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Country Visits
National Dialogue in Belarus - Collaborative Plan of Action to End TB

National Dialogue in Belarus – Collaborative Plan of Action to End TB

On the 6th and 7th August, TBEC ran the first National Dialogue for the Development of Partner Cooperation to End TB in Belarus. What does this long title actually mean? And what actually happened during the course of these two days in Minsk? During the two days, the 45 participants discussed how to organise people centred TB care in cooperation between civil society and how to introduce mechanisms for social contracting of TB care. The participants included: experts, key decision makers, people living with TB, representatives of civil society, two deputies from the Belorussian national assembly, three directors from state-level health departments, head of TB services, international experts, and journalists. The event was organised under the auspices of the regional TB Rep 2.0 programme. However, the thing that truly differentiated this from other events was that people living with TB participated on equal grounds with doctors and healthcare organisers. We would even go as far as to say that genuine dialogue took place – almost everyone who needed to be there was able to participate. What was discussed at the National Dialogue? One of the key questions during the meeting was regarding the development of cooperation between TB services and societal organisations in More…

Belarus: Key country in the fight against Multi-Drug Resistant TB

Belarus: Key country in the fight against Multi-Drug Resistant TB

In mid May, Daniel Kashnitsky and I joined with Tsira Chakaia and a Tajikistan member of parliament (MP), Jamshed Murtazaqulov, in a joint TBEC and Global TB Caucus (GTBC) visit to Belarus. Our intentions were to explore possible initiatives in Belarus under TB REP2 and also whether there is interest in creating a local MP caucus on TB. Over 3 days we had a fascinating series of meetings with parliamentarians, national health bodies, civil society, the WHO country office, and the British Embassy. The overall picture is very encouraging. Ten years ago, Belarus had some of the worst MDR rates in the world together with poor treatment success rates. Today a combination of improvements in the national programme and the introduction of new drugs, especially Bedaquiline (BDQ), have had a very positive impact. From this year onwards, BDQ is being made available in all parts of the country although there is still work to be done to ensure access to it for all. New case incidence is down from 58 in 2009 to 32 per 100 000 in 2017. Treatment success is up to an impressive 83%. Mortality is going down by around 10% per annum. New cases have dropped More…

TBEC's first-ever workshop in the Balkan region

TBEC’s first-ever workshop in the Balkan region

Although TBEC covers all 53 WHO Europe region countries, it is no secret that the majority of the TBEC’s advocacy and capacity building activities are focused on 18 high priority countries in the region, specifically, the Baltic states, Romania, Bulgaria and Eastern Europe and Central Asia region. So much so that it was not particularly surprising that as part of the TBEC member skills analysis and annual membership surveys, TBEC received numerous invitations from its few members in the region to visit and engage pro-actively in TB care in the Balkan countries. Thus, when an opportunity to organise a joint capacity building workshop with the European Respiratory Society (ERS) presented itself, TBEC was keen to take a chance and use it for a slightly “experimental” regional workshop in Zagreb, Croatia.  As often happens, the “experiment” paid off tenfold, and on 16-17 April, TBEC together with ERS successfully held the first-ever regional workshop in the region on “Enhancing TB advocacy, people-centred care and collaboration in TB care between civil society organisations and healthcare professionals across the Balkan states”. For TBEC, it was a workshop with a lot of “First-Evers”: 1) the first time TBEC had ever partnered with ERS to organize More…

The TB Europe Coalition delegation visited Latvia

The TB Europe Coalition delegation visited Latvia

On 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). Incidence of MDR TB cases has also decreased over the years from 332 cases in 1997 to 63 in 2014 (Chart 2). 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 More…

TB Europe Coalition meets and trains TB civil society and communities in Tajikistan

TB Europe Coalition meets and trains TB civil society and communities in Tajikistan

From 15 to 19 April 2015, members of the TBEC Steering Committee visited Tajikistan in order to meet with key stakeholders working on Tuberculosis (TB) and build the advocacy capacity of civil society and communities. This was the first TBEC visit in Central Asia and was facilitated by the recently created STOP TB Partnership Tajikistan and the organization hosting its secretariat, Young Generation for Tajikistan. Tajikistan is one of the 15 high-burden countries for Multi-Drug Resistant TB in the WHO European region. Since 2000, TB incidence has decreased from 250 to 100 cases per 100 thousands inhabitants. While general TB rates are improving, widespread poverty combined with mountainous terrain continue to limit access to health and TB services. In 2014, a total of 5313 new TB cases were reported. The country is currently drawing up its third national TB programme. The programme, however, remains heavily dependent on external financing, with close to 70% of NTP resources being provided by international donors, mainly the Global Fund and USAID. Other challenges for TB care relate to high rates of MDR- and XDR-TB, increasing incidence of TB among Tajik labour migrants, and difficult access to TB treatment in prisons. After three days of More…

The TB Europe Coalition meets TB actors in Georgia

The TB Europe Coalition meets TB actors in Georgia

 Between 3 and 7 November 2014, a delegation of the Tuberculosis Europe Coalition* (TBEC) visited Tbilisi, Georgia. TBEC representatives held discussions with key stakeholders and organised a two-day workshop to support ongoing efforts of civil society organisations working in the field of TB, which recently formed a national TB Coalition. TBEC’s visit and the creation of a national TB coalition was extremely timely considering the number of ongoing activities and opportunities for TB care and control in the country. Among these, the drafting and presentation of a National TB Strategy and the Global Fund’s concept note for TB and HIV, which are due in 2015, will have a prominent role. While working on these key documents, TB actors in Georgia will have to thoroughly reflect on the long-term sustainability of their TB programme and prepare for the major changes expected in the coming years. In fact, as in many other countries in Eastern European and Central Asian, Georgia is facing a reduction of international donors’ support to health, which risks to greatly affect the TB programme unless proper transition to domestic financing is put in place. Major concerns come from the phasing out of Global Fund, the main donor in the More…

TBEC meets and carries out advocacy workshop with key TB stakeholders in Armenia

TBEC meets and carries out advocacy workshop with key TB stakeholders in Armenia

From 6th-11th June, TBEC members Paul Sommerfeld, TB Alert UK, Bruce Warwick, RESULTS UK , and Zahedul Islam, International HIV/AIDS Alliance in Ukraine, met with TB advocates and other stakeholders in Armenia. Our visit was facilitated by Positive People Armenian Network, an NGO working to provide care and support for people living with HIV. The main aims of our visit, as with previous country missions, were to meet with key TB stakeholders (local NGOs, international NGOs, government representatives and donor agencies) in order to: Understand in greater detail the challenges for advocacy organisations working on TB or related areas (including the financing of TB advocacy and the broader local NGO landscape). Provide an advocacy workshop for local NGOs in Armenia. To further involve Armenian NGOs in future TBEC activities. Bilateral Meetings Throughout the week we held several bilateral meetings with both local and international NGOs. It was clear that when it comes to activities specifically related to TB in Armenia, the main players are international NGOs, including the Armenian Red Cross Society (ARCS),  Medecins San Frontieres (MSF) and Mission East. MSF are heavily engaged with the management of drug-resistant TB and have been working closely with the National TB Centre in order to provide Bedaquiline More…

Former Global Fund Chief Warns about a TB crisis in EECA

Former Global Fund Chief Warns about a TB crisis in EECA

The West cannot ignore a growing TB crisis in EECA, says Michel D. Kazatchkine, the former Global Fund Executive Director, and now a UN Secretary General‘s Special Envoy on HIV/AIDS in Eastern Europe and Central Asia, in his recent Huffington Post blog Recalling his recent trip to Uzbekistan, where he was on a mission devoted to HIV/AIDS, TB and MDR-TB, Michel Kazatchkine talks about a surprise to him “to hear medical students in Tashkent, Uzbekistan’s capital city, claiming in a unanimous voice that they see “phtisiology” as the most exciting professional future they wish to consider at the end of their studies” (the term used in Russian is ‘phtisiathry’ – ftiziatria – from Greek фθίσις — ‘spitting blood’ and ἰᾱτρεία — to cure, treat – a branch of clinical care that deals with Tuberculosis, common in all countries of the former USSR). Speaking on his visit to the Republican Scientific and Practical Centre of Phtisiatry and Pulmonology in Tashkent – which is also the reference point for TB in Uzbekistan – (the official web-site of the Centre is available in Russian), M.Kazatchkine commends the Head of the Centre, Professor Tillyashaikhov Nigmatovich, on the 800-beds in-patient facility, on ambulatory sections, a More…

TBEC participates in the WHO National TB Programme Review for Armenia

TBEC participates in the WHO National TB Programme Review for Armenia

Recently, Oxana Rucsineanu, a member of the TB Europe Coalition Steering Committee, was invited to take part in the WHO Review of the National TB Programme for TB Control in Armenia. Oxana’s invite follows calls from civil society organisations towards the WHO to include a civil society or key affected voice in these NTP reviews. With her extensive experience both of TB itself and of the need to include the civil society voice in TB programmes, Oxana was well placed to take part in this visit to Armenia. Here Oxana shares some of her findings and recommendations from the visit. Findings It is promising to see that recently one TB patient group, led by an MDR-TB survivor, has been formed in Armenia. This is considered a big step in making the voices of people affected by TB heard and their needs better articulated. On a similar note, the involvement of ex-patients in peer to peer education started in June 2014. There are several NGOs active in TB control in Armenia, though the extent to which they are working on the issue is certainly varied. These include: The Armenian Red Cross Society (ACRS), MSF, Mission East Armenia, Yerevan Home Care, Foundation for More…

TB in Romania: For Patients Waiting for XDR-TB Treatment in Romania, Someday Never Comes

TB in Romania: For Patients Waiting for XDR-TB Treatment in Romania, Someday Never Comes

In March 2014, Jonathan Stillo, a member of TB Europe Coalition’s Steering Committee, participated in the joint World Health Organization (WHO) and European Centre for Disease Control (ECDC) National Tuberculosis (TB) Program Review in Romania on a team of eleven international and fifteen national experts. This blog does not necessarily reflect the positions of WHO or ECDC and should be seen as one research and advocacy expert’s opinion that is informed by eight years of working in Romania. The published 2014 review of Romania’s TB program should be available in early autumn. Right now, 30,000 Romanians have various forms of TB. This is by far the largest number in the European Union (EU), accounting for about 25% of all cases in member states. Over the past ten years, the overall TB incidence in Romania has dropped steadily. However, even after this reduction, Romania’s TB incidence and prevalence eclipse all other EU countries. The Romanian incidence rate is presently more than five times the EU average and about twenty times higher than low incidence countries such as Germany. Romania also has the largest number of drug resistant TB cases in the EU. About 1,500 people are living now with Multi-Drug Resistant More…

The TB Europe Coalition supports sustainability of TB and HIV programmes in Macedonia

The TB Europe Coalition supports sustainability of TB and HIV programmes in Macedonia

On 2-5 June 2014, the TB Europe Coalition visited Skopje, Macedonia, to assist local stakeholders in the preparation of a sustainability plan of national TB and HIV programmes. During the mission, the TB Europe Coalition met with several actors and facilitated a workshop on financial sustainability in order to facilitate successful transition from Global Fund (GF) to domestic financing in the country. In spite of Macedonia being a low incidence country[1], a high number of cases are concentrated among the most vulnerable groups, such as injecting drug users, sex workers and Roma communities. With a 30% unemployment rate, a considerable part of the population left without health insurance and experience challenges in accessing health services. Most worryingly, the current financial crisis resulted in a reduction of domestic funding that has impacted the health system and especially the provision of prevention programmes by the Ministry of Health. In this context, the GF has played a crucial role in supporting TB and HIV programmes since 2004. However, Macedonia now qualifies as a Middle Income Country and according to the GF’s New Funding Model is no longer eligible for funding. With around 95% of TB and HIV preventive activities still depending on GF More…

TB Europe Coalition meets with Ukrainian civil society

TB Europe Coalition meets with Ukrainian civil society

Following the end of the TB Europe Network meeting in Kyiv, members of the TB Europe Coalition seized the opportunity of being in Ukraine to meet with local TB civil society organisations (CSOs) and relevant stakeholders in the country. This was the second visit of the TB Europe Coalition to Ukraine, following the first one in November 2010. On 25 April 2014, a group of TB Europe Coalition members met with the Delegation of the European Union to Ukraine. The discussion focused on the work of the European Union (EU) to support the fight against TB in the country and, more in general, the assistance offered by the Delegation to local CSOs. The representative of the EU Delegation explained that most of the money that the EU invests in TB in Ukraine is channeled through the EU contribution to the Global Fund and general budget support to the Ukrainian government. In spite of this, there may be opportunities for local non-governmental organisations engaged in the fight against TB to access resources, especially in the field of human rights and vulnerable groups, which remain priorities in the EU-Ukraine relations. In this sense, it was underlined that TB CSOs ill increasingly coordinate More…

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