TB REACH in Action: Care, cure and prevention for the hardest to reach

Friday, March 23rd, 2018 in Blog

TB REACH provides grants to partners around the world who are working to increase the number of people diagnosed and treated for tuberculosis (TB). TB is the number one infectious killer in the world and though curable, people affected by the disease are often missed in the health care system (4 million people each year). TB REACH provides funding to test innovative approaches and technologies to find and treat these missing people. TB REACH is a multilateral funding mechanism primarily supported by Global Affairs Canada.

Profile: Innovators in Health, India

Tushar Garg lives in Bihar, one of the poorest states in India. He is a medical doctor by training but wanted to get a better understanding of the challenges in rural public health in India. He now works as the program manager at Innovators in Health, running a program for TB REACH in a region of about one million people. Bihar reports about 70,000 new cases of TB each year, but many more go unreported and undiagnosed. TB diagnosis and treatment is costly – in lost wages, travel, medicines, and hospitalization.

The TB REACH program aims to make it easier for people to get tested and treated for TB, and it’s all about the ASHA (Accredited Social Health Activists) Health Workers. ASHA is the title for community-based health workers in India, it means hope in Hindi. They’re women, members of the communities with whom they’re working, and traditionally have focused on reproductive health.

Now, through training, assistance and resources provided by IIH’s TB REACH program, they have integrated TB testing and care into their daily routine. So when a trusted ASHA worker is making her rounds in the community, she not only knows what signs and symptoms of TB to look out for, but helps each of her patients navigate the incredibly complex system of care – from getting tested, to understanding what drugs to take and when.

Photo credit: https://commons.wikimedia.org/w/index.php?curid=50825008

One million people in India are missing from care – they haven’t even been diagnosed, and often spend years suffering from TB. Through the daily community work of these women, Tushar’s team at IIH is now seeing hundreds of new people getting diagnosed and completing TB treatment. And he believes that this kind of program will continue to work even when the TB REACH program is complete – because the ASHA workers are empowered with the tools and knowledge to bring health and welfare to their communities.

RESULTS Canada citizen advocates have a strong and successful history of campaigning for TB REACH in Canada. In 2016 the Government of Canada announced a funding commitment of $85 million to support another five years of grants for TB innovation around the world. This is a small portion of Canada’s Official Development Assistance (ODA) budget but each TB REACH grant helps organizations understand and improve the community impact of their projects, and how they might work to reach more people missing out on TB care and cure.

Profile: Interactive Research and Development, South Africa

TB is the leading cause of death in South Africa, the highest proportion of which occurs in the KwaZulu-Natal province. But even in such a high-burden area for TB, testing and treatment for pregnant women and children is often neglected. TB is particularly difficult to diagnose and treat in children. For pregnant women with TB, the risk of death for both mother and child increases significantly and even more so if the mother is also HIV positive. Prioritising the care of these two key populations within the health care system is critical in improving maternal and childhood outcomes.

In an effort to address this essential gap in TB care and prevention Munira Khan and Mfundo Sibiya run a special TB REACH program for pregnant women and children under 15 years of age. A team of 30 staff in 12 facilities within a sub district in eThekwini individually screen, test, treat, and most importantly, ensure follow up of pregnant women and children with TB. With an already complex disease like TB, this is no small feat, given the added biological and sociological complications of pregnancy and childhood.

The program has been adapting and using several different approaches to see what works best. This includes leveraging new technologies like the M-health childhood screening App for smartphones, increasing the education and training of health care workers, and building successful relationships with patients based on trust.

Photo credits: https://commons.wikimedia.org/w/index.php?curid=51083796

They are beginning to fill in the gaps in care for women and children suffering from TB. Munira has already noted renewed health care training in her region. Not only has this been personally very rewarding, she believes that in the long-term women and children will no longer be marginalized in the TB care system. In time Munira hopes their work will translate to preventing and curing TB for countless more women and children across South Africa.

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