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Momodou
Denmark
11786 Posts |
 Posted - 01 Apr 2009 : 19:16:09
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I thought these two articles might interest some of you. It was sent to me by the author.
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Call in Africa to fund the gap in the fight against TB
By Bobby Ramakant
Despite of African governments declaring tuberculosis (TB) as an emergency, Africa as a region, faces the largest funding gap of USD 10.7 billion to fully implement the Global < http://stoptb.org/globalplan > Plan to Stop TB by 2015. This fact came in spotlight when the TB funding in Africa required to meet the TB-related targets of millennium development goals (MDG) by 2015
was analyzed, said Kenyan activist Lucy Chesire at the 3rd Stop TB Partners' < http://stoptb.org/events/partners_forum/2009/ > Forum in Rio de Janeiro, Brazil (23-25 March 2009).
"The Ministers of health had recognized that TB is an emergency, but they don't act to mobilize resources to respond urgently to control TB and fully implement the Global Plan to Stop TB < http://stoptb.org/globalplan > " stressed Lucy.
< http://www.flickr.com/photos/81118447@N00/3391595313/ >
The countries in Africa had achieved a milestone by endorsing the African Union Abuja pledge of allocating 15% of national budgets to health, which was also reiterated at the 2008 African Union Summit in Egypt, the 2008 Conference of African Finance Ministers, and 2008 Special Conference of African Health Ministers. But they have failed to act on this pledge, said the activists. Only Botswana has kept the promise of allocating 15% of the national budget to health, the rest of the countries in Africa need to keep their promises.
To put pressure on these countries to fund the gap in TB control, the Africa Public Health Alliance had launched an 'African TB Partners Call on African Heads of State, Health and Finance Ministers to fund the gap in the fight against TB' at the 3rd < http://stoptb.org/events/partners_forum/2009/ > Stop TB Partners' Forum.
Activists expressed their concern that 4.2 million Africans are currently living with TB and of these 2.8 million are new TB cases, making TB arguably Africa's biggest public health concern. An estimated 639,089 African lives are lost to TB annually.
"The current global economic crisis is all the more reason why high burden TB countries in Africa should invest in TB control. As per a report < http://www-wds.worldbank.org/external/default/WDSContentServer/IW3P/IB/2007
/08/01/000158349_20070801103922/Rendered/PDF/wps4295.pdf > of World Bank and Stop TB Partnership (December 2007), high-burden TB countries are likely to recover 9-15 times of their investment in TB control" said Mayowa Joel of Nigeria. This report < http://www-wds.worldbank.org/external/default/WDSContentServer/IW3P/IB/2007
/08/01/000158349_20070801103922/Rendered/PDF/wps4295.pdf > indicates that the economic cost of not treating TB to Africa between 2006 and 2015 would be USD 519 billion while TB can be controlled with USD 20 billion in the same period.
Even though Africa makes up only 11.7% of the global population, Africa alone contributes 27 of the 50 countries globally with the highest numbers of people living with TB, and also 26 of the 50 countries with the highest number of TB-related deaths globally.
Furthermore nine of the world's 22 high-burden TB countries are in Africa: Democratic Republic of Congo (DRC), Ethiopia, Mozambique, Nigeria, South Africa, Uganda, Kenya, United Republic of Tanzania and Zimbabwe.
The outbreaks of extensively drug-resistant TB (XDR-TB) and multi-drug resistant TB (MDR-TB) now threaten to further complicate the TB epidemic.
TB continues to be the leading killer of people living with HIV (PLHIV). The need for collaborative TB and HIV activities to respond to rising challenge of TB and HIV co-infection, is compelling. 22 high HIV prevalence countries with an estimated adult HIV prevalence rate equal to or greater than 4% are in Africa.
Five of the TB most affected countries: Nigeria, Ethiopia, South Africa, DRC and Kenya are all also amongst Africa's most highly populated countries, are all regional hubs or countries with the most number of common borders with other countries, says the activists.
Many organizations have signed on this call and those interested in signing on the call to Africa to fund the gap in TB control, can email Lucy Chesire at lucy_chesire@yahoo.com or Mayowa Joel at mayowajoel@yahoo.com
This call will be delivered to the Heads of State, ministers of Health and Finance at the forthcoming African Union summit in 2009.
Bobby Ramakant
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Neglect of tuberculosis control among indigenous communities unethical
By Bobby Ramakant
The need to include indigenous people in the Global Plan to Stop TB < http://www.stoptb.org/globalplan > was echoed by many participants at the 3rd Stop TB < http://stoptb.org/events/partners_forum/2009/ > Partners' Forum in Rio de Janeiro, Brazil (23-25 March 2009).
< http://www.flickr.com/photos/81118447@N00/3397444569/ > DSC04120
"We demand inclusion of indigenous peoples in the Global Plan to Stop TB strategy and have launched a strategic framework aimed at addressing tuberculosis among indigenous peoples. The Stop TB Strategy builds on the successes of directly observed treatment shortcourse (DOTS) while also explicitly addressing the key challenges facing TB. Its goal is to dramatically reduce the global burden of tuberculosis by 2015" said Wilton Littlechild, Regional Chief, Assembly of First Nations.
There are approximately 370 million indigenous peoples globally in more than 70 countries. Although programmes have been designed to combat TB, indigenous populations globally have been left out of such efforts due to cultural barriers, language differences, geographic remoteness, and economic disadvantage. TB rates among indigenous people are consistently higher than general public. During the five year period 2002-2006, the first nations TB rate was 29 times higher than others born in Canada - for the Inuit, it was 90 times higher. Pacific islanders and Maoris are 10 times more likely to contract TB than other people living in New Zealand. In Kalaallit Nunaat, Greenland, residents have a risk rate more than 45 times greater than Danish born citizens.
"These challenges will not be easily met - but they can be met by ensuring indigenous peoples are true partners in global TB control. We have a comprehensive and achievable plan to stop indigenous TB globally, but to realize our goal we need support" said Chief Littlechild.
Indigenous people have a consistent pattern of health inequality across a variety of jurisdictions from resource poor to the resource rich. Indigenous health inequalities are multi-faceted, and are both social and political in nature.
"Indigenous leaders will continue to work with the United Nations Permanent Forum on indigenous issues, the World Health Organization (WHO) and the Stop TB Partnership in addressing indigenous TB globally" further added Chief Littlechild.
Highlighting the problem of TB treatment default and risk of developing drug-resistant forms of TB in indigenous people, Chief Littlechild said that "we wish to establish a secretariat to collect data of TB programmes in indigenous communities. Due to a broad range of reasons, indigenous people aren't able to access TB-related treatment and care services and if they are, then they are more likely to default, increasing the risk to develop drug resistance" said Chief Littlechild. With the High Level Ministerial < http://www.who.int/tb_beijingmeeting/en/index.html > meeting on multi- and extensively- drug-resistant TB (M/XDR-TB) going to open in Beijing, China (1-3 April 2009) later this week, it is indeed a clear message from indigenous communities for their Health Ministers to commit to responding to their specific issues regarding TB control.
In response to another question, Chief Littlechild said that "human rights based approach calls for genuine partnership and indigenous communities can be part of the solution."
The inequities faced by indigenous communities are much severe than in general population. "Countries like Canada report that poverty has gone down but poverty in indigenous communities has gone up. In prisons too there are a significant number of indigenous communities. There are host of other life conditions that put these people at an elevated risk of infectious diseases like TB - overcrowded housing and lack of access to safe drinking water are just few of those challenges" said Chief Littlechild.
The strategic framework to control TB among indigenous populations was developed through consultations with indigenous leaders, TB experts and health advocates from over 60 countries. It is designed to take an indigenous approach that links the right to health, education, housing, employment, and dignity. It is based on equality of opportunity to the highest level of health attainable world wide. It will serve as a tool to build a social movement to raise awareness of indigenous TB, to develop targets and messages, to pilot interventions and to monitor TB trends among indigenous peoples. An important component to this framework calls upon indigenous peoples to demand access to TB prevention and treatment measures in their communities.
- Bobby Ramakant
(The author is a World Health Organization (WHO) Director-General's WNTD Awardee 2008, coordinates the Stop-TB eForum Resource team at HDN and writes extensively on health and development. Email: bobbyramakant@yahoo.com)
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