World TB Day

A REPORT OF 2010 WORLD TB DAY CELEBRATION GOMBE STATE

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2010 WORLD TB DAY

A CALL TO STOP TB IN KADUNA STATE

BY MR. ISAH DANSSALLAH, PRESIDENT/CEO DESTINY RESOURCE CENTER/FOCAL PERSON,  KADUNA STATE CBOs FORUM ON TB/HIV COLLABORATION

World TB Day is a worldwide call to action and a means to mobilize political and social Commitment. This once-a-year event offers an unparalleled opportunity for stakeholders to raise awareness about the burden of TB in the society. It also bring  all people involved in national tuberculosis control programmes, civil society groups engaged in fighting TB, TB-affected communities and any other groups working to stop TB engage in World TB Day activities.

 This year’s slogan -On the move against tuberculosis: Innovate to accelerate action- offers stakeholders the opportunity to showcase the successes of people in their communities.

 The year 2010 marks the halfway point for the Global Plan to Stop TB (2006-2015). We can meet these goals, but only if we see this as a multi-sectoral problem that affects our work-force, economic, and put in place innovative approaches and work together in new and different ways.

 Nigeria has the highest TB burden in Africa and is 4^th among the 22 countries with high TB burden globally. Estimated incidence for all cases is 311per 100,000 pop (460,000) and estimated incidence for smear positive (SM+) cases is 131 per 100,000 pop (195,000).

It has an estimated TB prevalence of 521/100,000 (772,000) and estimated Mortality rate of  93/100,000 (138,000). The estimated prevalence of MDR-TB among new TB cases is 1.8% and  9.4% among previously treated TB with a prevalence of HIV in adult TB patients (15-49yrs) 27%.

Lagos, Kano, and Kaduna have the highest burden in the country because of the over population.  Kaduna state ranks the third list of high-burden TB state in Nigeria.   

Kaduna State TBLCP Number of total TB cases (all forms) reported under DOTS in 2009 is 4341. This simply indicates that there is the need for DOTS expansion for more case detection.

 Some key challenges:

Due to past patterns of donor involvement, states in the north still have far fewer

TB services than those in the south.

 There is no active participation of the civil society in campaigns to increase community- and patient-driven demands for improved TB and integrated TB/HIV services.

 The State TB and Leprosy Control program have not been funded by the state for over two years due to lack of release of the counterpart funds by the state ministry of health. 

 The State TB and Leprosy Control Program solely depend on the Netherlands Leprosy Relief (NLR)  with little or no plan to sustain the program by the state government  

 I therefore urge the Donors, the NTBLCP, and regional and state officials to devote particular attention to expanding TB control activities in the northern states. In

addition, states must develop targeted services to address the higher concentrations of TB among vulnerable groups, including the urban poor, people living in remote areas, prisoners, migrant laborers, and people living with HIV.

 CSOs, NGOs, and CBOs and the health care facilities needs to integrate TB program into their activities in order to promote TB/HIV collaboration

CSOs, NGOs, and CBOs needs to embark on effective TB campaign/awareness in order to increase new TB case detection in the state and Nigeria at large.

 The general public is therefore encourage to access the available TB services in the state (any cough that lasted for 2 weeks, please go to the nearest DOTS Center).   NGOs should be empowered to sensitize and mobilize reporters and editors of print, electronic and broadcast media about the impact of TB in the society for effective reporting.

 Though, I acknowledge Kaduna state government effort on health matters but there is the need to develop plans to sustain the current TB services rendered by development partners.

 Lastly, the Kaduna state government needs to demonstrate more political will and commitment through increases funding and releases to support DOTS expansion in the state.

 Long live Kaduna state!! Long live Nigeria!!

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Tuberculosis (TB) has remained a serious public health problem in Adamawa State. The World Health Organization estimates that there are over 10,000 cases of all forms of TB in the state. Actual TB case notification averages 2,800 annually for the past 5 years (figure 1).

Figure 1: Trends of Tuberculosis case notification in Adamawa State: 2004 – 2009.

Continuous DOTS expansion and strengthening over the years have not translated into improved case finding; rather, a high sputum conversion (85%0, cure rate (82%) and treatment success rate (89%) was recorded.

Figure 2: Tuberculosis treatment and diagnostic center expansion in Adamawa State: 2002 – 2009

There are 120 TB treatment centers with an average of 5 in each LGA and 34 treatment centers providing TB control services in the State (figure 2). These 2 trends imply that although expansion of services did not lead to the desired increase in case finding, improved access to TB control services contributed to better case holding.

The World TB Day (WTBD) provides an opportunity to reflect on programme performance and raise awareness on TB in Adamawa State with the hope of reaching policy makers and community members. With support from Implementing Partners (IPs) working in the area of HIV and TB in Adamawa State, activities to commemorate the 2010 WTBD were planned and implemented on the 24^th March 2010.

The Event:

The plan was developed and presented by the STBLCO to all IPs in Adamawa State at the 1^st Quarter TB/HIV Working Group Meeting which took place at the SACA office on 20^th March 2010. Contributions were solicited by the STBLCO from all IPs towards staging a successful WTBD at the meeting; the table below summarizes the contributions of our IPs for the 2010 WTBD:

The State Ministry of Health was earlier briefed by the STBLCO on the planned event, the Director Disease Control would have been part of the activities, unfortunately, he was off to Abuja on an official assignment. Early on the 24^th March, banners were fixed at strategic points in Jimeta metropolis.

The event started with a brief address by the STBLCO at the control office around 1:00pm which was followed by an initial press interview and refreshment.

The WTBD motorcade drove out of the Specialist Hospital premises. Starting with the main market street, then the bank street and finally reaching our 1^st stop at the Federal College of Education Yola.

The rally team interacted with students for 30minutes before continuing on its course.

The school authorities wanted the rally team to stage an interaction with FCE students on TB at the convocation square. However, this was not part of the plan. The STBLCO explained to the authorities that such event could be arranged specially for the school in the 1^st or 2^nd quarter of 2010.

The next stop for the rally was the State Ministry of health where the Permanent Secretary and the Deputy Permanent Secretary received the team on behalf of the Honourable Commissioner of health.

The Permanent secretary welcomed the Team. He emphasized the need to design and implement targeted interventions like awareness creation for the WTBD in order to improve case detection of TB in Adamawa State. He also reiterated Government’s commitment towards provision of counterpart funds to the State TBL programme which he said will move the programme forward in the State.

The rally continued on its course towards other densely populated areas of Jimeta metropolis and ended at the control office.

The events of the 2010 WTBD came to a close at 4:30pm.

(1 votes, average: 4.00 out of 5)

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24 March 2010 – Abuja – Nigeria commemorated the 2010 World Stop TB Day on Tuesday 24th March 2010; this year’s theme is “innovation” and the slogan is “on move against TB, innovate to accelerate action”.  The theme was chosen against the background of the fact that tuberculosis is still taking the lives of some 4500 people every day, despite massive efforts across the world to control it.  The aim is to focus on individuals around the world who have found new ways to stop TB and can serve as an inspiration to others. The idea is to recognize people who have introduced a variety of innovations in a variety of settings. 

At a press conference to mark the occasion, the Permanent Secretary Federal Ministry of Health (PSH), Mr Linus Awute mni, said that TB is still a major public health problem in Nigeria, with the country ranking 4th among the 22 high TB burden countries which collectively bear 80% of the global burden of TB. He revealed that the number of TB cases notified in the country increased from 31,164 in 2002 to 96,000 in 2009, representing a case detection rate of 31% and treatment success rate of 82%.

Guests at the occasion include Federal Government Officials, representatives of partners (WHO, USAID and other USG partners, ILEP, CDC, ARFH, and TBCAP), the Nigeria stop TB partnership, the network of persons affected by TB, and non-governmental organizations working in TB.

According to the PSH, The TB burden is further compounded by high HIV prevalence of 4.6%; the national prevalence of HIV among TB patients is currently estimated to be 27%.  In addition, the emergence of resistant TB (MDR-TB) resulting mostly from poor management and poor adherence to TB treatment also poses major threat for TB control efforts in Nigeria. Though the burden of MDR-TB in Nigeria is estimated to be 1.9% among new cases and 9.3% among re-treatment cases, the programme is at the moment conducting a drug resistance survey to determine the actual burden of MDR-TB in Nigeria. Preliminary report of the survey has confirmed the presence of MDR TB in Nigeria.

Mr. Awute then assured the gathering that the Federal Government of Nigeria is fully committed towards reducing the TB burden in the country as demonstrated by the creation of the National Tuberculosis and Leprosy Control Programme (NTBLCP) in 1989.  By 1993, the programme had adopted the WHO recommended DOTS strategy for TB control and by 2006, the revised Stop TB strategy TB control.  NTBLCP is currently providing TB diagnostic and treatment services free of charge nationwide in about 1025 Laboratories and 3459   DOTS treatment centers. 

The WHO Country Representative, Dr Peter Eriki, represented by Dr Klint Nyamuryekunge, delivered the WHO Regional Director’s (RD) message at the occasion.  He stated that although the region represents only approximately 12% of the world’s population, it accounts for 22% of new TB cases every year making it to have the highest TB notification rate per 100 000 population.  However, only 47% of the estimated new TB cases in the population are identified and of these, only 79% complete their treatment.  In addition, about 35% of all TB patients in the region are also infected with HIV and 33 countries in the Region have reported at least one case of MDR-TB and eight of them have reported at least one case of XDR-TB.

The Regional Director, Dr Louis Gomes Sambo, then called on national authorities to mobilize additional resources for TB control from government, the private sector and other partners. This could be facilitated through the establishment of national Stop TB Partnerships.  Governments, nongovernmental organisations, community-based organisations, prison and military services, and other partners should all collaborate to ensure uninterrupted availability of quality-assured first and second line anti-TB medicines. They should also facilitate testing of all TB patients for HIV and linking of all HIV co-infected patients to HIV/AIDS care services especially for antiretroviral treatment and co-trimoxazole preventive treatment in line with WHO guidelines. All HIV care providers should facilitate screening of their patients for TB to ensure that those who are infected receive the benefit of early diagnosis and treatment.  It is also essential for all countries to establish and scale up management of drug-resistant TB as part of basic TB control programme activities.  He also stressed the importance of engaging communities and civil society in the fight against TB.

Dr Sambo observed that although there are only five years to go before the MDG target year, the region could still “make TB cease to be a public health problem” if all stakeholders will join hands in the renewed fight against TB.  “Together, let us all use greater Innovation to move against TB this year”, he concluded.

The WHO Representative in Nigeria a/i, Dr Klint Nyamuryekunge (standing) delivering a goodwill message on behalf of WHO during a press conference to mark 2010 World TB Day in Abuja, Nigeria.  Sitting next right is Mr Linus Awute, mni, Permanent Secretary, Federal Ministry of Health, Abuja, Nigeria. 

27 March 2010 – Abuja – A panel discussion in the Federal Radio Co-orporation of Nigeria (FRCN)’s famous programme Radio Link took place for an hour.  The topic was Tuberculosis control in Nigeria and 4 discussants were drawn from the National TB programme (NTP), World Health Organisation (WHO), Tuberculosis Control Assistance Programme (TBCAP) and the affected community.

30 March 2010 – Abuja – The Nigerian Television Authority (NTA) played host to a team of four TB experts in its well watched Tuesday Night Live programme.  The experts were drawn from the NTP, WHO, Family Health International (FHI) and the affected community.  Discussions were held on the progress, challenges and prospects for TB control efforts in Nigeria.

 31 March 2010 – Abuja – TB articles have been published in 3 major dailies to create awareness and provide information on the current TB control efforts in Nigeria.

(1 votes, average: 5.00 out of 5)

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In Japan, we have translated all the materials issued by WHO into japanese and emailed to about 100 key stakeholders: Diet members, MOFA, MOF, MHLW, mass media, STBJ members, etc.
at the day, in front of the building of Japan anti-tubeculosis association(JATA) in tokyo, despite of unfortunate cold rainy weather, STBJ and RJ have distributed the leaflets to people on the street(please see the attached). this time we have focused on TB for the aged in japan in addition to global TB control, so that many passers-by seemed interested in it.

26th of March, the Yomiuri, the in japan, we have translated all the materials issued by WHO into japanese and emailed to about 100 key stakeholders: Diet members, MOFA, MOF, MHLW, mass media, STBJ members, etc.
at the day, in front of the building of japan anti-tubeculosis association(JATA) in tokyo, despite of unfortunate cold rainy weather, STBJ and RJ have distributed the leaflets to people on the street(please see the attached). this time we have focused on TB for the aged in japan in addition to global TB control, so that many passers-by seemed interested in it.

26th of march, the Yomiuri, the japanese newspaper, the world nunber one in circulation of 10 million, recognized by the Guinnes book record has featured TB with mr. Naruse, 35 years of age, who is former MDR-TB patient and has come out recently and works at JATA to promote TB advocacy.
I think that a lot of concerns are sure to lead to stop TB even by oneself.
HIs message is very impressive, and we will learn his experience on the World TB Day on the article. Japanese newspaper, the world nunber one in circulation of 10 million, recognized by the Guinnes book record has featured TB with mr. Naruse, 35 years of age, who is former MDR-TB patient and has come out recently and works at JATA to promote TB advocacy.
I think that a lot of concerns are sure to lead to stop TB even by oneself.
HIs message is very impressive, and we will learn his experience on the World TB Day on the article.

(2 votes, average: 4.50 out of 5)

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On the 24^th March 2010 Target Tuberculosis, a UK-based INGO, in partnership with The UK Coalition to Stop TB, held a joint World TB Day event in Westminster, central London.

Target Tuberculosis celebrated World TB Day with the launch of its photographic exhibition ‘Hope – Stories from India’ commissioned to the professional photographer David Brunetti. The photographs highlight the impact of the TB pandemic on marginalised communities in and around Dehradun, Uttarakhand State, North East India. These photographs, also featured on the front page of the Financial Times’ World TB Day special supplement, will be on show across the country later this year.

The event also formally launched the UK Coalition to Stop TB’s new campaign ‘TB: A Disease of the Past? Action Now!’ urging the UK Government  to take a lead on the international response to stop TB, by making TB a priority on the UK’s domestic and global health agendas. The UK Coalition to Stop TB is a Stop TB National Partnership, with over 30 organisational members of which Target Tuberculosis is an active member of.

The World TB Day event was attended by Members of Parliament from the three major political parties in the UK, together with representatives from the Department for International Development (DfID) and other major UK donors who support TB control. Lucy Chesire, TB patient activist from Kenya, gave an impassioned keynote speech about her personal experiences of TB, and the realities of TB-HIV co-infection.

Earlier in the day Kibble Ngalauka, Executive Director of the Sue Ryder Foundation in Malawi (SRFIM) – a grassroots organisation implementing community-based TB control initiatives, and Target Tuberculosis’s country partner in Malawi since 2005 – delivered the list of ‘TB Election Asks’ associated with the UK Coalition to Stop TB’s campaign to 10 Downing Street. The leaders of all three main political parties in the UK also gave statements of support for global TB control initiatives on 24^th March.

Through the delivery of the ‘TB Election Asks’ to 10 Downing Street and the photographic exhibition, we were able to effectively highlight to a wide audience the importance of raising awareness of the key issues surrounding tuberculosis and HIV-TB co-infections – the effect they have on the individual and society in terms of stigma and accessibility to appropriate care and treatment, around the world.

(1 votes, average: 5.00 out of 5)

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Collage of TB Events

Papua New Guinea’s National Tuberculosis Programme (NTP) commemorated World TB Day during March this year by gathering the support of the public and private sectors as well as the media to work together to fight tuberculosis in the country.

 Lead up activities took place throughout the five provinces presently covered by the NTP’s Global Fund Grant which are Milne Bay, National Capital District, Madang, Morobe and Eastern Highlands province. 

 These activities ranged from TB case management, clinic and hospital visits, TB awareness in schools and communities and meetings with stakeholders in order to foster greater support and collaboration on TB related issues.   

 World Vision’s TB DOTS Project mascot, Dotsy, is a household name and during this period she travelled to each of the provinces to raise awareness in settlements and villages with high rates of TB. In Eastern Highlands province Dotsy visited six upper primary schools in four districts.  In Morobe she travelled by boat to Finshafen and rode in the ambulance as she visited villages and island communities to conduct awareness.

 A TB training for media professionals was conducted in Port Moresby with the aim of educating journalists about this critical health issue and encouraging them to report on it in a way that engages the public and promotes action from decision makers. Journalists were invited to join our provincial teams in the field so to get a better understanding of the program at a grassroots level and have the opportunity to interview patients, nurses and volunteer treatment supporters.

 This training proved highly effective with extensive media coverage of TB issues throughout the month, including radio talk shows, television documentaries, and TB supplements in both major daily papers.

 World TB Day officially fell on March 24 and the international theme this year was “On the move against TB – Innovate to accelerate action”.  On this day in Port Moresby, a media conference was at the National Department of Health. The Health secretary Mr. Clement Malau, National TB Programme Manager Dr. Paul Aia, JTAI TB project manager Mr. Clement Totavun and World Vision’s TB DOTS Technical Advisor Mr. Marlon Villanueva were present to talk about TB and answer the questions from the media. The NTP partner agencies made an official statement to the press which called all sectors of society to take more action in regards to TB control and education in PNG.

 Meanwhile, on the same day, Morobe province held a major stakeholders meeting, with over 120 political and business leaders, to discuss TB issues and the way to move forward through a collective approach.  

 The other provinces organised large scale community awareness activities that attracted crowds of thousands in Eastern Highlands even though the weather was poor. In Milne Bay and Madang our awareness teams targeted key areas

 To finally conclude the World TB Day activities, the National Department of Health and its partner agencies such as the World Health Organization, Hope Worldwide, World Vision and Jane Thompson Association International organised a walkathon to literally put into practice the theme of being ‘On the Move Against TB’. The event drew 1,500 people, most of whom were Most of the people who took part were the TB front liners such as the TB clinicians, lab technicians, TB treatment support volunteers as well as the public and private sector who also showed their support in numbers to fight tuberculosis in Papua New Guinea.

 Afterwards there was a short program of education and entertainment including key note speakers such as the Australian High Commissioner, the Deputy Secretary for Health, the TB Program Manager, and WHO and World Vision representatives. Dotsy also entertained audiences alongside some traditional dancers. Companies such as Coca-cola (PNG) Amatil Limited and Paradise Foods came on board and donated assorted drinks and biscuits which were used to provide refreshments for those who took part. The event was broadcast on the evening television news and on the front page of the newspaper the following day.

(1 votes, average: 5.00 out of 5)

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