tb control through the engagement of community structures · tb control through the engagement of...

International Federationof Red Cross and Red Crescent Societies

TB Control through the Engagement of Community Structures

30 September 2010

Consultation Meeting to Strengthen the Active Engagement of Civil Society Organisations in

the TB work of WHO

Dr. Getachew GizawHIV, TB, Malaria UnitHealth DepartmentIFRC


The Red Cross and Red Crescent Movement

The movement consists of two international humanitarian institutions with headquarters in Geneva and National Societies in 186 countries. The two institutions are the International Committee of the Red Cross (ICRC) and the International Federation of Red Cross and Red Crescent Societies (IFRC). The National Societies comprise most of the more than 97 million Red Cross and Red Crescent workers – the world’s biggest volunteer force.5 Zone offices


RC/RC involvement in TB- historical analysis

1864 – 1900 heavy involvement in war-related

health services (ICRC )

1919 – 1960 – Running health facilities :

• hospitals, health centres, clinics

• Blood transfusion

• Training of nurses and auxiliary staff

1960 - 2000 more actions in areas of public

health interventions – Less on TB

Since 2000 – strong focus on TB

High focuson TB


Prevention

Health EducationIdentifying vulnerableGroups

Case Finding

Diagnosis

and

Treatment

Social care

Adherence monitoring

Psychologicalsupport

Nutritionalsupport

Authorities

Red Cross Red Crescent

Authorities

Red crossRed Crescent

Authorities

Red Cross Red Crescent

Case finding

Follow-upIFRC areas of collaboration with MOH in the

Laboratory and

ReferralsTreatment

Prevention and control of TB


Operational Aims

Fill a gap in Tuberculosis ControlFill a gap in Tuberculosis Control

Target the most vulnerable in the communityTarget the most vulnerable in the community

Provide basic, standardised and targeted quality service to Provide basic, standardised and targeted quality service to as many as possible.as many as possible.

Working in Partnership.Working in Partnership.


Approach

Continuum of care (household to health facility & vice versa)

HBC programme at household level.

Use of empowered community members.

Integration of TB &HIV programmes at service delivery level


Human resources

Core HCWs – Doctors & nurses

Community–based volunteers

Support staff


Who is the target audience of our programmes?

•General public•Community leaders•Civic and cultural institutions•People at workplaces•At risk groups- IDUs, alcohol users, prisoners and ex-prisoners•Current and former TB patients•People infected and affected by HIV•Authorities at Central and Local levels


Programme Performance - Brief Updates:

Budget and involved NSsSince 2003 the Federation, forcountry based programmes hasallocated approximately CHF10 million to save lives andPrevent the spread of TB.

31 Societies in Europe /Central Asia, Southern Africa,East Africa , West Africa ,Asia / Pacific are implementing TBProgrammes.

Main supporters: Donor RC Societies, Eli Lilly, USAID, GFATM

Program deliveries40,000 TB patients are supported on a daily basis

-2000 MDR TB patients among them-13% living with HIV (60-80% in Africa)1200 care providers and volunteers involved500,000 community members targeted annually with TB prevention80-90 % treatment completion rate among clients in IFRC programme


The ACSM – key elements for RC& RC actions

Objectives:

Make the TB epidemic (more) visible at country / district level

Advocate for internationally recommended strategies and policies

Mobilize the community and build its capacity to respond to the TB epidemic

Reach out to the most vulnerable groups and challenge discrimination when it occurs.


Working Together to Stop TB: IFRC is the member of Global Stop TB Partnership. 2004 - 2008 represented in the Coordination Board of the Stop TB Partnership.

IFRC is part of most of Working Groups of Stop TB Partnership.

IFRC part of selection committee of the “Challenge Facility for Civil Society”Initiative of the Stop TB Partnership.

IFRC signed the statement from the Civil Society Organisations during 2007 Ministerial Conference.

During 2006 -2007, the IFRC housed the Stop TB Regional Partnership for Europe and Central Asia

IFRC partners with private sector: member of Lilly MDR TB Partnership, Astra Zeneca

Working closely with WHO based on Global, Regional Partnership Agreements (agreement in Europe was signed in 2008).

Last but not least: our main partners are local / community based, patient based and civil society organisations, as well as Ministries of Health.


Key MessagesAffected communities and those at risk should be in the centre.

Need for fostering IFRC collaboration with WHO and others in:

• planning process

• human resource development process (specifically at

community level)

• service delivery

Closer consultation needed with civil society and private sector

Declarations and outcomes from high level meetings (Berlin,

Beijing) should be translated into actions.

J3

J3 Much better. Could align final bullet with others and say 'But aid unevenly spread'

Need to edit notes down to fit on one printed page. I've found there isn't time to say more than Jono, 2006-09-05


Why is there less engagement in TB since 1960?

Less request for support from MOH

Assumption that governments can handle TB

Earlier magnitude of TB less known/ disclosed

Less advocacy work for resource mobilization,

thus difficult to get funding support

Aggressive advocacy on HIV masked TB

though at later stage helped focus on TB/major OI


What can be done to foster concerted action on TB?

Active evidence based advocacy work to raise

awareness on the importance of addressing TB

MOH must give space for community based actors,

support their engagement & acknowledge work done

Strengthen community based actions in line with

PHC approach

Create strong mechanism for effectively interfacing

community level actions with facility level actions

WHO must leverage engagement of community

based actors & connections with MOH


Thank you

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