Tuberculosis

Integrated and Innovative Approaches to Preventing and Treating Tuberculosis

In many of the 22 countries that account for more than 80% of TB cases worldwide, URC is supporting anti-TB activities and national TB programs through integrated and innovative approaches to address systemic barriers to effective prevention and treatment, including patient-centered approaches to increase case detection and improve treatment adherence. We support interventions to scale up access to TB diagnostics and laboratories, improve the quality of supervision, and alleviate the human resource crisis by building the capacity of health workers. Through our programs in sub-Saharan Africa, Asia, and Eastern Europe, we are also working with policy makers, program managers, and community organizations to address the growing problem of multi-drug resistant TB (MDR-TB) and extensively drug resistant (XDR-TB) cases.

URC's South Africa TB Program gives children "We Beat TB" lap desks to educate them about the disease.

South Africa TB: Integration and Scale-up

Challenge

URC is assisting the South African government in implementing its National Tuberculosis Strategic Plan. Funded by the United States Agency for International Development (USAID), the South Africa TB Program is designed to help strengthen local capacity to detect, treat, and prevent TB. The URC team provides assistance in strengthening TB care initiatives at the district and community level, as well as strengthening the health system to manage the pressures exerted by the HIV/AIDS epidemic. While the program’s principal focus is at the provincial, district, and community levels, the team also provides assistance at the national level to strengthen critical health systems (e.g., information; supervision; and policies and guidelines for TB, MDR-TB, and XDR-TB prevention and control as well as infection control). The project’s core strategies include capacity building, sustainability, quality of care, and integration and coordination.

The team is building on lessons learned from the previous USAID-funded TASC II TB Project, also managed by URC. The project works in close collaboration with the National and Provincial Departments of Health and provides small grants to community-based organizations to fight TB in their communities. It supports TB control efforts in all nine of South Africa’s provinces, with a special focus on the South African Government’s 18 priority districts.

Results

Improved TB screening among HIV-positive clients in project-supported TB/HIV facilities: from nearly 75% in the first quarter of 2010 to more than 96% in the fourth quarter of 2011.
Helped adapt national treatment and diagnosis guidelines to include the GeneXpert algorithms, which rapidly detect both the presence of Mycobacterium TB and the resistance to rifampicin, a common TB drug.
Reached 72% of Black South Africans ages 16–64 and 62% of children ages 5–14 through Stop TB TV commercials.
Reached over 40,000 school-aged children through the “Kick TB” campaign, which– fuses soccer and social mobilization to create a platform through which TB-appropriate messages are conveyed to school-aged youth.
Awarded 36 small grants to date to 32 NGOs to help to increase demand and availability of TB and TB/HIV services.

TB Control in Georgia

Georgia’s health system is undergoing several rapid policy and programmatic changes. Since TB and MDR-TB pose a challenge to the country, the USAID Georgia Tuberculosis Prevention Project is working with the Ministry of Health to make sure that quality TB services are provided in an era of expanding privatization. The project is contributing to achieving the overall USAID/Georgia and Government of Georgia’s objective to reduce the number of all TB cases, with the goal of helping to achieve its Millennium Development Goals.

Bangladesh

Bangladesh ranks sixth among the 22 highest burden TB countries worldwide. Stronger health services are needed to combat the estimated 360,000 new TB cases each year and prevent the more than 70,000 annual TB-related deaths among the country’s young and growing population. MDR-TB is also a growing threat for Bangladesh, with more than 9800 cases in 2008, although the capacity to diagnose and treat MDR-TB remains limited.

Through the TB CARE II project, URC works closely with the Government of Bangladesh and the National TB Program to strengthen the country’s response to the disease and build local capacity to improve universal access to TB diagnosis and treatment as a critical means of reducing TB-related morbidity and mortality. Since 2011, URC has assisted the Government to:

Develop or revise guidelines targeting pediatric TB services and TB infection control;
Plan and implement a model for community MDR-TB treatment;
Provide counseling and vocational training for MDR-TB patients; and
Provide training in acid-fast bacilli microscopy, the primary diagnostic tool for TB detection and control, for all 103 lab technicians in six targeted districts.

Current Projects

HIV and AIDS Comprehensive Care Initiative (HACCI)
Funded By: US Centers for Disease Control and Prevention through the President's Emergency Plan for AIDS Relief
Project Duration: 2008 to present

Building Human Resource Capacity to Support Prevention, Care, and Treatment: Strategic Information and Other HIV/AIDS Programs
Funded By: US Centers for Disease Control and Prevention
Project Duration: 2008 to present

Better Health Services (BHS)
Funded By: US Agency for International Development
Project Duration: 2009 to present

Strengthening TB Case Detection and Treatment and TB-HIV Coordinated Activities
Funded By: URC
Project Duration: 2007 to present

South Africa Tuberculosis Program
Funded By: US Agency for International Development
Project Duration: 2009 to present

Increasing Access to HIV Testing and Counseling
Funded By: US Centers for Disease Control and Prevention
Project Duration: 2006 to present

HIV/AIDS and Tuberculosis Laboratory Support
Funded By: US Centers for Disease Control and Prevention
Project Duration: 2009 to present

Global Fund Consulting Services
Funded By: The Global Fund to Fight AIDS, Tuberculosis and Malaria
Project Duration: 2007 to present

Translating Research into Action (TRAction) Project
Funded By: US Agency for International Development
Project Duration: 2009 to present

Technical Assistance and Support Contract 3: Global Health (TASC3 Global Health)
Funded By: United States Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Bolivia
Funded By: US Agency for International Development
Project Duration: 2008 to present

USAID Health Care Improvement Project (HCI) | Ethiopia
Funded By: US Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Indonesia
Funded By: US Agency for International Development
Project Duration: 2009 to present

USAID Health Care Improvement Project (HCI) | Global
Funded By: US Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Mali
Funded By: US Agency for International Development
Project Duration: 2009 to present

USAID Health Care Improvement Project (HCI) | Nicaragua
Funded By: United States Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | South Africa
Funded By: US Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Swaziland
Funded By: US Agency for International Development
Project Duration: 2007 to present

USAID Health Care Improvement Project (HCI) | Uganda
Funded By: US Agency for International Development
Project Duration: 2007 to present

Lesotho Health Sector (LHS) Project
Funded By: Millennium Challenge Corporation
Project Duration: 2009 to present

Strengthening Uganda’s Systems for Treating AIDS Nationally (SUSTAIN)
Funded By: US Agency for International Development (USAID)
Project Duration: 2010 to present

Developing Strategies in the Central America and Panama Region to Strengthen Reponses to the HIV Epidemic
Funded By: Centers for Disease Control and Prevention (CDC)
Project Duration: 2010 to present

TB CARE II
Funded By: United States Agency for International Development (USAID)
Project Duration: 2010 to present

Improving TB Detection and TB-HIV Services Integration
Funded By: URC
Project Duration: 2011 to present

Georgia Tuberculosis Prevention Project (TPP)
Funded By: US Agency for International Development (USAID)
Project Duration: 2011 to present

Community Empowerment of People Against Tuberculosis (CEPAT)
Funded By: US Agency for International Development (USAID)
Project Duration: 2012 to present

Past Projects

Data Quality Audit (DQA) Framework
Funded By: The Global Fund to Fight AIDS, Tuberculosis and Malaria
Project Duration: 2008-2010

USAID's Health Promotion and Communication Project (HealthPRO)
Funded By: US Agency for International Development (USAID)
Project Duration: 2007–2012

USAID Health Care Improvement Project (HCI) | Russia
Funded By: US Agency for International Development (USAID)
Project Duration: 2007-2012

USAID Health Care Improvement Project (HCI) | Vietnam
Funded By: US Agency for International Development
Project Duration: 2007 to March 2011

Integrated Infectious Disease Capacity Building Evaluation (IDCAP)
Funded By: Accordia Global Health Foundation
Project Duration: 2008-2012

Improving Primary Health Care in Albania I and II (Pro Shëndetit)
Funded By: US Agency for International Development
Project Duration: 2003–2009

Nongovernmental Organization Service Delivery Program in Bangladesh
Funded By: US Agency for International Development/Bangladesh
Project Duration: 2002-2006

Health Systems Strengthening (HSS)
Funded By: US Agency for International Development/Cambodia
Project Duration: 2002-2008

Central America Health Consultancies
Funded By: The World Bank
Project Duration: 1990-1995

El Salvador Strengthening Health Project Technical Assistance and Support Contract 2 (TASC2)
Funded By: US Agency for International Development
Project Duration: 2006–2009

Diagnostic Test Cost Analysis for the Developing World
Funded By: The Bill and Melinda Gates Foundation
Project Duration: 2007–2009

Health Planning and Health Delivery Systems
Funded By: US Agency for International Development
Project Duration: 1983-1990

Primary Health Care Management Advancement Program
Funded By: The Aga Khan Foundation
Project Duration: 1991-1993

Partnerships for Health Reform Project and Partners for Health Reformplus
Funded By: US Agency for International Development
Project Duration: 1995–2005

Primary Health Care Operations Research Project (PRICOR) I and II
Funded By: US Agency for International Development
Project Duration: 1981–1991

Water and Sanitation for Health
Funded By: US Agency for International Development
Project Duration: 1988–1994

Kazakhstan TB Project
Funded By: Project HOPE
Project Duration: 2000-2001

Quality Assurance Project (QAP) I, II, and III
Funded By: US Agency for International Development
Project Duration: 1990-2008

TASC II Tuberculosis/South Africa
Funded By: US Agency for International Development/South Africa
Project Duration: 2004-2009

Integrated Technical Assistance Project
Funded By: US Agency for International Development/South Africa
Project Duration: 2004-2008

e-Health in Bangladesh: Survey on Strengthening Remote Health Service Facilities
Funded By: Grameen Communication Center
Project Duration: 2008

Technical Assistance and Support Contract 2 (TASC2): Global Health
Funded By: United States Agency for International Development
Project Duration: 2004–2009

TB Program Evaluation in Benin
Funded By: The Global Fund to Fight AIDS, Tuberculosis and Malaria
Project Duration: 2011-2012