Once every two years in May, many leading lights of TB care in the WHO Europe Region talk of going off to ‘Wolfheze’. Well, if you explore a detailed map of the Netherlands, you will find that Wolfheze itself is a tiny village in the woods on the Eastern side of the country. It is where the very first of a continuing series of meetings took place about 25 years ago. The name has stuck but the meetings since have mostly taken place in or near The Hague; this year in Scheveningen, the city’s seaside resort and suburb.

The organisers are a triumvirate of KNCV, ECDC, and WHO Europe plus, on the planning committees, representatives of other parties including TBEC. The hard core of the 200 or so participants are NTP Managers but with many other interested partners. Following pressure in past years, it is now accepted that there have to be plenty of civil society people there, not just present but being among the many speakers, session co-ordinators, and reporters.

In practice because of its small size, it is a relatively informal gathering of people from both low and high burden countries of the Region, and a great opportunity for networking and to update on current progress in all aspects of TB care.

This year the focus was on implementation of the calls that came from the United Nations High Level Meeting (UN-HLM) of last September. Overall TB numbers in our Region are declining by around 4% per annum, better than the global average of 2% but still insufficient to meet the 2030 targets. MDR continues to be our key challenge, with political will still insufficient. On the positive side, new drugs, especially Bedaquiline, are clearly helping to improve MDR treatment success rates.

The importance of civil society was often stated but still with limited reflection on how its engagement in national programmes is to be achieved and in particular, how it is to be sustainably funded. Nonetheless, there was a positive half-day session on Countering Stigma and Achieving People-Centred TB Care which was jointly organised by people from TBEC and KNCV and then co-chaired by Olga Klymenko and Jonathan Stillo, both TBEC Board members.

The session began with a strong personal statement by Olga and a video homage to Dean Lewis detailing problems of access to services through his two experiences of TB. Then there were presentations on two projects in Almaty, Kazakhstan. The first had linked the work of 4 local CSOs, 30 private clinics and NTP services. The second had reduced stigma among health staff by getting them to confront their assumptions about people with TB, through interactive training sessions.

The second half of the session was used to present outputs from the Wolfheze Working Group on People-Centred Care (WG-PCC) which had been co-ordinated by Paul Sommerfeld of TBEC. These were firstly A review of PCC research already available in the EECA region undertaken by Jag Dosanjh-Elton of TB Alert; and then, presented by Niesje Jansen and Jonathan Stillo, the WG-PCC Report to Wolfheze 2019on the results of a questionnaire undertaken by the WG which has elicited a number of interesting experiences and comments from both NTP Managers and CSOs.

Both reports are available here.

From the final discussion, it was agreed that the WG should continue in existence and undertake further work, focusing more directly on the experiences of people personally affected by TB. Jonathan Stillo kindly agreed to take over as Coordinator of the WG, thereby bringing a professional researcher’s perspective to its work. The aim remains to help NTPs with insights and information that help them to implement quality people-centred TB care.


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