NGOs are equal partners with government in TB care and control

Submitted by Dr P V Ranganadha Rao (ranganadharao) about 1 year ago

NGOs are equal partners with government in TB care and control

“NGOs have a very important role to play either as an organisation or under a national partnership" said Dr Nils Billo, executive director of The Union (International Union Against Tuberculosis and Lung Disease).

The contribution made by NGOs was acknowledged by several speakers at the 3rd Stop TB Partners’ Forum in Rio de Janeiro, Brazil, particularly in the inaugural ‘INSPIRE’ session and during discussions on the progress to stop TB. Though it was encouraging to see a threefold increase in the number of NGOs participating in TB care and control globally, barring a few persons who are noted as ‘TB Champions’, millions of people affected by TB are not actively involved to that level. Partnership of NGOs is a need at the national and even sub-national levels. Many achievements as a result of such partnerships of NGOs with the government were referred like DOTS - the corner stone programme of Stop TB strategy - which is available to 97% of the people in the world.

Experience of developing National level partnerships which include NGOs in India and Brazil brought out many important issues. Some common features were obvious in both the situations. Important ones to mention are: working together appears to be the main theme; partners belong to different sectors; funding should be available and trust remains an important binding factor.
“Battle against TB cannot be won by organisations or institutions in isolation or in competition"- said Dr Vineet Bhatia who has been facilitating the National partnership for TB Care and Control in India, which took shape in November 2008.

NGOs working together in collaboration with national programmes have helped in delivering services to many more people, particularly those hard to reach populations and those who are at higher risk of TB but not able to access TB related services (like migrants, sex workers, injecting drug users, miners, indigenous populations); have brought greater visibility, increased transparency and accountability in TB control programmes, and shown innovative approaches to combat TB effectively. NGOs were recognised for certain specific skills like social mobilisation and capacity building of health staff. Working complementary to each other and aligning to national TB programme surfaced as the need of the hour.

While recognising the advantages of national partnership of NGOs, a few challenges were flagged too, like: varying levels of trust between partners and with national programme; getting stuck between organisational priorities and partnership identity; having aligned with Government, NGOs are often not able to voice their concerns particularly if the TB programme is not performing optimally.

Long term sustainability of NGO partnerships remain a big question particularly when such initiatives are funded by external agencies. NGOs as a constituency will have to raise their funds and utilise non-financial resources to stay more independent and be able to raise issues with Government. Sustaining interest on TB control among the community-based organisations remains a big challenge.

Absence of strong patient groups is recognised as a constraint in getting community voice heard by the government. Very few TB Champions are active- contribution of TB champions like Lucy Chesire, Winston Zulu and Ms Carol Nyirenda were referred to emphasise the need of including affected community.

“If we are to win the fight against TB we, the people from the affected community, need to be meaningfully involved in policies and programmes. We are also experts. we have our degrees from university of life” said Carol Nyirenda, Zambian community activist and regional community representative at the Stop TB Partnership Coordinating Board.

Message is quite loud and clear about need to involve affected community and all national partnerships have to mend their ways and become more inclusive.

“NGOs are in the field and it is for the Governments to involve them in the TB care and control. Involving civil society as a partner is a creative and fruitful approach in solving TB problem" said Dr Giuliano Gargioni, Team Leader, Partnering and Social Mobilization, Stop TB Partnership.

It is essential for all programmes to map out NGOs working in different areas and include them to complement TB programme activities. Attitudes among people in both Government and in NGOs need to change to bring in all partners together with dignity and to achieve greater synergy to control TB.

In conclusion, working in partnership with NGOs seems to be an inevitable necessity to improve reach and care. Involving affected community surfaces as an immediate priority to improve TB care programmes at all levels. Commitment to the shared goal will be a motivation for all the partners. But what seems important is to identify ways of working in partnership with civil society and sustaining interest on TB among all partners and respect the contribution of all partners.

PV Ranganadha Rao

HDN Key Correspondent
LEPRA Society - Health in action, India

(The author has extensive experience of being a part of national NGO TB Consortium in India and the national partnership for TB care and control in India)

Keywords: 3rd Stop TB Partners Forum affected community Brazil 2009 civil society drug resistance extensively drug-resistant involvement MDR-TB multi-drug resistant NGOs partnership Rio 2009 sustainability TB TB control Trust tuberculosis XDR-TB

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