Perspectives: Creating Multi-sectoral Leadership in TB Control

Alyssa GovindanArticle

By: Angel Cheng, Global TB Caucus

GAVI

TB has a devastating impact not only on the health and wellbeing of people around the world, but also on economic growth and stability. As a result, the disease is increasingly presenting itself as both a moral and financial consideration for businesses concerned about their workers, consumers and communities where they operate. According to recent research commissioned by the Global TB Caucus, if global efforts to tackle TB continue at the same rate of progress, from 2015 – 2050, 28 million people will die, at a global economic cost of $983 billion.

In a time of declining foreign assistance, it is more important than ever to develop creative alliances between government, academic, civil society and private sectors to diagnose and treat TB. These partnerships are essential to leading the implementation of effective solutions through policy, financial resources, intellect, information, and creativity.

Multi-sectoral partnerships can largely be placed into three categories:

  • Building collaborative governance structures. These include initiatives that set standards for business conduct and reporting, and improve business operations and patient access
  • Provision of public services. These include collaboration to develop effective infrastructure for prevention and diagnosis, treatment access, education, and support services
  • Initiatives that address overall societal challenges such as social stigma, climate change, and air and water pollution

The anatomy of multi-sectoral partnership

Multi-sectoral partnerships in TB result from the realization that no individual entity has the capacity to address a problem this complex. Rather, it is by making the best use of available resources, skills and talents that the prevention and eradication of the world’s deadliest infectious disease may be possible.

In recent years, the business sector has recognized the value of investing time and money in improving health. This gradual evolution, when coupled with the need of governments and civil society for additional intellectual and financial capital, has motivated all sectors to engage more deeply in searching for solutions together.

When this type of collective action is successful, it establishes its participants as leaders in their own sectors, provides significant business opportunities, and establishes a framework for driving sustainable, long-term outcomes.

Nowhere is this more needed than in TB.

Example of a successful multi-sectoral TB partnership

The Innovations and Multisectoral Partnerships to Achieve Control of Tuberculosis (IMPACT) project in the Philippines demonstrates the potential for multi-sectoral collaboration. The five-year project has so far resulted in significant increased utilization of TB services across 43 provinces; improved quality and provision of public sector services; expansion of private sector providers; and removal of policy and systemic barriers that were hindering access.

The project’s current results are:

  • Mobilized community volunteers that resulted in 78% of presumptive cases seeking diagnosis and treatment
  • Improving access to diagnosis with the installation of 249 remote smearing stations
  • Scaled-up case finding through the engagement with 365 private hospitals, private pharmacies, jails and prisons, businesses, Indigenous Peoples, and Muslim religious leaders
  • Facilitated partnership between 3,500 health workers and 700 midwives as treatment partners and supervisors, and
  • Ensured quality TB care through Directly-Observed Treatment (DOTS) certification and focused training of public and private health care providers

The anatomy of a successful, multisector TB Partnership

UNDP/ Brian Sokol

The success of partnerships across sectors relies on the alignment of incentives, as well as the understanding and commitment of all partners. When each partner understands the benefits, the collective result will be much greater than any individual group could produce. The advantage of well-structured multi-sectoral partnerships is that they have the potential to become sustainable models of mutually beneficial collaboration that can achieve miraculous benefits for society and thus change the future of global health.

Successful partnerships incorporate a number of elements including:

  • Alignment of priorities. When partners share the same end goal they can contribute their own unique resources and expertise to ultimately achieve success
  • Diverse contributions. Partners from various industries and sectors have the opportunity to pull together a wider pool of knowledge and resources
  • Shared power and accountability. Successful partnerships incorporate balanced power and responsibility
  • Incorporating community voices. Multiple partners have the ability to give voice to civil society and other involved parties as well as incorporate feedback loops
  • Ensuring quality control. Measuring quality of services is extremely important in delivering health programs and can be scaled up through the utilization of multi-sectoral partnerships

March 24th is World Tuberculosis Day-a day dedicated to raising awareness about the disease that cost 1.7 million lives in 2016. Advancing the fight to eliminate tuberculosis (TB) is a complex and challenging undertaking that will only be successful with the integration of public and private interests and resources.

Alyssa GovindanPerspectives: Creating Multi-sectoral Leadership in TB Control