Tuberculosis (TB) Indefinite Quantity Contract: Task Order 1
Collaborating on innovative and sustainable solutions for a TB-free world
PATH is driven by the knowledge that, each year, nearly 1.4 million people die from TB–a curable disease. The HIV epidemic helps fuel this global health crisis: TB is the leading cause of death among people living with HIV.
Leading a consortium of organizations with extensive technical expertise, PATH works to scale up the international Stop TB Strategy in high-burden countries around the world. The consortium takes a health systems approach—first understanding the complex political, economic, socio-cultural, and epidemiological environments in which TB programs operate, and then offering practical, sustainable strategies to address diverse challenges.
This work is made possible with generous funding from the United States Agency for International Development’s TB Indefinite Quantity Contract Task Order 1. Read success stories from TB Task Order 1 here.
Our PATH-led consortium includes the following members and collaborators:
- American Society for Microbiology
- Dartmouth College
- Eli Lilly MDR-TB Partnership
- Fondazione Salvatore Maugeri
- Foundation for Innovative New Diagnostics
- Initiatives, Inc.
- Management Sciences for Health
- TB Photovoice
- University of California, San Francisco
- Partners in Health
A comprehensive approach
We pursue four strategies that are essential to successfully treating and curing patients, lowering mortality rates and incidence, and actively involving communities in decisions about their health. PATH:
- Develops, introduces, and scales up use of innovative health technologies and tools to diagnose TB and drug-resistant TB.
- Integrates TB with other health services including HIV, primary care, diabetes, and child health.
- Engages health providers and patients through public, private, and informal health-sector collaborations.
- Implements advocacy, communication, and social mobilization (ACSM) activities to ensure communities are involved in efforts to strengthen TB programs.
Progress in defeating TB
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Developing and introducing innovating health technologies and approaches
PATH supports the development and introduction of TB diagnostic tools and investigates the potential use of new non-invasive screening technologies through operations research. The goal is to help countries better detect TB and multi-drug resistant TB (MDR-TB) and promote more timely treatment. In Tanzania and DRC, PATH is supporting the introduction of GeneXpert® diagnostic technology using a health systems strengthening approach to build a sustainable foundation for effectively introducing the test.
Helping countries address multidrug-resistant TB
To combat the emerging threat of multi-drug and extensively drug resistant tuberculosis (MDR-TB), PATH worked with the World Health Organization (WHO) to develop an MDR-TB Planning Toolkit. The toolkit has been used by national TB programs in Zimbabwe, Ukraine, Mexico, and India, and regionally in South America and Asia, to strengthen national TB strategies and plans. Download the toolkit.
In India, the need for services to address multidrug-resistant TB services is high. PATH supported India’s Central TB Division in conducting local needs assessments and creating a new DOTS-Plus center, which now provides an additional 790,000 people with access to critical DOTS-Plus services.
Integrating TB with other health services
In Tanzania, PATH works closely with Ministry of Health and other partners to train and mentor health care workers on integrating services for people suffering from both TB and HIV. Across 35 districts, we are also supporting
the National TB and Leprosy Program in both integrating facility-based TB and HIV services and increasing access to testing and drug supplies. As a result, people can more easily get the care they need in one place.
When we began work in Tanzania in 2005, just 10 percent of patients with TB were being screened for HIV. Now, almost 90 percent of TB patients in about 1,000 health facilities have also received HIV testing. Read more about our work to integrate TB and HIV services.
PATH also supports critical efforts to find and treat TB in children, and tackle the co-epidemics of TB and diabetes.
Overcoming barriers to effective programming through advocacy, communication, and social mobilization (ACSM)
Engaging communities is a key strategy for increasing case detection—especially in the DRC, where health resources are both limited and stretched. With PATH’s support, local partner Club des Amis Damien (CAD) has trained new community health volunteers from community-based patient
support groups on TB case detection. With the help of these volunteers, nearly 2,500 individuals with TB symptoms have been referred to diagnostic and treatment centers, and nearly a third of those who tested sputum smear positive for TB were referred for treatment.
Supporting advocacy, communication, and social mobilization to stop TB
Affected communities are at the front lines in the fight against TB. PATH supports community leaders and government officials in designing, implementing, and evaluating a set of interventions known as Advocacy, Communication and Social Mobilization, or ACSM. Our collaborations support ACSM activities that involve communities in:
- Sustaining political and financial commitment for TB.
- Educating community members about TB services, and to reduce stigma around those infected.
- Mobilizing diverse stakeholders to raise demand for programs, and to ensure that services are delivered to those who need them most.
Importantly, our ACSM work includes building regional coalitions. In 2012, following intensive, PATH-supported training on ACSM, civil society leaders and former TB patients from five African countries launched the Africa Coalition on Tuberculosis (ACT!). ACT!’s mission is to bring together active civil society leaders and advocates from across Africa to mobilize their constituencies for universal access to high-quality, rapid TB diagnosis; appropriate, patient-centered care and treatment; and effective new drugs and vaccines. PATH will continue to provide technical support for the coalition’s work. Download the ACSM curriculum, and read a success story on an ACSM training in Georgia.
Linking the public, private, and informal health sectors
Ensuring strong health referral networks for improved TB screening, and for referral for TB diagnosis and treatment, requires both public and private sector players. In Vietnam, PATH is helping to build national TB referral networks that include committed pharmacists and other public and private sector health care providers. PATH helped develop and expand a public-private mix referral system, and then train private pharmacists to identify TB symptoms. Trained pharmacists were then able to refer nearly 3,000 potential TB patients for testing, and supported hundreds in completing treatment, many of whom could have been missed or sent home. Of those referred for testing, about ten percent were diagnosed with TB and able to access treatment through the work of PATH and our partners in Vietnam. For more information on PATH’s TB work in Vietnam, download our factsheet.