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Country Visits
It couldn’t happen to me? Living with MDR-TB in Romania

It couldn’t happen to me? Living with MDR-TB in Romania

Today we’re posting a second blog from Tom Maguire’s, part of the Campaigns Team at RESULTS UK, visit to Romania. During his time, Tom met with a young woman called Cristina to discuss her experience of living with multi-drug resistant tuberculosis (MDR-TB). This guest blog from Cristina shows the huge impact MDR-TB can have on a young woman’s life and the level of courage and determination that is needed to complete two years of treatment. You hear about it on TV but you think “Neah! It couldn’t happen to me”. And then it does. And you’re confused, thinking what you’ve done wrong, why did it pick you, until finally you realize you’ve done nothing wrong, you weren’t chosen, you’re just a percentage of those who catch TB, one of the poor, the malnourished or in my case simply unlucky. It all started in September 2012. I’d got  a cold – at least that’s what I thought – and I decided to go to the doctor (till today I don’t know why because it didn’t seem to be something severe). He consulted me, gave me some pills and told me to come for another check in few days. I took the More…

Tuberculosis in Romania: Tackling TB in Romania's Prisons

Tuberculosis in Romania: Tackling TB in Romania’s Prisons

Tom Maguire from the RESULTS UK campaigns team spent two weeks during December in Romania creating a short video and photo-story on drug-resistant TB. In this blog post he discusses some of the innovative measures that have been introduced in Romania’s prisons to reduce TB rates. Despite having one of the highest rates of TB and multi-drug resistant TB (MDR-TB) in Eastern Europe (30,000 people currently have TB in Romania and 1,500 people die from it every year), Romania’s TB rates in prisons are remarkably low.  Historically, TB rates have been drastically higher in prisons than in the general population for two reasons.  Firstly, prisoners are usually more likely to come from communities where TB rates are high. Secondly, once a person enters the prison system, prison conditions – including overcrowding, poor ventilation and poor nutrition – help the disease to spread. This isn’t just a problem in low- and middle-income countries; case rates of TB in prisons are among the highest recorded in any population globally, including here in the UK. In 2002, TB in Romania was 20-times higher than rates in the general population. Recognising the scale of the problem, the National TB Program in Romania applied for More…

TBEC runs national Advocacy Strategy Planning Workshop in Azerbaijan

TBEC runs national Advocacy Strategy Planning Workshop in Azerbaijan

Following an initial visit in June to link up with local TB-interested civil society organisations (CSOs), TB Europe Coalition (TBEC) agreed to run a workshop to help local groups build collaboration between themselves, increase individual advocacy skills, and plan a programme of advocacy action for the next couple of years. This took place over three days, 4-6 December 2013, in Baku, capital of Azerbaijan, in the premises of the Scientific Research Institute for Lung Disease, and was locally managed by Elchin Mukhtarli of Saglamlida Xidmat (Support to Health Public Union) TBEC’s primary contact in the country. The workshop brought together 12 participants from 7 different organisations. It was the second national advocacy planning event run by TBEC, the first having been in Romania in 2012. The lead facilitator was Paul Sommerfeld of TB Alert and member of the TBEC Steering Committee. It had been intended that there would be a second external facilitator but that was blocked by problems around obtaining visas in the time available. Nonetheless, that problem had a positive outcome as it led Paul and Elchin to seek out local specialists to make inputs on specific advocacy issues.  Naila Karimova, a local trainer, gave a useful presentation More…

TBEC meets and starts partnership with TB stakeholders in Azerbaijan

TBEC meets and starts partnership with TB stakeholders in Azerbaijan

From 3rd-7th June, TBEC representatives from TB Alert UK, RESULTS UK and Global Health Advocates travelled to Baku, Azerbaijan to meet with a number of TB civil society organisations (CSOs) and stakeholders. The trip was part of a series of visits to countries with high burdens of TB and MDR-TB in the WHO European Region that have been undertaken by the TB Europe Coalition in the past couple of years.  Past countries visits have included: Moldova, Bulgaria, Lithuania, Latvia, Estonia, Ukraine and Romania. The aim of our visit, as with previous ones, were to inform local advocates about the TBEC and also to explore how the TBEC might assist with advocacy concerns of Azeri CSOs and draw these advocates into the TBEC. Bilateral meetings: As a means of reaching our objectives, we held two days of bilateral meetings with CSOs working on TB in the country. During the week we had a range of interesting, engaging and informative meetings with: the Azerbaijan Health Communication Association; Support to Health; the Centre for Equal Opportunities; Democratic Institutions and Human Rights Social Union and Hayat International. We were also able to meet with a number of other stakeholders, including: USAID; the EU Delegation to Azerbaijan; the National Lung Disease Institute, More…

TBEC Participates in the 2013 WHO Review of Moldova Program

TBEC Participates in the 2013 WHO Review of Moldova Program

Last month, Jonathan Stillo, a medical anthropologist and active member of the TBEC and the Romanian STOP TB Partnership, was part of the World Health Organization team as TBEC representative that reviewed Moldova’s TB program. This was an unusually long review of a small country, but there is so much happening in Moldova related to TB, that even with two weeks and three separate review teams, it was difficult to see everything. Moldova has one of the highest rates of new MDR-TB in new cases in the entire world. It is also the poorest country in the WHO European region, with almost one-third of the population living in absolute poverty.  TB is only one of the many health problems the country is struggling with including cancer, cardiovascular disease, and HIV/AIDS. An additional challenge Moldova faces is that Global Fund support for second line TB drugs to treat MDR-TB will end in 2014. The WHO review examined issues such as Moldova’s new community centers for fighting TB, a fully ambulatory MDR-TB pilot project, new treatment guidelines, and a nationwide roll-out of GeneXpert testing . Most of these developments are promising, but for TBEC, the most exciting news coming out of Moldova More…

TBEC works with Romanian civil society to develop advocacy plan for TB

TBEC works with Romanian civil society to develop advocacy plan for TB

Following the TB Europe Coalition’s visit to Romania last year, the Coalition found itself collaborating with Romanian Angel Appeal (RAA), a charity working on health issues and a principal recipient of the Global Fund to Fight AIDS, TB and Malaria. RAA organised an advocacy training for members of the Stop TB Partnership Romania and asked TBEC to help facilitate the two-day workshop. During the course of the workshop, it became clear that there is a lot of concern regarding the current TB situation in Romania, particularly around drug-resistant TB. Jonathan Stillo, a medical anthropologist studying TB in Romania who has recently joined TBEC, has described how Romania has one of the worst treatment success rates for multidrug-resistant TB (MDR-TB) in the world. Jon explained why: “This is due to a number of factors ranging from a severe lack of national funding and frequent drug stock-outs to stigmatization and a lack of knowledge about the disease and the severity of the situation, even among decision-makers.” Members of TBEC were able to see this for themselves during a visit to the drug-resistant TB ward at a hospital in Bucharest. There, they met two young girls in their early 20s, both appearing otherwise More…

TBEC meets with TB stakeholders in Moldova

TBEC meets with TB stakeholders in Moldova

From 12 until 16 August 2012, Paul Sommerfeld from TB Alert UK, Fanny Voitzwinkler from Global Health Advocates France and Cristina Enache from Romanian Angel Appeal met with TB advocates in Chisinau and Balti, Moldova. Our visit was facilitated by PAS: the Centre for Health Policies and Studies (NGO Principal Recipient of the Global Fund for TB and HIV) and Speranta Terrei (a community-based organisation based in Balti working with TB patients). The main objectives of the TBEC visit were to inform local advocates about the TB Europe Coalition, EU advocacy, the Berlin Declaration and the M/XDR-TB Action Plan, to explore how TBEC might assist with the advocacy concerns of Moldovan NGOs and draw Moldovan TB advocates into TBEC. 13 August: preliminary meetings – Chisinau During the first day of the visit, the TBEC met with the Centre for Health Policies and Studies (PAS) Director Viorel Soltan (former Deputy Minister of Health, former GFATM board member for the European region and current Chair of the Global Fund Finance and Operational Performance Committee) and his staff to get an understanding of the local dynamics when it comes to TB care and control, the impact of the GF cancellation of Round 11 More…

TB Europe Coalition meets with TB stakeholders in Bulgaria

TB Europe Coalition meets with TB stakeholders in Bulgaria

Last week, members of the TB Europe Coalition travelled to Sofia to meet with the Bulgarian National TB Programme and civil society organisations working on TB to learn more about TB activities and advocacy in Bulgaria. The first day in country, coalition members met with representatives from the National Patients’ Organisation, a non-disease specific umbrella organisation that unites more than 70 patients organisations in Bulgaria. NPO’s activities include national advocacy in which they engage in the legislative process around healthcare, supporting members working in disease specific areas by capacity building, patient empowerment and creating patients groups, and working with the general public by running a call centre that communicates directly with citizens and provides medical and legal advice. NPO currently does not have a TB-specific organisation representing TB patients in Bulgaria, but expressed strong interest in working together to create one. The TB Europe Coalition also met with Bulgaria’s National TB Programme during which they learned more about the successes achieved and challenges faced in TB control. Bulgaria’s National TB Programme receives funding from the Global Fund to Fight AIDS, TB and Malaria – funding that is essential to filling the gaps in the National TB programme and funds all More…

Impact of TBEC’s visit to Lithuania

Ms Inga Bulotiene, Chair of Saules Smiltys (the only NGO working on TB in Lithuania), tells us about the TB Europe Coalition’s successful visit to Lithuania. The charity and support foundation, Saulės Smiltys, was established in 2007. Since then it has actively been supporting patients who are ill with a hazardous and infectious disease – tuberculosis. In addition to providing society with information about TB, its symptoms and effects, Saules Smiltys has helped reduce the number of sick patients by improving treatment and has provided technical support to the Pulmonology departments of Kaunas, Vilnius, Klaipėda and Siauliai. In June 2011, two members of the TB Europe Coalition visited Lithuania. Saules Smiltys organised an important meeting at the Lithuanian Parliament, chaired by Mr A. Matulas (Chairman of the Lithuanian Parliament’s Health Affairs Committee). The meeting attracted a range of civil society stakeholders as well as leaders of TB services from the Ministry of Health, the National TB and Infectious Diseases TB hospital, academia, and the local WHO office. The meeting was extremely beneficial as it resulted in major changes for Saulės Smiltys and more generally to a greater cooperation between civil society and governmental structures: Saules Smiltys was invited to join More…

TBEC members visit Latvia

In a series of visit to high burden TB countries (see the story of our visit to Lithuania: https://www.tbcoalition.eu/2011/07/20/tbec-delegation-visits-lithuania/ ), a delegation of TBEC members from the UK (TB Alert), Belgium (Global Health Advocates) and Lithuania (Saules Smiltys) met with Latvian stakeholders in Riga. A rich schedule was prepared by TREPES: a social benefit organisation staffed by volunteers. TREPES is a general welfare association which also conducts educational activities and awareness raising campaigns on TB in different settings (prisons, schools, rural areas etc…). http://vairoprieku.lv/lv/news Picture on the left: TREPES’ “Let’s breathe green campaign” with the daisy (symbol of TB in Latvia) on the occasion of the World TB Day A joint meeting between all relevant actors in the fight against TB in Latvia and the TBEC took place on 27 July. It gathered NGOs working on TB and HIV, youth associations, the Infectology Centre of Latvia, the Clinic for Lung and Health Diseases, the Ministry of Health and the Welfare Department of Riga City Council. TB incidence in Latvia has decreased from 74/100.000 in 1998 to 36/100.000 cases in 2010. In absolute numbers this means 825 new TB cases in 2010. Incidence of MDR TB cases have also decreased over More…

TBEC Delegation Visits Lithuania

In June, two members of the TB Europe Coalition visited Lithuania, in a general move to reach out to civil society actors in TB high-priority countries in the EU and neighbouring countries (previous field visits have already taken place to Ukraine and Romania). The trip was co-organised by Saules Smiltys, the only NGO we know to be working on TB in the country. They are based in Kaunas, the second city of Lithuania, and began in 2007 as a volunteer effort to improve conditions for children suffering from TB. They arranged visits for us to the city TB office and the children’s TB wards in Kaunas, and to the national Rotary office in Vilnius. The most important meeting of the trip was one called by the Chairman of Parliament’s (Seima) Health Committee, which also included a range of civil society stakeholders as well as leaders of TB services from the Ministry of Health, the National TB and Infectious Diseases TB hospital, academia, and the local WHO office. Lithuania has witnessed a decline of 44% of TB cases in the past eleven years. An interesting observation is that TB in Lithuania is not especially poverty-related (only 11%). There is recognition that More…

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