International Federationof Red Cross and Red Crescent Societies
TB Control through the Engagement of Community Structures
30 September 2010
Consultation Meeting to Strengthen the Active Engagement of Civil Society Organisations in
the TB work of WHO
Dr. Getachew GizawHIV, TB, Malaria UnitHealth DepartmentIFRC
International Federationof Red Cross and Red Crescent Societies
The Red Cross and Red Crescent Movement
The movement consists of two international humanitarian institutions with headquarters in Geneva and National Societies in 186 countries. The two institutions are the International Committee of the Red Cross (ICRC) and the International Federation of Red Cross and Red Crescent Societies (IFRC). The National Societies comprise most of the more than 97 million Red Cross and Red Crescent workers – the world’s biggest volunteer force.5 Zone offices
International Federationof Red Cross and Red Crescent Societies
RC/RC involvement in TB- historical analysis
1864 – 1900 heavy involvement in war-related
health services (ICRC )
1919 – 1960 – Running health facilities :
• hospitals, health centres, clinics
• Blood transfusion
• Training of nurses and auxiliary staff
1960 - 2000 more actions in areas of public
health interventions – Less on TB
Since 2000 – strong focus on TB
High focuson TB
International Federationof Red Cross and Red Crescent Societies
Prevention
Health EducationIdentifying vulnerableGroups
Case Finding
Diagnosis
and
Treatment
Social care
Adherence monitoring
Psychologicalsupport
Nutritionalsupport
Authorities
Red Cross Red Crescent
Authorities
Red crossRed Crescent
Authorities
Red Cross Red Crescent
Case finding
Follow-upIFRC areas of collaboration with MOH in the
Laboratory and
ReferralsTreatment
Prevention and control of TB
International Federationof Red Cross and Red Crescent Societies
Operational Aims
Fill a gap in Tuberculosis ControlFill a gap in Tuberculosis Control
Target the most vulnerable in the communityTarget the most vulnerable in the community
Provide basic, standardised and targeted quality service to Provide basic, standardised and targeted quality service to as many as possible.as many as possible.
Working in Partnership.Working in Partnership.
International Federationof Red Cross and Red Crescent Societies
Approach
Continuum of care (household to health facility & vice versa)
HBC programme at household level.
Use of empowered community members.
Integration of TB &HIV programmes at service delivery level
International Federationof Red Cross and Red Crescent Societies
Human resources
Core HCWs – Doctors & nurses
Community–based volunteers
Support staff
International Federationof Red Cross and Red Crescent Societies
Who is the target audience of our programmes?
•General public•Community leaders•Civic and cultural institutions•People at workplaces•At risk groups- IDUs, alcohol users, prisoners and ex-prisoners•Current and former TB patients•People infected and affected by HIV•Authorities at Central and Local levels
International Federationof Red Cross and Red Crescent Societies
Programme Performance - Brief Updates:
Budget and involved NSsSince 2003 the Federation, forcountry based programmes hasallocated approximately CHF10 million to save lives andPrevent the spread of TB.
31 Societies in Europe /Central Asia, Southern Africa,East Africa , West Africa ,Asia / Pacific are implementing TBProgrammes.
Main supporters: Donor RC Societies, Eli Lilly, USAID, GFATM
Program deliveries40,000 TB patients are supported on a daily basis
-2000 MDR TB patients among them-13% living with HIV (60-80% in Africa)1200 care providers and volunteers involved500,000 community members targeted annually with TB prevention80-90 % treatment completion rate among clients in IFRC programme
International Federationof Red Cross and Red Crescent Societies
The ACSM – key elements for RC& RC actions
Objectives:
Make the TB epidemic (more) visible at country / district level
Advocate for internationally recommended strategies and policies
Mobilize the community and build its capacity to respond to the TB epidemic
Reach out to the most vulnerable groups and challenge discrimination when it occurs.
International Federationof Red Cross and Red Crescent Societies
Working Together to Stop TB: IFRC is the member of Global Stop TB Partnership. 2004 - 2008 represented in the Coordination Board of the Stop TB Partnership.
IFRC is part of most of Working Groups of Stop TB Partnership.
IFRC part of selection committee of the “Challenge Facility for Civil Society”Initiative of the Stop TB Partnership.
IFRC signed the statement from the Civil Society Organisations during 2007 Ministerial Conference.
During 2006 -2007, the IFRC housed the Stop TB Regional Partnership for Europe and Central Asia
IFRC partners with private sector: member of Lilly MDR TB Partnership, Astra Zeneca
Working closely with WHO based on Global, Regional Partnership Agreements (agreement in Europe was signed in 2008).
Last but not least: our main partners are local / community based, patient based and civil society organisations, as well as Ministries of Health.
International Federationof Red Cross and Red Crescent Societies
Key MessagesAffected communities and those at risk should be in the centre.
Need for fostering IFRC collaboration with WHO and others in:
• planning process
• human resource development process (specifically at
community level)
• service delivery
Closer consultation needed with civil society and private sector
Declarations and outcomes from high level meetings (Berlin,
Beijing) should be translated into actions.
J3
Slide 12
J3 Much better. Could align final bullet with others and say 'But aid unevenly spread'
Need to edit notes down to fit on one printed page. I've found there isn't time to say more than Jono, 2006-09-05
International Federationof Red Cross and Red Crescent Societies
Why is there less engagement in TB since 1960?
Less request for support from MOH
Assumption that governments can handle TB
Earlier magnitude of TB less known/ disclosed
Less advocacy work for resource mobilization,
thus difficult to get funding support
Aggressive advocacy on HIV masked TB
though at later stage helped focus on TB/major OI
International Federationof Red Cross and Red Crescent Societies
What can be done to foster concerted action on TB?
Active evidence based advocacy work to raise
awareness on the importance of addressing TB
MOH must give space for community based actors,
support their engagement & acknowledge work done
Strengthen community based actions in line with
PHC approach
Create strong mechanism for effectively interfacing
community level actions with facility level actions
WHO must leverage engagement of community
based actors & connections with MOH
International Federationof Red Cross and Red Crescent Societies
Thank you
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