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Health care

Global goal to end Tuberculosis needs more support and funding

Even after World Tuberculosis Day, Cordaid continues to emphasize the need to boost the global campaign to end TB. “It remains the leading infection disease in the world. In DR Congo the TB epidemic is alarming. An increasing number of TB cases prove to be drug resistant”, says Jean Lambert Mandjo, who coordinates the Cordaid HIV and TB Project in DR Congo.

(TB drug administration in Ihimbi. © Adriaan Backer)

In 2018 alone nearly 170.000 TB cases were detected in DR Congo. This makes up for the second-worst TB situation on the African continent.

“Globally, more than 1.5 million people are dying of TB annually. Even more people are suffering daily from this disease that can be avoided and cured.”

Jean Lambert Mandjo, HIV and TB Project Coordinator in DR Congo

To gain traction on the epidemic, there is an urgent need to improve TB case detection. This is why the Global Fund works with Cordaid in DR Congo to:

  • integrate TB screening into routine health assessments;
  • mobilize private health care providers to diagnose and provide treatment;
  • develop more effective methods to report TB and integrate them in national health programs.

Finding and treating patients throughout DRC territory

In conjunction with the National Tuberculosis Program and with generous support from the Global Fund, Cordaid and its partners are actively detecting and screening cases of tuberculosis. “We do this throughout the vast territory of DR Congo”, says Jean Lambert Mandjo, “in the urban as well as the most isolated rural communities. But also in prisons and other high-risk locations. Finding and treating patients, and leaving no one behind is our leitmotif. In addition, we plan to expand access to quality treatment for all TB patients”, he continues.

‘TB Village’: a successful community outpost

Recently, a Cordaid supported community health post opened its doors in N’Djili, in the province of Kinshasa. This ‘TB Village’, as it is called, is located in the heart of a populous community and offers free quality care services to all. It uses new and high quality tools to screen TB as well as HIV and AIDS. “The purpose of this advanced health post is to pro-actively search for all cases of TB in the community”, Mandjo explains. “Specifically those who remain beyond the reach of our health centers.”

In the first 4 days alone, medical staff took 464 X-rays and revealed 143 new TB cases. 2 of them proved to be multi-drug resistant TB cases.

2 causes for alarm: drug resistance and under-reporting

Overall, the number of TB related deaths in DR Congo has decreased in 2018. “This in itself is good news”, Mandjo continues. “But it shouldn’t detract our attention to two alarming trends: drug resistance and under-reporting.”

tuberculosis

X-ray analysis in a health center in Idjwi, South Kivu. (© Adriaan Backer)

Drug-resistant tuberculosis is a serious public health problem in DR Congo. In 2018, 770 people contracted a form of tuberculosis resistant to at least Rifampicin – the most effective first-line TB drug. The overwhelming majority of these people had multidrug-resistant tuberculosis, which is resistant to both Rifampicin and Isoniazid, another essential first-line anti-TB drug.

Under-reporting and under-diagnosis of TB cases pose serious threats as well. According to WHO estimates, the DRC is expected to report 322 TB cases per 100,000 population. Yet in 2018 it has reported 188 per 100,000 inhabitants. This means an approximate 60% of people who have tuberculosis have not been reported and diagnosed.  And under-detection among children is far greater than among adults.

In 2018, tuberculosis prevention and treatment in low- and middle-income countries was underfunded by 3.5 billion USD.

To globally increase detection, diagnosis and treatment  of TB, the Global Fund, WHO and the Stop TB Partnership launched the FIND. TREAT. ALL. #ENDTB-campaign in May 2018. The aim is to reach 40 million people with TB with quality treatment in the next 5 years. In DR Congo, Cordaid’s efforts are geared towards this aim.

Global goal to end TB by 2030 not met without extra funding

Given the challenges, Mandjo calls for more international support and funding. “Globally, there is more political will and awareness to end TB. But countries need to move faster. They urgently need to increase national and international funding to fight the disease. Especially address the alarming increase of drug-resistant TB and reporting gaps. If we don’t step up our efforts, we will not end TB by 2030, which is the global target of Sustainable Development Goal 3.

In 2018, tuberculosis prevention and treatment in low- and middle-income countries was underfunded by 3.5 billion USD. Without extra funding¸ the funding gap will increase in 2020. On top of that, additional funding is needed to accelerate the development of new vaccines, diagnostics and medicines.

“More than 1.5 million people are dying of TB annually. Even more people suffer daily from this disease that we can avoid and cure,” Mandjo concludes. “This is unacceptable. We must join forces, to do what the world promised to do, which is to leave no one behind and end TB by 2030.”

Read more

This publication shows in detail how Cordaid addresses HIV and TB in fragile contexts (PDF, in French)

Read the World Health Organization’s 2018 Global Tuberculosis Report

The Global Fund

The Global Fund to fight AIDS, Tuberculosis and Malaria is the world’s leading partnership organization designed to accelerate the end of the three epidemics. In 2018 it invested 5.089.205 USD in 2018 for the fight against tuberculosis.