TB Programs should take more responsibilities now to strengthen the efforts for TB/HIV collaboration

The TB programs of the countries are gradually shifting focus on 100% case detection as part of universal access. This means responsibilities of the TB programs will increase many folds, especially towards the TB/HIV component in terms of facilitating TB case detection among the HIV high risk groups and PLHIV at the community level, through strategic advocacy, communication and social mobilisation (ACSM) approach.

The ACSM component is still weak in TB/HIV collaborative programs. The NGOs and CBOs working with HIV high risk groups in HIV prevention programs have shown weak linkages with the TB programs. Similarly, PLHIV networks and home based care programs are not well connected with the TB initiatives. TB case detection among HIV program participants is happening chiefly in the healthcare facilities. Those not accessing the services are remaining with undiagnosed TB and seeking treatment either in private or indigenous healthcare services, often gets maltreated/incompletely treated/undertreated for TB, thus also increasing the risk of MDR-TB.

It is a big challenge for the TB program to reach the HIV program participants, the high risk groups and infected and affected population with the required package of awareness, information and services. This can be achieved through an effective collaboration with the NGOs, CBOs and PLHIV networks, especially those who are already implementing HIV prevention, care and support programs.

In India, Round 9 TB project supported by GFATM is expected to improve and expand the ACSM component in the TB/HIV collaborative program of the country. The project will be covering 374 low performing districts of India and aiming at facilitating TB case detection in hard-to-reach areas and marginalized population including the HIV high risk groups, infected and affected people. The project will be involving the PLHIV networks in the TB program through their sensitization and capacity building on TB. Moreover, the project will be responsible to popularize the NGO-TB schemes and help the NGOs to adopt the schemes. Those schemes generally provides good opportunities equally to the NGOs already working in HIV sector to contribute significantly to the TB sector as well in terms of enhancing ACSM and TB case detection in the high risk groups, infected and affected population.

We are strongly hopeful.

Sugata Mukhopadhyay
Universal Health