Guest Blog Post: Making Health a Priority to Eliminate TB

Guest Blog Post:  Evaline Kibuchi, Chief National Coordinator Stop TB Partnership – Kenya

The world is talking about achieving universal health coverage (UHC). This will only be achieved when all donors make health a priority. We have an opportunity to eliminate TB. In Kenya, 60% of the TB response and almost all MDR TB programming is funded by the Global Fund. Without a successful replenishment, the Kenya TB program would collapse. With a fully funded Global Fund, more can be done to address the catastrophic costs associated with TB care.

Evaline shared a pointed example of how critical patient centred care is, and that failing to address the needs of patients, in particular for key populations, can have deadly consequences.

On April 25, 2018, Joyce, a 12-year-old Kenyan girl, died of MDRTB. She had visited eight hospitals and clinics before she was finally diagnosed with MDRTB in August 2017. The late diagnosis meant that she had to be admitted to a hospital for treatment. Her mother, who was a fruit vendor, had to quit her business to take care of her daughter. For five months of treatment in the hospital, the cost was $12,000. The father, who is a construction worker, was unable to pay the bill in full, so he had to negotiate to pay the hospital $15 per month before they would finally release his daughter. At this rate, it will take 66 years for him to clear this debt.

When she was finally discharged, Joyce had to be on an oxygen concentrator machine to assist with her breathing which cost the family $1000. Living in a slum area meant that the family didn’t have a reliable electric supply, so they had to depend on a backup generator; the fuel cost $10 per night to run. On April 25, there was a power blackout and the family were unable to purchase fuel or secure another generator and Joyce died. As shocking as it may seem, it could have been worse for the family. The hospital where Joyce had been admitted is supported by the Global Fund and the cost of medicines also covered by the Global Fund grant. The case of Joyce points to the challenges that remain and the importance of the Global Fund in addressing the needs of key populations including urban poor.

Adolescents and young women remain at high risk for all three diseases, AIDS, TB and malaria, just as the world’s largest-ever generation of young people come of age in low- and middle-income countries.  Additionally, TB prevalence is 4 to 7 times higher in slums than in other urban areas.  New analyses have calculated that adolescents and young adults ages 10–24 years account for 17% of all TB cases – over 1.7 million cases each year. Many of these young women and men are living in poor communities and crowded housing, placing them and their peers at risk for TB. Too many people in those communities are not reached by health programs that educate people about TB, actively identify potential cases, help reduce people’s exposure, and link people to care.

                                                                                                                                        

Evaline Kibuchi is the Chief National Coordinator Stop TB Partnership – Kenya, and was a member of the Affected Communities and Civil Society Advisory Panel for the UN HLM TB that guided HLM community engagement, mobilized support and represented advocacy priorities of the communities they represent.

To learn more about the need to get back on track to end the epidemics see GFAN’s Get Back on Track Report and read more about TB Key Populations and the critical need to increase support to ensure these communities will not be left behind in our TB Key Populations Report.