Building Global Capacity on Drug-Resistant Tuberculosis

Publié: 14 août 2015

By Sylvia Khamati-Logendo, Health Advisor, Kenya Red Cross Society.

On behalf of IFRC, Lilly MDR-TB Partnership and United Way Worldwide

The borderless nature of tuberculosis (TB) came to the fore again this month when a woman travelled from India to the United States and visited three states before she became sick and tested positive for extensively drug-resistant TB (XDR-TB) – the deadliest form of this airborne disease. 

The public health response was swift and efficient, and the risk that the disease will spread is virtually nil – thanks to the existing healthcare infrastructure and response. But the incident reminds us of the gravity of drug-resistant TB. Without proper treatment, a typical case of TB can become resistant, creating a public health risk that can spread silently across the world.

According to the World Health Organization, nearly half a million patients developed multidrug-resistant TB (MDR-TB) in 2014, and about 50,000 went on to develop the more severe XDR-TB. The burden of these drug-resistant cases falls largely on low- and middle-income countries, where health systems struggle to mount an effective response.

That is why, in 2005, the International Federation of Red Cross and Red Crescent Societies (IFRC) set forth an ambitious agenda: mobilizing local communities to thwart drug-resistant strains of TB once and for all.

Earlier this month, officials from IFRC, National Red Cross and Red Crescent Societies, and United Way Worldwide, together with the Lilly MDR-TB Partnership, met to assess progress on TB prevention and treatment efforts. We focused on a careful analysis of reports from ten countries in order to assess progress and identify challenges, build more active participation in the lives of people living with TB and MDR-TB, and advocate for increased access to treatment and care for those most in need. 

The end goal is to improve local public health capacity ensure that people living within affected communities are better placed to identify, counsel and ensure that people living with TB and its drug-resistant forms get diagnosed, treated and cured.

A crucial aspect of this goal is making sure that community and civil society representatives play an active part in efforts to address TB at the local, regional, and national levels. By establishing connections across these levels, we can ensure that health systems are responsive to the specific needs of communities affected by TB.

The recent meeting provided participants with best practices from a number of countries and the on-the-ground efforts underway.  

Kenya, for example, borrowed lessons from their experience addressing HIV and AIDS, intensifying efforts to diagnose MDR-TB early and provide access to quality care. As a result, TB patients have begun receiving social and nutritional support, and TB-HIV services are better integrated. By working hand in hand with ten health facilities, Kenya is leading the way on connecting communities with care.

In Georgia, support from this partnership has created a strong patient organization. By gaining a seat on the Country Coordinating Mechanism, which oversees the delivery of healthcare activities financed by the Global Fund to Fight AIDS, Tuberculosis and Malaria, these patients are now helping to mobilize quality treatment for people with TB across the country.

These are positive steps – but drug-resistant TB continues to outpace us. Only one in five people with MDR-TB receive treatment, according to WHO estimates.

We must dial-up the urgency surrounding drug-resistant TB, improve coordination between stakeholders, and strengthen our collective advocacy. All of these efforts must extend to the local level, while information gleaned from affected communities is shared through public health networks nationally and internationally.

In an age when drug-resistant TB can move across the world in a matter of hours, our only hope of stopping the disease globally lies in our ability to support, collaborate with, and learn from those grappling with TB locally.