Lydia Buzaalirwa, author of the Aids Healthcare Foundation (AHF) Africa Bureau, Director Quality Management.
By LYDIA BUZAALIRWA
Advocates fighting TB in Africa, worldwide are pressing for ambitious strategic goals, calling for enthusiastic multisectoral cooperation and action. This includes substantial increases in funding, a key element for African nations to effectively address and eliminate TB. As AIDS Healthcare Foundation, we implore various stakeholders to elevate funding for TB prevention and treatment programmes in Africa.
Strategic collaborations among government bodies, private sector organisations, civil society groups, and international organisations are critical. Increased funding is instrumental for elevating the importance of testing and early diagnosis of TB. Advocacy and community engagement are paramount to amplify awareness and comprehension of the disease. We must all play a part in mitigating TB infections in Africa, not just on World TB Day, but throughout the year. The forthcoming 2nd UN High-Level Meeting on TB in 2023 offers an invaluable platform for stakeholders to recommit to eliminating TB in Africa.
Currently strides are being made in TB control, but Africa faces hurdles in accessing crucial TB services. This opinion piece delves into the current status of TB on the continent, underscoring key challenges and the pressing need for stakeholder involvement and funding enhancement. Examining TB statistics reveals Africa’s significant disease burden. Africa is home to 17 of the 30 high-burden TB countries worldwide. It is also home to five of the 10 focal countries for multidrug-resistant (MDR) TB/HIV co-infections in Africa.
Although there have been gains in focused TB control globally and within Africa, these are offset by the slow pace of reductions in new cases and deaths, largely due to disruptions in funding and services competing with COVID-19. The decline in global TB spending from $6 billion in 2019 to $5.4 billion in 2021 contrasts sharply with the estimated annual requirement of $13 billion for the past eight years. One can see the decline in decreased domestic financing across 136 selected lower-middle-income countries, covering nearly all of Africa.
Africa’s challenges include weak healthcare systems, poverty, insufficient nutritional support, and restricted access to new treatments and diagnostic tools. These hurdles impede effective TB control and warrant immediate attention. The socio-economic repercussions of TB are considerable, impacting health and constraining individuals from engaging in social and economic activities. TB treatment costs can be prohibitive, exacerbating financial strains for affected families, particularly those in poverty. Insufficient healthcare investment renders communities increasingly susceptible to TB.
Human resource shortages in healthcare, aggravated by high staff turnover, result in missed opportunities for case identification and precise TB diagnosis. These shortcomings translate into treatment delays and continued TB transmission. Stakeholders must also make available newer treatment regimens and improved diagnostic technologies to enhance healthcare workers’ capabilities in detecting, diagnosing, and treating TB.
The Stop TB Partnership has released a global plan to terminate TB as a public health threat by 2030. To attain these objectives, renewed efforts are required in strengthening health systems, including developing innovative technologies and case management strategies. This calls for a multisectoral approach to the TB epidemic, ensuring immediate implementation of required interventions.
Addressing these issues mandates cross-sector collaboration involving health, education, nutrition, and social welfare sectors. By embedding TB control strategies within broader developmental agendas, Africa can tackle underlying issues contributing to high TB prevalence and lingering low funding. Stigma reduction, gender mainstreaming, and human rights-based approaches remain vital for fair and effective TB responses. Here, we elaborate on specific steps for achieving some of the plan’s objectives by 2030.
Mobilising Additional Funding
Despite TB’s devastating impact, we see it relegated in health agendas and faces inadequate funding. In Africa, governments contribute merely 22% of essential resources, leaving 44% of needs unfunded. To make considerable headway in TB control, we require intensified efforts to mobilise additional resources from domestic and international donors. This necessitates advocacy, networking, and robust leadership to ensure TB gains the focus and funding it merits.
Learning from COVID-19
The pandemic has overshadowed TB control progress, causing a dip in the number of individuals receiving TB treatment. However, lessons learnt from COVID-19, including solidarity, resolve, innovation, and equitable resource utilisation, should be applied to TB control. Leveraging experiences from the COVID-19 response can bolster African healthcare systems, enhance diagnostic abilities, and improve TB treatment access.
We call upon stakeholders to augment funding for Africa’s TB response, essential for elevating awareness, early detection, and treatment. Collective and immediate actions are vital for reducing TB infections. The upcoming 2nd UN High-Level Meeting on TB in 2023 presents an unparalleled opportunity for stakeholders to reconfirm their commitment to eradicating TB in Africa.
NB: The author, Lydia Buzaalirwa, is the Aids Healthcare Foundation (AHF) Africa Bureau, Director Quality Management.