TB Advocates Gather in Rio de Janeiro

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Some of the greatest minds on TB gathered this week here in Rio de Janeiro, Brazil, where advocates, researchers, and donors from all over the world attended the Stop TB Partnership. TB is killing nearly 2 million people a year, yet still gets far too little attention, and the purpose of the conference was to refocus global action on this disease.

Advocates like Lucy Chesire of Kenya explained the personal impact of TB on their lives and what global leaders — including President Obama — should do. She said, “We must measure our success by how many lives we have saved. History will judge by the actions and decisions we take here and the implemenation of programs on the ground. TB-HIV will destroy mankind if mankind does not destroy TB-HIV.”

Be sure to watch a few of the online videos of the meeting, including Lucy’s presentation at the plenary, at:

http://webcast4.isat.com.br/stoptb/

I have had the priviledge to attend the meeting, along with about 1800 others from around the world, and I will post here some accounts and photos, including from some interesting visits to health programs in poor areas in Rio.

Some members of the Infectious Diseases Society of America, such as Richard Chaisson, Director of TB Research at Johns Hopkins University, also attended the meeting.

Chaisson participated in a briefing for the media sponsored by IDSA’s Center for Global Health Policy and Advocacy and RESULTS, in which he explained how TB is having a terrible impact among people with HIV/AIDS. He said, “Once someone whose immune system has been damaged by HIV becomes ill with tuberculosis, without treatment, the likelihood of death is essentially 100 percent within six months. The problem in Africa is HIV patients are not being diagnosed early enough. They die and they die quickly.”

Chaisson also took part as rapporteur in a session sponsored by CREATE that focussed on practical ways of bringing TB care right into some of the most difficult to serve communities, such as prisons, mines and urban slums.

He said community mobilization in these places, including the use of peer educators, is the key to success in these areas. However, he noted that payment of community health workers, who can do an extraordinary job, is important and all TB strategies must be budget for this.

I certainly saw this in the visit I made to a health clinic yesterday in a poor area in Rio, where the crucial role of community health workers was clear.

In fact, a recurring theme of this meet has been the need to bring TB control more into the community, including in social awareness at the local level. While in many places in the most affected communities, in Africa for instance, you might see HIV/AIDS billboards and hear radio announcements, the level of outreach and social mobilization about the issue of TB, in terms of prevention, treatment, and care, is far lower than it needs to be.

Chaisson said that this lower level of community participation results in comparatively less “demand” for TB services. This results in turn in less adherence to services and a slower pace in the expansion of programs.

Winstone Zulu, a Zambian advocate, told me, “We need to end the mystification of TB, that is, the sense that it is too complex for ordinary people and should be left to specialists to discuss and deal with, because unless there is community participation we will get nowhere in this fight.”

Much needs to be done to address TB, and key to success will be what the head of the Partnership, Marcos Espinal, called for at this meeting, which is a renewed sense of outrage about the terrible toll this disease is taking.

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