No longer business as usual for tuberculosis response



By Shobha Shukla, CNS
November 21, 2012
The author is the Managing Editor of Citizen News Service (CNS). She is currently providing on-site news coverage from 43rd Union World Conference on Lung Health, with kind support from the Lilly MDR TB Partnership and Global Alliance for TB Drug Development (TB Alliance). She is a J2J Fellow of National Press Foundation (NPF) USA. She received her editing training in Singapore, has worked earlier with State Planning Institute, UP and taught physics at India's prestigious Loreto Convent. She also authored a book on childhood TB (2012), co-authored a book (translated in three languages) "Voices from the field on childhood pneumonia" and a report on Hepatitis C and HIV treatment access issues in 2011. Email: shobha@citizen-news.org, website: http://www.citizen-news.org

Kuala Lumpur: As the curtain draws upon the 43rd Union World Conference On Lung Health in Kuala Lumpur, all those involved in health care in some way or the other - TB affected communities, governments, donors, researchers, healthcare professionals, broader civil society, among others - need to deliberate upon this dictum.

If you are the government then show the political will to bring some order into the chaos that pervades the world of TB, especially in the high burden TB countries. TB is not only a public health problem but also a socio economic problem. Make the health systems (right from primary health centres to tertiary care centres) accountable to the communities they serve. And, above all, make the systems work. Invest in better diagnostic tools and quality medicines that would save lives; invest in research and development for better drugs and vaccines--rather than indulge in amassing arms and ammunition that take away lives. Putting good laws in place is important, but they are of no use on paper only and need to be implemented at ground level. Bridge the gap between policy and practice. Political commitment and implementation fidelity will go a long way in controlling TB.

If you are the donor then please continue with innovative financing and quality assurance mechanisms to respond to the health challenges of today. Invest in TB control programmes, but at the same time do ensure that there is equitable distribution of funds and that they are fully utilized to deliver the desired results within the given time framework, and not frittered away. The price of funding lies in achieving the intended outcomes. Also, please ensure a robust and sustained funding for research for finding effective vaccines and safer, shorter, cheaper drug regimens for TB treatment.

If you are the researcher, then the entire world has high expectations from you. The world is desperately waiting for effective vaccines and cheaper, safer and shorter duration drug regimens as well as improved diagnostic tools. All our eyes are focused upon you to deliver what is the desperate need of the hour. Your painstaking labour can bring back the joy of life to many.

If you are a health professional/caregiver, please be accountable to the communities you serve. Link your knowledge to practice, with compassion. The patients look up to you like God. They need to be respected as human beings despite their TB and not treated with disdain as a mere number in the hospital register. You are there to help them--that is your job (for which you are getting paid) if not your vocation. So justify the trust and honour the tremendous faith reposed in you by the patients’ community. In the patients’ well being alone lies your prosperity.

If you are the media please take some time out from reporting crime, sex and scandal and give some attention to the catastrophe called tuberculosis that globally kills nearly 5000 people every day despite being curable. Communicate the severity of the disease that could affect anyone of us. Spread the awareness in loud and clear messages. A bus mishap killing all on board (50 perhaps) makes headlines. TB is like the full load of 100 such buses crashing every day, yet it rarely gets front page coverage. Become the voice of the voiceless by focusing attention on TB, educating the masses, empowering communities, and forcing administrators to deliver the goods, so believes Citizen News Service – CNS.

If you are civil society members (I think all of us fit into this category as we all, hopefully, are civil, and a part of society) then bring some meaningful activism and advocacy in the TB world. As civil society activists we have to work individually and together, at regional, national and multilateral levels to (i) hold political leaders and decision-makers accountable to immediately accelerate efforts to achieve ZERO TB deaths; (ii) participate in all aspects of strategy development and implementation plans-- both at the country and global levels-- with an active engagement of affected community members; (iii) uphold the respect for human rights of people affected by TB, and promote a people-centered care model that recognizes the right of every person to be informed and empowered about TB and (iv) demand universal access to quality, affordable and integrated health care for all.

If you are the affected community, then wake up! Be an activist and an advocate for your own self. Even a mother may not feed her baby unless the baby cries. If you are standing at the bottom rung of the ladder and looking up for manna to fall down, you may have to wait endlessly. Bring the ladder down and make it rest horizontal so that all those who were supposedly above you are now with you. You have tolerated your neglect enough; do not tolerate it any more. The HIV community has done this in a short span of time and extracted a much better deal for themselves in terms of improved diagnosis, treatment and care. The TB community simply needs to replicate that model. Those who are cured should not wipe the disease off their memory but lead the bandwagon of helping those who are still struggling and demand a better deal for them. Take TB out of the doctors’ clinics and make it a more patient centric and community/family supervised treatment.

This is my prayer to all of us. Amen!

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Posted on: November 21, 2012 08:25 PM IST