Mammoth task for Zimbabwe in ending TB
29 March 2017
THE country will this Friday commemorate World Tuberculosis Day in Shurugwi, Midlands as it faces a mammoth task of exploiting local resources to fund tuberculosis programmes in the face of dwindling donor funding.
Bulk of the TB funding in the country comes from donor partners, with the Global Fund providing the largest chunk while trends show that donor support has been dwindling.
World TB Day is commemorated annually on March 24 as a way of building public awareness that the disease is still a public health threat and the country will this year host its belated commemorations on March 31 under the theme: ‘United to end TB.
According to Stop TB Partnership, the day is designed to build public awareness that tuberculosis today remains an epidemic in much of the world, causing the deaths of nearly one-and-a-half million people each year, mostly in developing countries.
TB remains a public health threat in Zimbabwe and it ranked among the 30 TB high burdened countries in the world and health critics posits that Zimbabwe might not achieve the 2030 End TB strategy if resources are not harnessed locally to fund TB programmes.
According to a Global Fund report, Zimbabwe was allocated US$51 million for the 2010-2014 period for TB programmes while the grant dropped to US$38 million for the 2015-2017 period, a development that health critiques believe should motivate the country to focus more on harnessing domestic resources for TB programmes.
According to the United Nations AIDS programme (UNAIDS), international donor contributions dropped from a peak of US$9,7 billion in 2013 to US8,1 billion in 2015.
The End TB strategy seeks to end the global epidemic, with targets to reduce TB deaths by 95 percent and cutting new cases by 90 percent between 2015 and 2035 while ensuring that no family is burdened with disastrous expenses due to TB.
The country has over the years with the support of donor partners employed several strategies in fighting TB but funding remains the greatest impediment.
In the wake of dwindling donor support, UNAIDS executive director, Dr Michel Sidibe last year called on countries to come up with ways of mobilising domestic funding of HIV and TB programmes.
Community Working Group on Health director, Itai Rusike argues that the fact that TB programmes remain wholly donor funded is a challenge that the country needs to address in order to end the epidemic while citing that public awareness on TB remains limited especially in communities that are already at risk.
“Poor health education in mining communities means that those who live with the disease are often stigmatized by their community, resulting in social exclusion.
“Because TB disproportionately affects vulnerable and marginalised populations, there are often combinations of factors that decrease the likelihood of patients seeking or completing treatment, which contributes to the rise in drug resistant TB.
“Unlike HIV and AIDS programmes, TB programmes are not well funded both from the national budget and international funding partners,” Rusike said.
According to the World Health Organisation, 5 000 people succumb to TB each day, globally adding that the heaviest burden is carried by communities which already face socio-economic challenges: migrants, refugees, prisoners, miners and others working and living in risk-prone settings among other risk communities.
“TB strikes some of the world’s poorest people hardest. WHO is determined to overcome the stigma, discrimination, and other barriers that prevent so many of these people from obtaining the services they so badly need,” said World Health Organisation, Director-General Dr Margaret Chan.
WHO asserts that more than a third (4, 3 million) of people with TB go undiagnosed or unreported, some receiving no care at all and others accessing care of poor quality while poverty, malnutrition, poor housing and sanitation and other risk factors such as HIV, tobacco, diabetes, alcohol use predisposes people to TB.
According to the World Health Organisation, Zimbabwe is among the few countries that contribute between 80-85 percent of the global TB, TB-HIV and drug-resistant TB (DR-TB) and in 2015, the prevalence of TB in the country was 292 cases per 100 000 populations.
Approximately 30 000 people were diagnosed with TB in 2016 as TB continues to the leading cause of death among people living with HIV, and approximately 70 percent of Zimbabweans suffering from TB are co-infected with HIV.
While the country commemorates TB day, amid other milestone achievements that have been made in TB programmes with cases detection currently standing at 70 percent, the looming funding challenge means that Zimbabwe and other developing countries need to be proactive as the issue of harnessing local resources remains critical, if the country is to end the epidemic by 2030.