TB and Poverty
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Meeting of the TB & Poverty Subgroup at Union World Conference, Cape Town:
Symposium Summary

On the 13th November 2007, a successful meeting of the TB & Poverty Subgroup was held at the Union World Conference, Cape Town. The overall aim of the meeting was to provide joint working amongst sub-group members. The objectives were to provide opportunity to meet and share ideas and experiences, review progress against outputs of TB and Poverty Action Plan and outline future direction and activities.

Summary of subgroup meeting

Policy briefs:

  1. TB control in China (2006)
    http://www.equi-tb.org.uk/uploads/tb-china.pdf

    This paper considers findings from EQUI-TB's work in China. Using a range of methods, researchers uncovered critical challenges facing TB control in China, including economic and social barriers, how to support vulnerable people including rural-to-urban migrants and delays in diagnosis and treatment.

  2. Strengthening research capacity to improve TB control for poor people (2006)
    http://www.equi-tb.org.uk/uploads/tb-capacity.pdf

    This paper examines the ways in which EQUI-TB has worked in different countries to strengthen the research process and get findings into policy and practice. Key elements include using trans-disciplinary approaches, cross partner working and linking communities with policy makers.

  3. Who is the most vulnerable to TB and what can we do about it? (2005)
    http://www.equi-tb.org.uk/uploads/tb_vulnerable.pdf

    This paper looks at the concept of vulnerability and how it relates to TB control. By using evidence that identifies vulnerability, TB control strategies can become more focused on reaching those who need TB services the most.

  4. Barriers to accessing TB care: how can people overcome them? (2005)
    http://www.equi-tb.org.uk/uploads/tb-barriers.pdf

    This policy brief describes the inequitable situation in resource poor countries where gender, age, socio-economic status and geographical location intertwine with poor and ineffective health systems to create serious challenges to TB control. A range of approaches to overcome barriers are described.

  5. REACH: Challenging barriers to health care in Malawi (2005)
    http://www.equi-tb.org.uk/uploads/tb_reach.pdf

    This paper explores how unequal access to healthcare services affects the way people experience disease at community level. It looks at the range of processes used by REACH trust Malawi to communicate findings into policy and practice so that barriers that exist for poor and vulnerable people are properly addressed.

All of these papers, and more, can be found on the EQUI-TB website http://www.equi-tb.org.uk/

Background Reading:

Lancet Article: "The Global Plan to Stop TB: a unique opportunity to address poverty and the Millennium Development Goals"
Publication: Lancet 2006; 367: 955-57, March 18, 2006
http://www.thelancet.com

  1. Cambanis A, Yassin M, Ramsay A, Squire SB, Arbide I, Cuevas L. A one day method for the diagnosis of pulmonary tuberculosis in rural Ethiopia. Int J Tuberc Lung Dis 2006; 10:230-2.

  2. Malmborg R, Mann G, Thomson R, Squire S B. Can public-private collaboration promote TB case detection among the poor and vulnerable? Bulletin of the World Health Organisation 2006; 84:752-758

  3. Kemp JR, Mann G, Nhlema-Simwaka B, Salaniponi FML, Squire SB. Can Malawi's poor afford free TB services? Patient and household costs associated with a TB diagnosis in Lilongwe Bulletin of the World Health Organisation 2007 85; 580-585.

  4. Nhlema-Simwaka B, Benson T, Kishindo P, Salaniponi FML, Theobald S, Squire SB, Kemp JR. Developing socio-economic measures to monitor access to tuberculosis services in urban Lilongwe, Malawi. Int J Tuberc Lung Dis. 2007 11(1):65-71

  5. Tuspasi T, Radhakrishna S, Quelapio MI, et al. Tuberculosis in the urban poor settlements in the Philippines. Int J Tuberc Lung Dis. 2000; 4:4-11

  6. Yan F, Thomson R, Tang S, Squire SB, Wang W, Liu X, Gong Y, Zhao F, Tolhurst R. Multiple perspectives on diagnosis delay for tuberculosis from key stakeholders in poor rural China: Case study in four provinces Health Policy 2007;82:186-199

  7. Lonnroth K, Aung T, Maung W, Kluge H, Uplekar M. Social franchising of TB care through private GPs in Myanmar: an assessment of treatment results, access, equity and financial protection Health Policy and Planning 2007:22:156-166

  8. Floyd K, Arora VK, Murthy KJR, Lonroth K, Singla N, Akbar Y, Zignol M, Uplekar M. Cost and cost-effectiveness of PPM-DOTS for tuberculosis control: evidence from India Bulletin of the World Health Organisation 2006; 84 (6)

  9. Muniyandi M, Ramachandran R, Gopi PG, Chandrasekaran V, Subramani R, Sadacharam K, Kumaran P, Santha T, Wares F, Narayanan. The prevalence of tuberculosis in different economic strata: a community survey from South India Int J Tuberc Lung Dis. 2007 11(9):1042-1045

    Further reading:

  10. Hanson C, Floyd K, Weil D. Tuberculosis in the poverty alleviation agenda. In: Raviglione M (ed). TB: a comprehensive international approach. New York: Informa Healthcare, 2006

  11. Liu X, Thomson R, Gong Y, Zhao F, Squire SB, Tolhurst R, Zhao X, Yan F, Tang S. How affordable are TB diagnosis and treatment in rural China? An analysis from community and TB patient perspectives Trop Med Int Health. 2007 (accepted 02/07/07)

Special Editorial: "Tackling poverty in tuberculosis control" © 2005.
Publication: The Lancet, 366:2063, December 17/24/31, 2005
http://www.thelancet.com

It reports on a workshop that was organized 6-8 December in Bellagio, Italy by the Liverpool School of Tropical Medicine. The editorial flags the WHO document "Addressing Poverty in TB Control" that was published earlier this year, and it mentions the January 2006 launch of the Global Plan to Stop TB (2006-2015) as a step towards moving the TB and Poverty agenda forward.

Click here to view the article

Presentations from the meeting can be found below: