Now Released: TB REACH case studies on improved case finding

27 October 2014 - Geneva/Barcelona - Stop TB Partnership’s flagship initiative, TB REACH, has compiled and released a series of case studies on new and improved ways of finding people living with TB.

Improving Tuberculosis Case Detection: A compendium of TB REACH case studies, lessons learned and a monitoring and evaluation framework, highlights the successes and lessons learned from TB REACH grantees across the globe in strengthening TB care, implementing novel approaches to detect TB, and increasing TB case notifications. It was released in Barcelona at the 45th Union World Conference on Lung Health.

TB REACH was set up in 2010, in response to a call from partners and high-burden countries to support innovative approaches to achieving universal detection of TB patients. The program provides grants to innovative, experimental or pilot projects that bring TB detection and treatment to vulnerable or hard to reach populations. Over the past four years, it has provided over 90 million USD to 142 projects worldwide in 46 countries, supported by the generous contribution from the Canadian government and UNITAID.

Jacob Cresswell, the head of TB REACH, said "These case studies highlight the work of our partners to improve case detection. While there are guidelines on specific questions about what things to do - the 'how to' of improving case detection is missing from Guidelines. This document shows what can be done when we think different and move outside business as usual. While this document cannot present all TB REACH experiences we want to recognize the work of all our grantees and the work of our partners."

The persistent gap in TB case detection is a cause for concern worldwide, even as global TB targets are being set higher. The post-2015 TB targets approved by the World Health Assembly in May 2014 reflect the desire of the global TB community to rectify this lack of success in detection and in providing quality care for all people with TB. In order to reduce the number of people falling ill with TB by 90% and TB deaths by 95% by 2035, all new patients need to be found and treated.

Only a few countries have been successful in closing the gap between the estimated number of new cases of people with TB (incident) and those notified in health systems as having TB. While millions of people become ill with TB each year, many of them are missed by National TB Programmes (NTPs) for a number of reasons. TB REACH's funding aims to support new and innovative projects to help close this gap.

The case studies do not intend to be prescriptive, but provide ideas and context for various approaches that can be adapted, measured and evaluated. Its intended use is for National TB Programs in countries with high rates of TB and their partners who are interested in improving TB case notification and in benefitting from the lessons others have learned.

In Global Fund’s new funding model, countries often identify low TB case detection as one of the most important barriers to improving TB care, but they fail to propose interventions that would plausibly increase case detection. This document gives a collection of interventions and activities on TB case finding, the context in which they were implemented, and their externally validated results.

TB REACH funds promising, but untested methods for reaching and treating vulnerable populations - people who otherwise often go undetected or are only detected in a later state of disease, and therefore rarely receive good-quality treatment or any treatment at all. Through small, one-year grants, TB REACH finances innovative thinkers to test out their ideas on a larger scale, programmatic level, thereby giving plausible and well-informed ideas a chance to develop into well monitored projects implementing interventions which when successful have the potential to inform national policy and investment plans and country dialogue for Global Fund applications.

TB REACH offers one-year grants to TB programmes and partners for technically sound, innovative and cost-effective TB case detection interventions; provides fast-track funding; focuses on poor, vulnerable and marginalized groups, and populations with limited or zero access to TB care services; encourages local innovation and bold solutions that may not be funded elsewhere; requires detailed reporting on technical and financial progress and case notification data; ensures external monitoring and evaluation of all projects; and delivers rapid results for improved TB care.