By-Liner
U.S. Renews Pledge to Stop Tuberculosis
March 24, 2009
By: Larry André
Despite recent progress, Tuberculosis (TB) remains a massive global public health problem, with over 9 million new cases and more than 1.6 million deaths each year. Along with HIV/AIDS and Malaria, TB is one of the three leading causes of deaths worldwide due to infectious diseases. About ten percent of TB patients are also co-infected with HIV, and TB is the leading cause of death for AIDS patients. This is why the World Health Organization (WHO) recognizes World Tuberculosis Day on March 24th to call attention to the disease and to mobilize action to combat TB. The American people are committed to working in partnership with the people of Tanzania to fight this terrible disease.
TB is not just a public health challenge but it is also a development problem as it strikes people during their most economically productive years. TB not only takes an enormous personal toll, it also places a tremendous economic burden on families, communities, and countries. While TB treatment is often free, diagnosis, laboratory charges, transport, food and other costs can account for 8-20% of annual household income for TB patients, according to a study recently released by the World Bank.
Although a cure for TB has existed for more than half a century, the disease is often diagnosed late, treated improperly or not treated at all leading to transmission in the community and death. Unfortunately, the most vulnerable people have the greatest difficulties in accessing good quality care. TB is both a disease of poverty and a contributor to poverty, and it takes a tremendous toll especially on poor families in developing countries.
The United States is on the frontlines of the battle against TB, with the American people supporting TB programs in over 40 countries, including Tanzania. In collaboration with national TB programs, the U.S. Government works to improve the quality of basic TB programs or DOTS (Directly Observed Therapy, Short Course) services; upgrade laboratory infrastructure; build a foundation to introduce new diagnostic technologies; and work with WHO and other partners to conduct drug resistance surveys and surveillance.
Tanzania ranks 14th on the list of 22 high-burden tuberculosis (TB) countries in the world with an estimated 120,000 new TB cases annually since 2004. Thanks to improved quality of services and evaluation, treatment success has slowly increased toward the World Health Organization (WHO) global target of 85 percent. While diagnosis of new TB cases has improved, the case detection rate for new TB cases in Tanzania remains low at 46 percent--well below the global target of 70 percent.
The HIV/AIDS epidemic is associated with a 60 percent increase in active TB in Tanzania and half of all new adult TB patients are HIV-positive. Plans to expand treatment to HIV-positive TB patients will reduce the death rate, and improved TB reporting systems will help to ensure follow-up and reduce patient default rates.
In 2005, the American people began supporting activities to help Tanzania in the battle against TB as part of our long-term commitment to improving the health of Tanzanian communities. This support is designed to strengthen human resource capacity, introduce and scale-up TB-HIV/AIDS integrated activities, promote community awareness of TB and TB-HIV co-infection, and mobilize communities to reduce stigma. In Tanzania, 570 sites across fourteen regions have received support from the American people in the past year alone to provide TB-HIV/AIDS services.
To achieve these goals, we are focused on the following activities:
Support the National HIV/AIDS control program and National TB/LP Program to coordinate and improve TB/HIV collaborative activities
Introduce new technologies and data management systems in laboratories to improve TB and Multi-drug resistant TB (MDR-TB) diagnostic capabilities, especially for the Central Tuberculosis Reference Laboratory
Develop multimedia information and educational materials for TB awareness and social change
Reduce stigma and disseminate TB counseling materials
Engage communities in TB control by training private pharmacists, traditional healers, and village health workers in suspect TB identification and supporting TB diagnostic capacity within communities
Strengthen referral systems between existing TB-HIV/AIDS treatment programs and increase the number of TB patients tested for HIV
Strengthen DOTS skills and increase collaboration of providers in both the private and public sectors
Increase national capacity to manage MDR-TB
The American people are providing well over $10 million to fight TB in Tanzania this fiscal year through the United States Agency for International Development (USAID), the U.S. Centers for Disease Control (CDC) and multilateral donors including the Global Fund.
Some successes achieved as a result include:
Formed the National Interim TB-HIV/AIDS Collaborative Committee and developed a draft national policy for TB/HIV/AIDS collaborative activities
Over 30,000 TB clients were counseled tested and received results and15,400 care and treatment clients received TB treatment the past year
Expanded TB-HIV/AIDS collaborative activities and recruited TB-HIV/AIDS collaboration coordinators
Supported the review of public and private professional health education institutions’ training to incorporate TB components
Implemented initial social mobilization activities with the media and Community-Own Resource Persons (CORPS)
Engaged the Association of Private Health Facilities in Tanzania (APHFTA) and supported a coordinated response from the public and private sectors for TB-HIV/AIDS activities to ensure the best use of all resources and available funding.
These are impressive achievements, but challenges remain. And we know what needs to be done. The Global Plan to STOP TB 2006 – 2015 provides us the road map and key interventions. The American people are fully committed to working with all of our partners throughout Tanzania, and worldwide, to renew the charge against TB.
Larry André is the Chargé d’Affaires of the United States of America in Tanzania