CategoriesRun4TB WACI Health News

The African Civil Society Platform on Health and GFAN Africa Urge African and World Leaders to Urgently Address Drug Resistant TB

Contact:

Carol Nawina: carolnawina@gmail.com  + 260 97 7960043
Rosemary Mburu: rosemary@wacihealth.org  +254 711 308858
Emmanuel Etim: info@africahealthplatform.org + 251 912 623 935

 

Drug Resistant TB: Time to Act is now

Tuberculosis is killing more people than any other infectious disease; close to two million people died from TB last year. The rise of these reported TB cases is a big cause for concern.

“But the emergence of new superbugs that can resist even the most powerful antibiotics should make bigger headlines”, Says Rosemary Mburu, Executive Director, WACI Health. “While antimicrobial resistance is going to affect treatment for many health conditions, drug-resistant TB is particularly concerning as it accounts for about one-third of all antimicrobial resistance deaths”.

The growth of these forms of drug-resistant TB has a potentially disastrous impact in the fight against the disease. In 2015, there were approximately 580,000 cases of drug-resistant TB. Only 20 percent of those were diagnosed, treated or reported to national health systems across the world. Drug-resistant TB ended up killing 250,000 of people that year.

“This form of the disease now threatens many recent gains made against the response to TB and HIV globally,” said Carol Nawina- Kachenga, Executive Director, CITAM+. “Over the last few decades, the global community has worked so hard to defeat HIV. Today, Tuberculosis, the world’s most infectious disease is threatening to reverse these gains by killing our communities. It is killing our grandmothers in Kinshasa, our mothers in Soweto, our brothers in Ndola and children[1] all over Africa. It is pushing us further into poverty and killing our dreams.

“Africa is home to four of the 27 global high multidrug-resistant TB burden countries: Democratic Republic of Congo, Ethiopia, Nigeria and South Africa.” Says Olayide Akanni, Executive Director, Journalists Against AIDS, Nigeria. “ Our people continue to suffer in the face of lack of new drugs to treat drug-resistant TB and ineffectiveness of existing treatments, which are long and often cause adverse side effects.”

A widespread epidemic of extensively drug-resistant (XDR) tuberculosis is also unfolding in South Africa, where cases have increased substantially since 2002. Alone, the country contributed 562 of the 4,040 XDR-TB cases enrolled on treatment globally in 2014. “This is a time bomb in South Africa and President Jacob Zuma must champion TB R&D in South Africa and globally, through his G20 membership,” says Daniel Molokele, Steering Committee Member, CISPHA.

Global health partners must halt and reverse the growth of drug-resistant TB. The time to act is now.

On World TB day 2017, we, members of the CISPHA and GFAN Africa, united in our resolve to ending TB:

  1. Join other global health organizations in calling for TB to be added to the World Health Organization’s list of high priority drug-resistant bacteria. Our call comes in the wake of WHO’s first ever list of antibiotic-resistant pathogens released as part of the effort to address the growing threat of antimicrobial resistance. Currently, that list does not include TB.
  1. Call upon African governments to prioritize tuberculosis in national health and development agendas by increasing investments in research and development for TB to support creation and uptake of new tools and drugs to respond to drug-resistant TB.
  1. In the run-up to the upcoming G20 meeting in Hamburg, Germany, in July, we call upon G20 leaders – including President Jacob Zuma – to demonstrate leadership in responding to drug-resistant TB by committing to fund new research to develop better drugs and treatment regimens to respond to the disease.

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About CISPHA: The Civil Society Platform on Health in Africa (CISPHA), is an Africa regional advocacy platform, which aims at a coordinated Civil Society response on health in Africa.  The Platform was launched in 2009, when 60 networks and network organizations, joined forces to utilize evidence for Advocacy and Lobby at continental level, linking the efforts at national and regional levels to influence decision processes at the African Union and its institutions. CISPHA is hosted by WACI Health.

About GFAN Africa: Nested within CISPHA, the Global Fund Advocates Network (GFAN) Africa is a regional hub for GFAN. GFAN Africa unites voices and efforts from all over Africa to support a fully funded Global Fund to Fight AIDS, Tuberculosis and Malaria.

[1] In high burden TB settings it has been noted that 15-20% of all TB cases are among children.

CategoriesBlog Run4TB

We Must Invest in TB-HIV Programming or Lose Two Fights at Once

By Stephen Mule

This year, the two deadliest infectious diseases traded places. The World Health Organization (WHO) announced that tuberculosis had overtaken HIV, as the deadliest infectious disease globally. The WHO report, released in October, estimated that there were almost 10 million new cases of TB in 2015. The disease killed 1.5 million people, ahead of 1.2 million claimed by HIV. For those of us who have committed ourselves to ending TB by 2030, this is extremely disconcerting.

But it doesn’t have to be that way. Advances in science have brought us so far that we cannot allow this disease to beat us now. One of the most important of those scientific imperatives is the understanding of how these two diseases fuel each other. For instance, TB kills more than a 1000 people living with HIV every day. To end HIV as an epidemic, we must end TB as an epidemic and vice versa.

To end this deadly combination, we must respond aggressively to co-infection between the two diseases. In 2004, WHO established guidelines on addressing HIV-associated TB, emphasizing the necessity of linking TB and HIV services. The guidelines also outlined a set of joint activities that needed to be delivered to address the interface between the two diseases. Those guidelines evolved further into a more complex mechanism that sought to expand detection and prevention of TB, among people living with HIV. The approach also aimed at enhancing ownership of TB-HIV work, especially among people working in the HIV field. The WHO updated those policy recommendations in 2012, giving greater clarity on 12 specific activities needed to improve health services and health outcomes for people with, and at risk of, TB and HIV.

To end these two epidemics, we need to make sure that these policy guidelines are implemented. Doing that is one of the key ingredients in sending these two diseases into retreat. In 2014, ACTION Global Health Advocacy Partnership investigated whether the guidelines had been translated into commitments at global and national levels and produced a report titled From Rhetoric to Reality.  The study showed that while bold policy steps had been taken to fight both TB and HIV, much more was needed. To address gaps, ACTION recommended that national HIV strategic plans prioritize TB-HIV joint activities—with a specific focus on screening all people living with HIV for TB—to ensure access to TB prevention, testing, treatment, and care.

Two years later, ACTION conducted another study and released a report titled From Policy to Practice. This report explores the progress made in TB-HIV integration efforts since 2012. It shows that HIV programs globally are lagging behind in accelerating TB-HIV activities, while TB programs are, comparatively, performing well in their efforts to accelerate TB-HIV activities. The study also found that global guidelines to address TB-HIV have not been prioritized by leading donors and affected countries.

To defeat TB and HIV, we have do more. The HIV community cannot afford to be left behind any longer in instituting joint TB-HIV integration.

International funders of HIV must also invest more vigorously in TB-HIV programming. The science is unequivocal in showing that more work around where these two diseases interact is indispensable to ending these highly interlinked diseases.

In the last twenty years, we have had remarkable investments in responding to HIV and tuberculosis. Without a doubt, great progress has been made against these diseases. But to end them as epidemics by 2030, we must accelerate our investments and implementation in TB-HIV activities.

The window is closing fast. The choices are stark. We must find ways of doing greater TB-HIV integration or risk losing two fights at once.

Stephen Mule is a Member of Parliament in Kenya and the Chair of Africa TB Caucus.

CategoriesBlog

The Far-Reaching Impact Of Strengthening Primary Health care

Author : 

Suzanne Ehlers & Rosemary Mburu

Suzanne Ehlers is President and CEO of Population Action International;
Rosemary Mburu is Executive Director of World AIDS Campaign International

Website: The LANCET Global Health Blog

With the launch of the new Sustainable Development Goals, health and development experts around the world are reflecting on what it will take to accomplish them. As a global community, this is a unique opportunity to think carefully about what works and what doesn’t, and to use the new goals to redouble our efforts to support programmes, solutions, and systems that work.

To fuel progress in global development, we need catalysts that cut across multiple challenges and support multiple development interests. There is a widespread understanding among decision-makers in low- and middle-income countries that high-performing primary health-care systems play that catalytic role. These systems are central to reaching global and country-specific goals, achieving universal health coverage, and meeting the majority of individual and community health needs before they become emergencies. A healthy population in turn sets the stage for gains in education, economies, and peace and security.

Providing sexual and reproductive health services in the context of primary health care is a long-established principle and practice. The 1994 International Conference on Population and Development (ICPD) Programme of Action called for ensuring access to reproductive health through primary health care. Similarly, a 2008 UNFPA publication stated that achieving progress towards sexual and reproductive health and rights depends on a strong and functional health system in every country, especially at the primary and first referral levels.

With respect to HIV, tuberculosis, and malaria, the 2006 Abuja Call for Accelerated Action Towards Univeral Access called for the promotion and integration of access to prevention, treatment, care, and support in primary health-care services. High-performing primary health-care systems enable countries to maximise the impact of core investments in programmes to defeat these and other infectious and non-communicable diseases. For example, primary health-care systems can be the basis for the scale-up of essential HIV and AIDS services in hard-to-reach areas and among underserved populations.

Unfortunately, despite broad global agreement on the value of robust primary health care, there is not a simple recipe to achieve it. Domestic financing and country ownership are critical elements, and it is time for countries to set priorities and budgets that explicitly aim to strengthen primary health-care systems, complementing the efforts of donors. Civil society also has a key role to play, not only holding decision-makers accountable but also working with them to develop strong systems that can be reached by all.

To enact policies and budgets that lead to measurable primary health-care improvements, however, decision-makers need better information about the components of high-performing primary health-care systems, particularly their poorly understood service delivery elements – such as the quality of care, and patients’ ability to access the system, and the degree of coordination among various care providers. A new partnership called the Primary Health Care Performance Initiative (PHCPI) seeks to address this gap in information, giving decision-makers the tools to adopt policies and practices based on evidence.

We are excited about PHCPI because it presents an opportunity for collaboration among diverse communities working to address other issues of global health and development. This is a chance to look ahead to where improvements to primary health-care systems can take us all in the future. We can rise above disputes over which health issues deserve the most attention, or what set of indicators gives us the best picture of a system’s health. We can harness data to make policy decisions about health care that are truly responsive to communities’ needs. We can unite around the opportunity to dramatically improve the health of millions of people by focusing on primary health care, the frontline of health in people’s communities.

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