Monday, October 17, 2011
TI-TB collaboration - why it is not happening?
I would like to draw your kind attention to the important topic of TI-TB collaboration (TI: Targeted Intervention for high risk groups like sex workers, MSM/Transgender, Injecting Drug Users, Migrants and Truckers).
In 2005-06, when I was working with CARE India as the Technical Head of the HIV/AIDS program in 22 cities of 5 highly vulnerable states of the country, during one of my field visits in UP I observed there was a strong need of TB services for the sex workers and due to no knowledge of RNTCP they used to visit private practitioners for TB treatment by spending huge amount of their hard-earned money.
Later on, Avahan project (supported by BMGF and technical support provided by Family Health International/FHI) made similar observation in their project areas (emerging TB treatment needs of the HIV high risk groups) and developed operational linkages between their on-going TI projects with RNTCP. By keeping Avahan’s TI-TB collaboration experiences in mind, Central TB Division (CTD), while developing the schemes for NGO/PPs also came up with the opportunity of the TB/HIV NGO-PP scheme.
The uptake of the TB/HIV NGO-PP schemes remain sub-optimal. Among them the situation of TI-TB collaboration through such scheme is even poorer (only 03 TI projects of the whole country have been linked to RNTCP through the TB/HIV NGO-PP schemes).
NACP III has been currently implementing 454 TI projects of the sex workers (coverage: 7.09 lakhs), 155 TI projects of the MSM (coverage: 2.74 lakhs), 261 TI projects of the IDUs (coverage: 1.42 lakhs), 212 TI projects of the migrants (coverage: 37 lakhs) and 76 TI projects for truckers (coverage: 11 lakhs).
I do believe, the potential of TI-TB collaboration is still largely untapped and we are missing TB cases in the HIV high risk groups (especially IDUs, migrants and female sex workers). This is critical in the perspective of CTD’s decision to achieve targets of universal access in the next phase of the program.