Global Fact Sheet | Tuberculosis Tuberculosis, long overlooked by global health programs, has reemerged as one of the prominent health challenges of our time, alongside the related epidemic of HIV/AIDS. Worldwide in 2008, there were close to 10 million estimated new cases of tuberculosis. TB causes more deaths than any other curable infectious disease and disproportionately affects the poor and working-age segments of society. Fuelled by HIV and weak health service delivery systems, and increasing resistance to standard anti-TB drugs, tuberculosis presents a serious barrier to improving health outcomes in resource limited settings. Achievement Highlights ¡ Treatment success rates of smear positive TB patients in project- supported sites in Swaziland are consistently over 70%. ¡ By the end of the project, USAID TASCII TB (a precursor to the South Africa TB Program) had assisted in ensuring that more than 80% of TB patients were screened for HIV in project-supported facility sites; more than 90% of facilities had a treatment start rate of less than 5 days; and the case detection rate reached the WHO target of 70%, among other accomplishments. ¡ e development of training curricula, materials, and job aids to assist providers to adopt and apply TB control guidelines, from community health workers in Botswana, to computer-based TB trainings for health professionals in Indonesia. ¡ e development of a set of recommendations for regional minimum standards for TB control for member states within the Sothern African Development Community. ¡ In Lesotho, the introduction and implementation of key policies and guidelines including the MDR TB case management guideline. ¡ Implementation of the 3 I’s in URC supported sites in South Africa as well as implementation of a school-based program in South Africa under the USAID-funded TB Program. ¡ In Rangareddy district in Andhra Pradesh, India, collaboration between URC’s HCI project and the RNTCP resulted in a 40% increase in total screening, 57% increase in screening of new suspects, and 55% addition in case detection rate during the 12 month period of August 2009 to July 2010 ¡ In Orenburg Oblast in Russia, over 100 patients are now screened monthly for TB at the AIDS Center and more than 200 are tested in polyclinics of Orenburg Oblast; before 2007, there was no screening in polyclinics. In St. Petersburg, there has been a 30% increase in the number of HIV patients tested for TB in 2008 compared to 2007 ¡ In Bolivia, treatment success and cure rates have increased significantly in the Municipalities in Departments of La Paz, Santa Cruz, and Cochabamba, where URC has worked since 2006; treatment abandonment rates also dropped. University Research Co., LLC is a member of the Stop TB Partnership and the Global Business Coalition on HIV/AIDS, Tuberculsosis and Malaria. We have worked on bilateral and multilateral TB control activities with support from the US Agency for International Development (USAID), the US Centers for Disease Control and Prevention (CDC), and the Southern African Development Community (SADC), among others. Since the 1990s, URC has assisted in developing TB control systems in more than a dozen countries in Africa, Asia, Latin America, and Europe. In order to make a sustained contribution to locally-supported TB control efforts, URC works with Ministries of Health (MOHs), National TB Control Programs (NTPs), community and civil society organizations, academic institutions, and the private sector to build capacity of health service delivery systems to address TB, particularly among those most vulernable.
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Global Fact Sheet | Tuberculosis
Tuberculosis, long overlooked by global health programs, has reemerged as one of the prominent health challenges of our time, alongside the related epidemic of HIV/AIDS. Worldwide in 2008, there were close to 10 million estimated new cases of tuberculosis. TB causes more deaths than any other curable infectious disease and disproportionately affects the poor and working-age segments of society. Fuelled by HIV and weak health service delivery systems, and increasing resistance to standard anti-TB drugs, tuberculosis presents a serious barrier to improving health outcomes in resource limited settings.
Achievement Highlights¡ Treatment success rates of smear positive TB patients in project-
supported sites in Swaziland are consistently over 70%.
¡ By the end of the project, USAID TASCII TB (a precursor to the South Africa TB Program) had assisted in ensuring that more than 80% of TB patients were screened for HIV in project-supported facility sites; more than 90% of facilities had a treatment start rate of less than 5 days; and the case detection rate reached the WHO target of 70%, among other accomplishments.
¡ The development of training curricula, materials, and job aids to assist providers to adopt and apply TB control guidelines, from community
health workers in Botswana, to computer-based TB trainings for health professionals in Indonesia.
¡ The development of a set of recommendations for regional minimum standards for TB control for member states within the Sothern African Development Community.
¡ In Lesotho, the introduction and implementation of key policies and guidelines including the MDR TB case management guideline.
¡ Implementation of the 3 I’s in URC supported sites in South Africa as well as implementation of a school-based program in South Africa under the USAID-funded TB Program.
¡ In Rangareddy district in Andhra Pradesh, India, collaboration between URC’s HCI project and the RNTCP resulted in a 40% increase in total screening, 57% increase in screening of new suspects, and 55% addition in case detection rate during the 12 month period of August 2009 to July 2010
¡ In Orenburg Oblast in Russia, over 100 patients are now screened monthly for TB at the AIDS Center and more than 200 are tested in polyclinics of Orenburg Oblast; before 2007, there was no screening in polyclinics. In St. Petersburg, there has been a 30% increase in the number of HIV patients tested for TB in 2008 compared to 2007
¡ In Bolivia, treatment success and cure rates have increased significantly in the Municipalities in Departments of La Paz, Santa Cruz, and Cochabamba, where URC has worked since 2006; treatment abandonment rates also dropped.
University Research Co., LLC is a member of the Stop TB Partnership and the Global Business Coalition on HIV/AIDS, Tuberculsosis and Malaria. We have worked on bilateral and multilateral TB control activities with support from the US Agency for International Development (USAID), the US Centers for Disease Control and Prevention (CDC), and the Southern African Development Community (SADC), among others. Since the 1990s, URC has assisted in developing TB control systems in more than a dozen countries in Africa, Asia, Latin America, and Europe.
In order to make a sustained contribution to locally-supported TB control efforts, URC works with Ministries of Health (MOHs), National TB Control Programs (NTPs), community and civil society organizations, academic institutions, and the private sector to build capacity of health service delivery systems to address TB, particularly among those most vulernable.
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URC TB projects, 2005–2010
¡ USAID TB CARE II
¡ USAID TB IQC
¡ USAID South Africa TB Program
¡ USAID TASC II TB/South Africa
¡ Development of Harmonized Minimum Standards for TB Control, SADC
¡ USAID Health Care Improvement Project/ Bolivia
¡ USAID Health Care Improvement Project/India
¡ USAID Health Care Improvement Project/ Indonesia
¡ USAID Health Care Improvement Project/ Swaziland
¡ USAID Health Care Improvement Project/ Vietnam
¡ USAID HealthPRO Project, the Philippines
¡ USAID Quality Assurance Project Bangladesh
¡ WHO Bangladesh
¡ USAID Translating Research into Action, Bangladesh
TB/HIV projects
¡ USAID Health Care Improvement Project/Russia
¡ USAID Health Care Improvement Project/Lesotho
¡ URC Health Care Improvement Project/South Africa
¡ CDC Swaziland and South Africa, HIV Counseling and Testing Project
¡ CDC Swaziland, Provision of HIV and TB Laboratory Support
¡ CDC Botswana, Building Human Resource Capacity to Support Prevention, Care, and Treatment
Building a sustainable national response to TBURC works closely with the National TB Control Programs (NTPs) to support a stronger nationwide framework for TB control. In many countries, URC provides assistance on developing and revising key policies and guidelines for DOTS implementation, drug resistant TB, or TB/HIV integration. Working with policy makers at the national level, URC helps country partners take their activities to scale to meet the pressing need for TB services. URC also helps connect NTPs to address common issues and tackle cross-border movement of TB patients. In 2009-2010, for example, URC worked with the SADC Secretariat to asses TB policies in the 14 Member States and make recommendations for a set of harmonized regional TB standards.
Supporting effective community involvement in TB controlURC works closely with community-based organizations to strengthen DOTS programs, increase case detection and referrals for care, and improve advocacy and awareness for accessing TB services. In Bangladesh, URC helped organize community groups to participate in events such as World TB Day. In the Philippines and India, URC trained local partners to deliver key messages related to infection control, TB screening, and treatment adherence. In South Africa, URC administers a small grants program so local partners can take messages to scale and encourage active community involvement to strengthen DOT services that are critical for ensuring adherence among patients.
Promoting an integrated response to TB and HIVURC has combined its global expertise in HIV/AIDS to assist partners to provide comprehensive, decentralized and high quality TB/HIV services at the local and facility levels. In countries such as Russia, Swaziland, Vietnam, and South Africa, URC works with partners to integrate TB and HIV services by introducing strategies to increase HIV testing for TB patients and TB screening for people living with HIV, building referral networks from HIV entry points, and streamlining systems to allow co-infected patients to access coordinated care.
Improving responses to tackle drug resistanceURC is helping NTPs to strengthen their response to multi-drug resistant TB (MDR TB) by assisting partners to implement programmatic management of MDR TB, improve awareness and implementation of infection control strategies, and ensure access to second-line drugs. In Lesotho and Botswana, URC has worked with the NTP to develop and implement guidelines for the programmatic management of MDR TB. In South Africa, URC has supported vital studies to determine the readiness of public sector facilities to implement routine infection control to protect vulnerable groups like healthcare workers.
Strengthening health systems to support TB Our projects build up key sectors such as laboratory and diagnostics networks to support improved case detection and monitor treatment success. URC trains health care workers and strengthens supportive supervision to ensure providers comply with treatment guidelines. URC works with partners to emphasize a continuum of care for TB patients. In Swaziland, URC assists the National Referral Laboratory to improve HIV/TB diagnosis processes, particularly in peripheral laboratories, to access new technologies. In South Africa, URC supports workplace programs to improve adherence to treatment in the private sector.
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