IMG_4709On 15th – 18th September 2015, three members of the TB Europe Coalition visited Latvia in order to conduct a TB Advocacy workshop, reach to civil society actors in the one of the TB high-priority countries in the EU, and strengthen their voice in a fight against tuberculosis (TB) in the country.
The workshop was organised in collaboration with the Centre for Disease Control and Prevention in Latvia (CDPC) and co-financed by the European Commission.

Latvia with an estimated population of 2.35 million has consistently ranked among the countries with the highest rates of MDR-TB in the world. TB incidence in Latvia has decreased from 74/100,000 in 1998 to 31.8/100,000 cases in 2014. In absolute numbers this means 637 new TB cases in 2014 (Chart 1).Chart1 Incidence of MDR TB cases has also decreased over the years from 332 cases in 1997 to 63 in 2014 (Chart 2).

Chart2

However, Latvia is among the 27 high MDR-TB burden countries in the world and the number of people belonging to social groups at risk of TB is increasing. Among new TB cases, 10% developed MDR-TB and among retreated cases this rises to 26%. Co-infection rates are also high with around 15% of TB patients with known HIV status living with HIV (Chart 3).

Chart3

On the first day of the visit the TBEC delegation met with five (CDPC, TB outpatients department in Riga, Riga Municipality, The Latvian Red Cross Latvian, the NGO “Baltic HIV Association”) stakeholders active directly or indirectly in TB area. The main goal of the preliminary meetings was to learn about the current TB situation in Latvia directly from a range of stakeholders involved in TB action and identify gaps and issues that require more attention and better solutions in order to improve TB services for TB patients. The meetings were also attended by two Latvian TBEC members; it created an opportunity for them to increase linkage between all integrated agencies in the country.

DSC_0116The workshop itself was split in two days, followed by a meeting with key decision-makers from the Ministry of Heath of Latvia on the third day. All participants were individuals active in civil society organisations, governmental institutions and former TB patients that are already or could become involved in action on TB, as many of them work with HIV positive people and could potentially expand their role into TB. Currently in the country, there is not a NGO that would be focusing only on TB issue and TB advocacy.
The workshop programme was adopted and adjusted according to the specific needs of participants and to the findings identified during our preliminary meetings with the stakeholders on the first day of the visit.

The last day – the meeting with Latvian decision-makers was a result of two days of intensive work and preparation with Latvian civil society organisations that participated on the workshop.
The participants agreed on few main and important points which they were prepared to communicate to the Ministry of Health:
A new TB Action Plan for the period 2016-2018 to be developed as a matter of urgency, as the current National TB Action Plan runs until to the end of 2015
Facilitate greater engagement of civil society organisations in the TB programme through training programmes and a small grant scheme
Improve access in rural areas to TB diagnostic services
Increase use of civil society organisations to strengthen and expand TB ambulatory services

The TBEC delegation summarised the points into the Statement that was delivered to the Deputy Secretary of State on Health Policy, the Head of Environmental Health Unit, and the Head of European and International Cooperation Division at the meeting.

The meeting was for all five civil society representatives the first experience of meeting with the high level ministry officials. There is a mutual interest, among Latvian civil society organisations that participated on the workshop and the meeting, to communicate more and cooperate together on TB actions and TB advocacy.


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