. However, most do not know how to start TB programming, and many national TB programmes do not have experience of working effectively with community groups.”

A new resource

To help tackle this need, the Alliance – in collaboration with PATH – produced a new Good Practice Guide on Community-based TB and HIV integration. It draws on the expansive global experience of both organisations in order to provide guiding principles and practical steps to integrate TB into HIV programming.

Dr Mburu (co-author of the Guide) explains: “The resource is filled with the direct experiences of community-based HIV service organisations (such as Alliance Ukraine) around TB advocacy, communications, social mobilisation and service delivery. It is a practical, hands-on tool any organisation can use to plan and implement effective TB and HIV activities.”

The Guide also offers sensible advice on how community-based organisations can work collaboratively with national TB programmes in their own countries.

Drawing on the global experience of the Alliance

The Alliance is present in 15 of the 22 high burden TB countries. It is an active contributor to global TB policy through the work and experience of its partners across the globe. We are a member of the TB and HIV working group of the STOP TB partnership, and an active participant in the TB TEAM, the technical support mechanism for Stop TB partnership. The Alliance also provides general technical support through its Regional Technical Support Hubs.

An end to TB in our lifetime

Alongside our civil society partners, we advocate for additional funding for TB and HIV programming at the global level. Just last week, we applauded the UK government’s announcement that it would provide $1bn to the Global Fund to Fight AIDS, Tuberculosis and Malaria. This followed many years of joint work with others across the UK and internationally and will allow the Global Fund to deliver its full potential of bringing these three diseases under control.

As the foreword* in the Good Practice Guide says: “We want to end TB in our lifetime. We know it’s possible if we all work together towards this common goal.”

* By Dr Lucica Ditiu (Stop TB Partnership), Dr Frank A Bonsu (National TB Control Programme, Ghana) and Ms Carol Nawina Nyirenda (Community Initiative for TB, HIV/AIDS and Malaria, Zambia)