As the World commemorated World Tuberculosis (TB) Day 2024 under the theme ‘Yes! We can end TB’, a call is being made to have a more integrated approach to tackling the TB epidemic.
Executive Director of the Caribbean Vulnerable Communities (CVC), Ivan Cruickshank, in addressing Jamaica’s National TB Annual Review recently, pointed to the important role community and civil society organisations play in ending TB. “We need to move the TB conversation out of the biomedical realm and pay closer attention to some of the social factors that are driving the disease. This means we need to take a closer look at how poverty, overcrowded living conditions, undernutrition, poor access to healthcare and stigma are all contributing to the growing TB epidemic” Cruickshank said.
The annual TB Review provided a significant opportunity for stakeholders to reflect on the WHO End TB Strategy, the situation of TB in Jamaica, challenges in TB diagnosis and care, as well as, explore strategies to reduce TB incidence and reach elimination of this preventable disease. The WHO End TB Strategy, which is aligned to the United Nations Sustainable Development Goals, emphasises the role of communities and civil society in ending the TB epidemic by 2030
The CVC Executive Director further made the case for more community involvement by pointing to the fact that about one-third of people who develop tuberculosis (TB) globally are not reached by current health services or systems. “There needs to be more meaningful community engagement as we seek to improve the reach and sustainability of TB services and accelerate progress towards ending TB by 2030,” Cruickshank noted. He called for a comprehensive plan to fight tuberculosis in Jamaica and across the region which puts communities at the center of the response. “There needs to be a defined role for CSOs and communities in national TB Strategies. We should also include community level indicators in the TB Monitoring and Evaluation frameworks. There should also be increased efforts to encourage NGOs and CSOs to get involved while we scale TB education programmes. TB should also be integrated into community level HIV programmes, as well as, engaging community volunteers to do TB related outreach,” he argued.
In proposing strategies to be adopted, the CVC Executive Director noted that there are several lessons that can be learnt from the HIV response which can be incorporated in the response to tuberculosis, especially when it comes to dealing with stigma.
“It’s crucial to address the stigma associated with TB. Historically, like HIV, tuberculosis stigma and discrimination, has been targeted at both people affected by the disease and the disease itself. This undoubtedly creates additional barriers for people to access healthcare for fear of being ‘labeled’ with the disease. This then leads to delayed diagnosis, treatment and risk of further infections. Much of the stigma stems from a lack of awareness and knowledge of the disease because there are also deep-rooted cultural beliefs that TB is a ‘curse’ and that people should be isolated upon infection. That is why we see the incidence of TB generally higher in already stigmatised groups such as the homeless and prisoners,” said Cruickshank.
Meanwhile he suggested that in order to end TB, countries need to build awareness about the scale and impact of TB in communities and share practical steps on how civil society and communities can get involved, including, how to work with clinics and the Ministry of Health. These steps, if taken, can bring the region a far way to reaching our goal of ending TB by 2030.
