AllianceTB handout
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Transcript of AllianceTB handout
RESPONSE
Alliance programmes The Alliance has presence in 15 of the 22 high burden TB countries. We work on TB/HIV through our programs in:
• AllianceUkraine
• AllianceUganda
• AllianceZambia
• AllianceNationaleContreleVIH/SIDACôted’Ivoire
1. Community health workers and PLHIV Network Support Agents
• InvolvementofPLHIVinhealthservicedeliveryandtotackledualstigma
• Linkbetweencommunitiesandhealthsystemstostrengthenreferralsystemsandinfectioncontrolmeasures
• Supportdeliveryofcommunity-basedDOTS(DirectlyObservedTreatment,Short-course)
• SecondmentofcommunityhealthworkerstoTBclinicstoprovideHIVcounsellingandtestingandreferraltoHIVservices
• Mobilesputumcollectionasamodelforintensifiedcasefinding
2. Strategic partnerships
• CollaborationwithnationalTBprogrammes
• PartnershipwithTBserviceprovidersandcommunity-basedorganisations
3. Advocacy at national and local levels
• Dialoguewithpolicyanddecisionmakers
• Workingwithjournalists
4. Anti-stigma programmes
• Developmentoftrainingmaterial
• Trainingoftrainers
• TrainingonTB/HIVstigmaforhealthcareworkersinordertosupportinfectioncontrolinhealthfacilitiesandmitigatestigmaamongsthealthcareworkers
5. Care and support of PLHIV/TB
• ClinicalservicestoPLHIV/TB:TBtests,referralsforscreeningandtreatment,community-basedDOTS
• Capacity-buildingoflocalcivilsocietyorganisationstoprovidecareandsupporttoPLHIV/TB
6. Knowledge sharing across the Alliance and with other partners
• CommunitiesofpracticeonTB/HIV
• DisseminationofbestpracticesandstandardsinHIV/TBintegration
7. Technical assistance in TB and HIV work within the Global Fund grants
Issues faced by people living with both HIV and TB disease include:
• Dualstigmaanddiscrimination
• WeakreferralsystemsbetweenTBandHIVservices
• PoorTBinfectioncontrolmeasuresathealthfacilities
• Limitedaccesstoisoniazidpreventivetherapy
• Humanrightsviolationsfromlawenforcementandhealthservices
AccesstoTB/HIVintegratedservicesislimitedatcommunitylevel.TheAllianceistryingtoaddressthisgapthroughourprogrammes.
33 million peopleareinfectedwithHIVworldwide
1.1 million peopleareco-infectedwithbothTBandHIV
5,000 peoplediefromTBeveryday
TBaloneaccountsfora quarter ofallAIDS-relateddeaths
Less than 1% ofpeoplelivingwithHIVwhoneedIsoniazidtherapytopreventTBhaveaccesstoit
ISSUESFACTS
INTERVENTIONS
TB/HIV integrated interventions provided or promoted by Alliance programmes
LESSONS LEARNEd FROm TB WORK WITH PEOPLE LIVING WITH HIV
Supporting community action on AIDS in developing countries
www.aidsalliance.org
• KANCO,Kenya
• Lepra,India
• VasavyaMahilaMandali,AndhraPradesh,India
• ViaLibre,Peru
• HASAB,Bangladesh
TBhealtheducation,Palaniswamy,India©GideonMendelfortheAlliance,2004
Formoreinformationemail:[email protected]@aidsalliance.orgorvisitourwebsitewww.aidsalliance.org
About the AllianceEstablishedin1993,theInternationalHIV/AIDSAlliance(theAlliance)isaglobalallianceofnationally-basedorganisationsworkingtosupportcommunityactiononAIDSindevelopingcountries.Todatewehaveprovidedsupporttoorganisationsfrommorethan40developingcountriesforover3,000projects,reachingsomeofthepoorestandmostvulnerablecommunitieswithHIVprevention,careandsupport,andimprovedaccesstoHIVtreatment.
TheAlliance’snationalmembershelplocalcommunitygroupsandotherNGOstotakeactiononHIV,andaresupportedbytechnicalexpertise,policywork,knowledgesharingandfundraisingcarriedoutacrosstheAlliance.Inaddition,theAlliancehasextensiveregionalprogrammes,representativeofficesintheUSAandBrussels,andworksonarangeofinternationalactivitiessuchassupportforSouth-Southcooperation,operationsresearch,trainingandgoodpracticeprogrammedevelopment,aswellaspolicyanalysisandadvocacy.
Alliance good practice programme standards for TBThe Alliance is developing good practice programme standards to guide our HIV programming around the world. Our standards for HIV and TB are listed below:
STANdARdS
GOOd PRACTICE PROGRAmmE STANdARdS FOR TB
GOOd PRACTICE STANdARd 1
OurorganisationhasinplacealocalTBstrategywhichsupportstheintegrationofTBandHIVactivities.ItexaminesmechanismsforthemainstreamingofTBworkintocurrentprogramming
GOOd PRACTICE STANdARd 2
OurorganisationensuresthatallpeoplelivingwithHIVareofferedorprovidedwithaccesstoTBdetectionservices(screening,diagnosisandtreatment),andwhereappropriate,accesstopreventivetreatment
GOOd PRACTICE STANdARd 3
OurorganisationensuresthatallpeopleofferedHIVtestingaremadeawareofTBinfection
GOOd PRACTICE STANdARd 4
Ourorganisationprovidesinformationon,orrefersTBpatientsto,HIVtesting,counsellingandHIVinformation
GOOd PRACTICE STANdARd 5
OurorganisationhasinplaceaninfectioncontrolpolicytoreducetheriskofTBtransmissiontopeoplelivingwithHIV
GOOd PRACTICE STANdARd 6
OurorganisationhasinplacestrategiestoaddressTB-andHIV-relatedstigmaatindividual,service,communityandstructurallevels
GOOd PRACTICE STANdARd 7
OurorganisationworkswithlocalTBorganisationsanditsTBworkisinformedbythenationalTBprogramme
Aliance resourcesUnderstanding and challenging TB stigma. A toolkit for action.
Available at:
www.aidsalliance.org/includes/Publication/1Stigma_Intro_and_A.pdf
CASE STUDY
Community-based DOTS (Directly Observed Treatment, Short-course): Lessons from BangladeshBangladeshisoneofthe22leadingcountriesinTBburden,with50%oftheadultpopulationbeinginfectedwiththeTBbacilli,andanincidencerateof102/100,000peryear.AlthoughtheHIVprevalenceislessthan1%,thecountryhasaconcentratedepidemicmainlyamongstinjectingdrugusers.
ToaddresstheissueofTB,aDOTprogrammewasstartedin1993infourUpazillas(healthadministrativeunits)whichwasscaleduptonationalcoveragebytheendof1998.In2003,TBcontrolwasrecognisedasapriorityareabythegovernmentfollowingadvocacyeffortsbyvariousstakeholders.
Community-basedDOTSinBangladeshwasspearheadedbyBRACthroughvillagedoctorsfromtheDamienFoundationandcommunityhealthvolunteers.Inaddition,theprogrammemobilisedteachersandreligiousleaderstosupportsuperviseddrugintake.SupportfromtheGlobalDrugFacilityhasbeencrucialtoensureanuninterruptedsupplyofdrugs(commoditysecurity).
TheprogrammehasbeenstronglysupportedbytheNationalTBControlProgramme.Throughthecombinedeffortsofgovernmentalandnon-governmentalorganisationsthefollowingresultswereachieved:
• Increaseinthecasedetectionrateto66%
• Maintenanceoftreatmentsuccessrateexceeding90%since2004,andaround95%bytheendof2008
• IncreaseinDOTScoveragefrom92%in200to99%byendof2007
• DevelopmentofMDR-TBandTB/HIVby2008
ConclusionCommunityDOTScansignificantlycontributetoimprovedTBoutcomesinhighburdencountries
Contributed by Dr Tahmina Sultana, HASAB, Bangladesh