The TB Working Group enhances NGO capacity to design and implement quality TB programs, with a focus on community-oriented programming.
Working Group Co-chairs: Kayt Erdahl, PATH; Devasena Gnanashanmugam, Independent; and Nene Fofana, Population Services International. CORE Group representatives on STOP TB's Advocacy, Communications and Social Mobilization activities/groups: Kayt Erdahl, and Elena McEwan,Catholic Relief Services. Dr. McEwan also serves on the Civil Society GAVI Steering Committee
WHAT'S NEW IN COMMUNITY-ORIENTED TB CARE?
- Getting Involved in Community-Based TB: How to Get Started. An International Handbook for Non-Governmental Organizations and Civil Society Organizations. A new publication from CORE Group, the MCHIP Project and others.
- National Tuberculosis and Leprosy Programme: Community-Based TB Care: Experience from Temeke, Tanzania A new publication from The United Republic of Tanzania/Ministry of Health and Social Welfare
- ENGAGE TB Newsletter
In support of World TB Day 2012 spotlight on Pediatric TB, CORE Group’s Tuberculosis Working Group presented three webinars from world leaders in the fight against pediatric TB.
Childhood TB: An MSF Field Perspective (3/13/2012)
- Pediatric TB: The Basics (3/7/2012)
Tuberculosis that is “resistant to all drugs”
Global reporting on what is being called “totally drug resistant TB” (TDR-TB) is causing alarm and confusion. WHO has provided guidance on their findings on this topic. For now, they do not recognize the “TDR-TB.” Find out why, and what this means for TB control efforts worldwide.
Women and Tuberculosis: Taking Action Against a Neglected Disease
Tuberculosis is the third leading cause of death for women worldwide, according to the World Health Organization, but what can we do about it? Find out in this concise, current overview from Action/RESULTS.
Chehera: The human face of TB
This beautiful and moving series of artworks created by people with TB can be used to get attention, raise awareness, and generate dialogue.
Online Presentation: Pediatric Tuberculosis: Missed Opportunities. A South African Perspective.
Presented by Dr. Anneke Hesseling, Professor and Director, Pediatric TB Research Program, Desmond Tutu Research Centre, Stellenbosch University, South Africa. June 8, 2011.
Dr. Hesseling shares her clinical expertise AND her practical programming experience in addressing pediatric TB is low resource settings. Despite the difficulties of diagnosing and treating pediatric TB, Dr. Hesseling makes the case that practical, effective approaches do exist, in accordance with guidelines from the World Health Organization. Dr. Hesseling maps out ways forward, which are urgently needed to address this huge, neglected problem.
Online Presentation: Gene XPert. A groundbreaking new diagnostic technology for diagnosing TB.
Presented by Dr. Elizabeth Talbot, Associate Professor of Infectious Diseases and International Health at Dartmouth Hitchcock Medical Center, and Medical Scientist, FIND: Foundation for Innovative New Diagnostics. March 25, 2011.
What else is new?
Stop TB PartnershipTB/HIV Working Group
Transforming the HIV/TB Response: Defining the next 10 years
The Stop TB Department of WHO, in collaboration with Georgetown University, organized a high level international consultation on behalf of the TB/HIV Working Group of the Stop TB Partnership, in conjunction with the AIDS 2012 conference in Washington DC on July 21, 2012. The aim of the meeting was to discuss innovative ideas and ways to define and shape the global TB/HIV response for the next decade. It also harvested experiences and identified key challenges and barriers in the scale-up of collaborative TB/HIV activities, including key research gaps.
Why aren't children with tuberculosis getting the attention and care they deserve? CORE Group’s TB Working Group has decided to focus special attention on this issue to accelerate community-based approaches to pediatric TB care and prevention.
October 2011 - The World Health Organization (WHO) reports for the first time that the number of people falling ill with tuberculosis (TB) each year is declining. New data, published today in the WHO 2011 Global Tuberculosis Control Report, also show that the number of people dying from the disease fell to its lowest level in a decade. Yet, current progress is at risk from under-funding, especially efforts to combat drug-resistant TB.
"Written by and for trainers...planning and organising participatory educational sessions with community leaders or organised groups to raise awareness and promote practical action to challenge HIV and TB stigma and discrimination. Can be used alone or with accompanying HIV Stigma materials." STAMPP, CREATE and International HIV/AIDS Alliance, 2009- See local organization project descriptions, posted below, March, 2011
Lessons Learned from TB Work with People Living with HIV. Includes descriptions of integrated interventions and good practice standards
Improving Adherence to Treatment Patients not taking medicine is a chronic barrier to good health. How can we frame the issue and address it effectively? Presentation by Ira Wilson, Professor of Community Health, Brown U, January, 2011.
CORE Group's report out from the annual meeting of the International Union Against Tuberculosis and Lung Disease. Posted December, 2010. (Scroll down to Union Conference Reports.)
Overview of our Working Group
CORE Group’s TB Working Group maintains a consistent—some might say relentless—focus on community-based TB programming. Just a few years ago, TB control was typically managed by “National Tuberculosis Programs” (NTPs), independent government entities, often separate from even the Ministry of Health. This top-down, biomedical model is evolving however, in response to the advent of HIV (TB being the biggest killer of people with HIV), the resulting resurgence of TB, the emergence of multi-drug resistant TB, and a growing understanding of the value of civil society involvement in health efforts.
Obviously, those already active in CORE Group's Community Health Network believe in the effectiveness and efficiency of social and community mobilization, behavior change communications, and patient-centered approaches. In the TB world, these kinds of ideas are often lumped together under the rubric of “Advocacy, Communications and Social Mobilization.” ACSM includes community-oriented efforts to educate the public, reduce stigma, identify likely cases of TB, minimize infection, refer suspects for diagnosis, deliver test results, and support curing of patients as they take medication on a daily basis for as long as several years—in close collaboration with government health systems.
As a relatively new set of activities within the TB world, many gaps exist in understanding how to best use community-level efforts to identify, cure and prevent TB. The data is even thinner with regards to TB and women, children and/or HIV-positive people, especially in low-income settings.
CORE Group’s TB Working Group is helping to identify and fill those gaps. We produce a range of resources, including community-based program design guidelines and case studies, and explore best practices in TB/HIV integration. Here’s a sampling of what we currently have in the works:
- Supporting the development and dissemination of Advocacy, Communications, and Social Mobilization efforts within the STOP TB partnership
- Advocating for better understanding of the value of community-based efforts
- Promoting awareness, diagnosis and treatment of pediatric tuberculosis, and integration of maternal health and TB services.
- Overseeing the update USAID’s Technical Reference Materials—a basic overview of TB control for NGOs interested in getting involved
- Reviewing resources under development by the TB Coalition for Technical Assistance (TBCTA)
- Growing our community-based TB listserv, with a focus on linking with field-based practitioners
- Addressing other practical needs as they arise
Presentations, Tools and Resources: Focus on the Practical
- Pediatric TB and HIV: The Potential of New TB Vaccinces (Elluminate recording - May 17, 2010) Presenter: Dr. Hoosein Coovadia, University of KwaZulu Natal, South Africa. World renowned TB expert Dr. Coovadia visited CORE Group's office to provide an overview of: the state of TB in the world, its links with HIV, effects on women and children, the potential for a TB vaccine, and progress being made towards vaccine solutions. Powerpoint Presentation
- WHO Revised TB Treatment Guidelines: What's New? (Elluminate recording - March 22, 2010) Presenter: Sarah Royce, MD, MPH, University of California, San Francisco Dr. Royce presents an overview of changes made to WHO's TB treatment guidelines, including drug regimens, sputum monitoring, and treatment guidelines for people with HIV and TB. Powerpoint presentation
- Working Group Meeting: TB/HIV State of the Art Update - October 6, 2009
CORE Group's TB and HIV Working Groups joined forces to convene this rich event. Click on the link above for an overview of the cutting edge questions, and presentations on scaling up, pediatric TB/HIV, partnering with communities, the role of malnutrition and more.
- Improve Drug Treatment Adherence Through Patient Support (Elluminate recording - March 4, 2009)
Presenter: Martha Benezet, MCDI
Martha Benezet joined the session from South Africa to discuss MCDI's innovative and effective Facility-Patient Liaison program
- The Expansion of Community-Based Tuberculosis Programming: Critical Program Design Issues for New Partners - 2008
This easy-to-read 40-page paper outlines nine program design challenges for NGOs interested in working on community-based TB programming. The challenges were the result of the two-day Lessons Learned Exchange convened by CORE Group the previous year.
- Linking TB and HIV/AIDS Programs (Elluminate recording) - December 18, 2008
Presenter: Kayt Erhdahl, Project HOPE
Project HOPE is implemented a Child Survival TB Project in Malawi, focused on improving TB and TB/HIV treatment outcomes and increasing case finding through capacity building for health care providers and involvement of groups in local communities. Kayt Erdahl shared experiences from the TB/HIV project in these focus areas and in patient case management, drug management, infection control, nutrition and collaboration between TB and HIV services. Powerpoint: Linking TB and HIV/AIDS Programs
- Accessing and Working with Marginalized Populations (Elluminate recording) - September 24, 2008. Presenter: Alka Dev, Doctors of the World (now Healthright)
- Practical TB Infection Control for Community-based TB Programs (Elluminate recording) - June 11, 2008. Presenter: Kevin Fennelly, MD, MPH, New Jersey Medical School Powerpoint Presentation: Practical TB Infection Control for Community-based TB Programs
- Lessons Learned Exchange: TB Programming from the Community-Based Perspective - February 5 & 6, 2007
Representatives from CORE Group, CRS, PCI, DOW, Project HOPE, PSI, MCDI, WV, PATH, CARE, USAID, STOP TB, TBCAP, and the Open Society Institute met for two days to discuss this relatively new topic. Click on the link for the agenda, PowerPoint presentations and even poster competition award winners!
Community-based TB case studies, project models, journal articles
- CORE Group Case Study: Partnering with Grandmothers and Healers to Eliminate the “Disease of Dust” in Senegal: Community-Based Tuberculosis Control
- CORE Group Case Study: Integrating TB and HIV Care in Mozambique: Lessons from an HIV Clinic in Beira
- CORE Group Case Study: Implementation of a National TB Control Program in Minority Communities: Accomplishments and Challenges from Kosovo
- CORE Group Case Study: Tuberculosis Control in Karaganda Prison through DOTS: Lessons from Kazakhstan
- CORE Group Case Study: Using Incentives to Improve Tuberculosis Treatment Results: Lessons from Tajikistan
- STOP TUBERCULOSE BOUAKÉ, working in Côte d’Ivoire, mobilizes communities and supports patients with TB and/or HIV, as described in their 2010 project report.
- Penduka is a local project, based in Namibia. Their project brochure provides a snapshot of their integrated, community-based project model. 2011.
- MWASO is a local organization, based in Malawi. As you can see if their project achievements, they conduct a range of activities, including working with traditional healers, raising community awareness (see photos), community mobilization and creating sputum collection points. 2011.
- Population Services International (PSI) has a TB and TB-HIV portfolio that focuses on public-private partnerships, primarily in Asia and Africa. 2011.
- Project Concern International has been working in Mexico, implementing innovative community-based TB efforts, with excellent results. Two documents capture important aspects of this work and the Mexican context: Promising Practices in Tuberculosis Prevention: The SOLUCION TB National Experience in Mexico, and From Cough to Cure: Household Survey Findings Report on Knowledge, Attitudes and Practices in TB in Mexico. 2010.
- TB and HIV: An Old Disease Takes on a New Partner This short booklet highlights some of the ways in which Catholic Relief Services is addressing co-infection around the world. 2009.
- Cost effectiveness of community-based TB care in Ethiopia. Randomized control trial. Use of health extension workers reduced treatment costs by 60%-80%. Case detection and treatment success rates were higher for those patients under extension worker care as well. 2009.
- Decentralized TB services, from county to township, China. Intervention project and study by Nuffield Center for Int'l Health& Development. Published in Intl Jl of Tb and Lung Disease. Decentralized treatment improved patient access, quality of care, treatment outcomes. 2008.
- Maguindanao Tuberculosis Control Project: Operations research to assess gender inequalities in access to TB services for women CRS chose the Philippines to study how the DOTS strategy can be strengthenedy by identifying and closing any gender gaps in the diagnosis and treatment of women. The study uncovered key disparities in TB services for men and women, providing the basis for recommendations to design more culturally and gender sensitive TB health programs. 2008.
Overviews of older USAID Grants CORE Group NGO member organizations are/have implemented--description, outcomes, constraints and lessons learned:
- CARE Indonesia
- CARE Zambia
- CRS Philippines
- MCDI South Africa
- PCI Mexico
- Project HOPE Malawi
Union Conference Reports
CORE Group has regularly hosted a booth and participated in the annual meeting of The International Union Against Tuberculosis and Lung Disease. Reports from this meeting document the progress being made in this fast-moving field over the past several years.
- IUATLD Meeting Report- "The Union" Annual Conference-October 26-30, 2011, Lille, France
- IUATLD Meeting Report - "The Union" Annual Conference - November 11-15, 2010, Berlin, Germany: Theme: TB, HIV and lung health
- IUATLD Meeting Report - "The Union" Annual Conference - October 16-20, 2008
- IUATLD Meeting Report - "The Union" Annual Conference, Cape Town, South Africa. Theme: Confronting the Challenges of HIV & MDR in TB Prevention and Care - 8-12 November 2007
- IUATLD Meeting Report - Union World Conference on Lung Health, Paris, November 1-4, 2006
- ACTION: Advocacy to control TB internationally
- The Global Fund to Fight AIDS, Tuberculosis and Malaria: Global public/private grantmaking partnership
- International Union Against Tuberculosis and Lung Disease (The Union): Scientific group addressing TB, HIV and lung issues
- Stop TB Partnership: Global, multilateral body fighting TB
- Treatment Action Group: Advocates for better treatment, technologies, and cures for TB, HIV
- World Care Council: People with TB, HIV promoting quality care, rights and responsibilities
- World Health Organization TB Home Page: Global standards, protocols, policy recommendations
- US Agency for International Development TB programs: Facts, program information, news
Practical References and Resources
Advocacy, Community and Social Mobilization publications STOP TB Partnership, country level focus, generally.
Civil Society Consultation: Report, and Statement from Civil Society. Convened by STOP TB, critique from CSOs. October, 2010.
Community involvement in tuberculosis care and prevention: Towards partnerships for health. World Health Organization. 2008.
Compendium of Indicators for Monitoring and Evaluating National TB Programs World Health Organization. 2004.
EurasiaHealth TB Knowledge Network Clearinghouse of English and Russian language materials.
Global Health E-Learning Center Includes a basic and advanced online learning course. USAID.
Global Plan to STOP TB: 2011-2015 STOP TB Partnership.
Global Tuberculosis Institute Patient and provider education and training resources, facts and news, clinical focus.
Guidelines for intensified tuberculosis case-finding and isoniazid preventive therapy for people living with HIV in resource-constrained settings World Health Organization, December, 2010.
2007 Tuberculosis Technical Reference Materials [English] Basic overview for NGOs interested in getting involved.
Self Study Modules in Tuberculosis Centers for Disease Control. Slides with beginnners overview of TB, treatment, infection control, etc. 2010.
The Patients' Charter for Tuberculosis Care: Patients' Rights and Responsibilities. Globally endorsed document. 2006.
TB CAP Toolbox While focused on the national level, this library does include community-based and patient oriented resources.
TB Education and Training Resources Centers for Disease Control. For use by health professionals, managers, general public.
Tuberculosis Control Programming for PVOs: Facilitator's Manual. To be updated soon!
- Understanding and Challenging TB Stigma. "Written by and for trainers...planning and organising participatory educational sessions with community leaders or organised groups to raise awareness and promote practical action to challenge HIV and TB stigma and discrimination. Can be used alone or with accompanying HIV Stigma materials." STAMPP, CREATE and International HIV/AIDS Alliance, 2009.
- World Health Organization's TB Projects, Programs and Resources homepage