Warning – Tuberculosis!

09:06, 27 June 2018

According to WHO criteria, the beginning of the Tuberculosis epidemic in Ukraine was registered in 1995.

In order to provide a full and effective response to the Tuberculosis epidemic in Ukraine, there was created the Partnership «Stop TB. Ukraine».
The feature of this epidemic in Ukraine is in the Soviet system for the provision of anti-tuberculosis care, which provided for the detection of tuberculosis by means of fluorography, after what there followed isolation of the patient in the anti-tuberculosis clinic until the completion of his treatment. That meant the patient with tuberculosis was completely under the state’s care and the health care system until his recovery. After getting the independence, the country was not able to support such a system properly, it was not possible to assign the appropriate treatment scheme to a patient due to the lack of medicine, there weren’t enough funds for the maintenance of the large anti-tuberculosis facilities, and meanwhile the incidence was rapidly increasing, and the treatment-resistant forms of tuberculosis appeared.
The rapid increase in the tuberculosis incidence, the increase in cases of combined tuberculosis infection and HIV, and the increase in the incidence of the treatment-resistant tuberculosis forms have become a real challenge for the Ukrainian health care system. It became apparent that the efforts of medical workers were not enough; it was necessary to involve NGOs and the international community in overcoming the epidemic. Since 2000, the international funds such as the United States Agency for International Development, the Global Fund to Fight AIDS, Tuberculosis and Malaria helped in the matters of the tuberculosis epidemic. Also, Ukraine received funds from the World Bank and other international funds and organizations.
Large international organizations such as WHO (World Health Organization), PATH (Program of Advanced Technologies in Health Care, headquartered in Seattle, USA, works in more than 80 countries of the world), ICF «Public Health Alliance» and others joined to the problems of overcoming of tuberculosis and HIV. In addition, to the fight against tuberculosis were actively involved the Ukrainian Red Cross Society, «All-Ukrainian Network of People Living with HIV», AUNPO «Convictus Ukraine»,  NPO «Svitlo Nadiji» (Light of Hope), the AUCF «Coalition of HIV Service Organizations», the NPO «Foundation “Public movement  “Ukrainians against tuberculosis”» and others.
Over the last 10 years, there appeared organizations focusing on the fight against tuberculosis exactly and on the rights protection of the affected people, such as the All-Ukrainian association of people who affected by tuberculosis «Stronger than TB», the Charitable Foundation of fighting against tuberculosis «VITA-LIGHT». Such a rapid development of the public sector provides tremendous opportunities for patient-oriented care provision and for protecting the patients’ rights, providing them with social support. Moreover, each of the named organizations has its own unique experience of work in the area of overcoming the tuberculosis epidemic but until the last times, the interaction of civic organizations was not enough. The need to create a platform for the exchange experience, the development of a common strategy, the dissemination of best practices, information events for an attraction of attention to the existing problems, and improving the interaction of civil organizations with the state and the international community became evident. The important step is the further development of a civil society in Ukraine, broad involvement of non-governmental organizations to take an active part in the fight against tuberculosis and the creation and development of new organizations.
In order to ensure a full and effective response to the tuberculosis epidemic in Ukraine, consolidation of the state efforts, non-governmental organizations, communities of people affected by tuberculosis, international funds, the Partnership «Stop TB. Ukraine» was created.
The first General Partnership Forum was held on the 12th of March, 2018, in which the 41 participants (among them were: scientists, experts, people who had an experience of tuberculosis disease, heads of medical institutions and organizations, including anti-tuberculosis clinics) announced the establishment of the Partnership «Stop TB. Ukraine» and created the Head Committee and the Secretariat for the effective management and strategic development of this perspective association.
The chosen aims of the Partnership «Stop TB. Ukraine» are to unite the efforts of the Partnership members for the effective promotion in the overcoming the tuberculosis epidemic in Ukraine by 2035, as it’s foreseen in the UN Sustainable Development Goals and the WHO Tuberculosis Strategy; as well as uniting the society efforts, governmental and non-governmental organizations in achieving the goal of the Global Tuberculosis Control Plan of the Partnership «Stop TB 2016-2020».
The Partnership has enormous potential since it has joined the efforts of more than 40 organizations and institutions, including international organizations and organizations providing outpatient care services to outpatients; the Partnership members have vast experience in conducting the informational work and advocacy on the implementation of effective anti-tuberculosis control measures in Ukraine.
According to the decisions of the Common Forum, Strategy and Action Plan of the Partnership, the priority directions of its activity are:
– involvement of civil society organizations to the active participation in the fight against tuberculosis, raising of the public awareness, solving of the problems associated with the negative attitudes of society towards patients with tuberculosis and HIV-infected individuals and their discrimination;
– development of opportunities and institutional capacity of TB-communities, advocacy of their activities, involvement in the Partnership activity;
– development and implementation of a measured plan of the implementing the Global Initiative «TB Free Cities» (ZERO TB initiative)  Informing the regional authorities, local governments, and communities on the Initiative;
– advocacy of the implementation of a social order for the provision of services to patients with tuberculosis in the regions of Ukraine, the development of recommendations for improvement of the situation, dissemination of the best practices, development of appropriate proposals for state institutions;
– conducting the independent monitoring of the implementation of the National Tuberculosis Control Program and preparing information materials with suggestions for improving the situation;
– participation in the development and implementation of the National Strategy for Advocacy, Communication and Social Mobilization for supporting the National Tuberculosis Control Program in Ukraine in 2018–2023;
– the building of institutional capacity of the Partnership «Stop TB. Ukraine», advocacy and state support for the Partnership activity;
– establishing of the sustainable cooperation with Global Stop TB Partnership, ensuring the participation of Ukraine's representatives in the international events on the matters of tuberculosis control activities, preparing proposals for getting the financial support for the implementation of the Partnership;
– facilitating the preparation and participation of the Ukrainian delegation in the High-level Meeting on the matters of fighting against tuberculosis.
Overcoming the tuberculosis epidemic requires the consistent implementation of the effective strategy based on evidence-based medicine. This conceptual project of a model of anti-tuberculosis help oriented of the people needs in Eastern Europe and Central Asia was prepared and published in 2017 by the technical partners of the Regional anti-tuberculosis Project in Eastern Europe and Central Asia (TB-REP) «Strengthening of the Health Systems for the effective control of tuberculosis, including the medical resistance of the pathogen», carried out with the financial support of the Global Fund to Fight AIDS, Tuberculosis and Malaria.
The partners of this project are The London School of Hygiene & Tropical Medicine, the London School of Economics and Political Science, and the European Respiratory Society in collaboration with the WHO Regional Office for Europe, Center for Healthcare Policy and Research, of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, as well as with the Alliance for Public Health, Stop TB Global Partnership, and the TB European Coalition.
The implementation of this model will give an ability to improve the early detection of tuberculosis and increase the effectiveness of treatment. Outpatient tuberculosis treatment in some areas has already been successfully introduced in Odessa and Odesa Oblast.
Moreover, the city of Odessa joined the «TB Free Cities» initiative. The development of cooperation between non-governmental organizations and the health care system in Odesa and Odesa oblast will enable methodically correct implementation of new approaches to the detection and tuberculosis treatment and provide timely and effective help to people with combined TB/HIV infection and forms of tuberculosis medicine resistant.
Informational work, both with patients and with medical professionals and representatives of non-governmental organizations, is very important for the introduction of the new model. The partnership forms the database of information materials on the prevention and treatment of tuberculosis, disseminates the best and innovative international experience, exchanges experience, promotes the community activation, attracts new members and partners to overcome the Tuberculosis epidemic in Ukraine. This lets to reduce the level of stigma and discrimination, improve patient adherence, and improve the interaction between the physician and the patient, which improves the effectiveness of treatment.
Any person can request about the prevention and treatment of tuberculosis, the protection of his rights as a patient or a healthcare worker, the activity of the Partnership «Stop TB. Ukraine», having written on its official page in the social network in Facebook: https://www.facebook.com/StopTB.Ukraine 
Here you can also find the cartoons for adult and children and the scientific films for the medical workers which will help you understand the disease more deeply, ways of treatment, and its prevention, and inform you where you can apply and what to do if there is a cough more than 2 weeks or the diagnosis of «tuberculosis» has already been established, but it's scary to ask for help for various reasons.
To attract the public's attention to this ailment and encourage it to make more efforts in overcoming the epidemic of the disease, the World Tuberculosis Day is commemorated on the date of 24th of March every year. This date was chosen not by chance: exactly this day 134 years ago a German microbiologist Robert Koch announced the discovery of TB agent. This year, all members of the Partnership held informational and awareness campaigns in more than half of Ukraine Oblasts and Kyiv.
The World Health Organization aims to overcome the epidemic completely by 2035, and by 2050, to achieve zero mortality from tuberculosis. This includes the steps by all stakeholders to provide high-quality medical care for TB patients, drastic changes in public health policy and health care systems, and stimulating more active research and innovation with the aim to end the epidemic and overcome tuberculosis. Therefore, the Partnership is already joining the international movement, which aims to increase the political commitment of the states to overcome the problem of tuberculosis, in Ukraine, within the frames of the health care reform, and is involved in the development of a strategy for the provision of anti-TB care to the population.
This way, on the 26th of September, 2018 in New York, the United Nations General Assembly will hold a high-level meeting on the matter of tuberculosis. In this regard, the Partnership has prepared proposals for organizing a delegation from Ukraine, including issues in the world and Ukraine, as well as the ways of solving them, which from our point of view should be voiced at the High-level meeting. The relevant document, with the support of all members of the Partnership, was sent to the President of Ukraine, the Prime Minister of Ukraine, the Minister for Foreign Affairs of Ukraine, acting director The Minister of Health of Ukraine, the Minister of Finance of Ukraine, the Minister of Social Policy of Ukraine and the Minister of Education and Science of Ukraine. Particularly, the President of Ukraine was invited to head a national delegation, initiate the allocation of at least 0,1 % of the annual gross domestic expenditure of all countries for Tuberculosis research, introduce a transparent and uninterrupted mechanism of state procurement of modern medicine for the treatment of tuberculosis and combined TB/HIV infection, implementation models of anti-TB care focused on human needs. The partnership also develops the cooperation with the Parliamentary Platform Against Tuberculosis, local, regional and national authorities, and international institutions.
A separate direction of the activity of the Partnership is the implementation of the «TB Free Cities» initiative. The highest rates of tuberculosis in Ukraine are Odessa, Kherson, Chernihiv, Mykolaiv, Dnipropetrovsk oblasts and Kyiv. It is there a broad information campaign will be held, cooperation with local authorities on the development and approval of targeted programs, advocating for the allocation of funds, activating communities and the public to monitor their use. The mayor of the city of Odessa has already signed the resolution with the intention of joining the «TB Free Cities» initiative. As the members of the Partnership are organizations and institutions of Odesa and Odesa Oblast, the Partnership plans to provide comprehensive methodological and informational assistance in implementing this initiative through assistance in developing the implementation strategy, seeking additional funds for patient support, information work, etc. Based on the international experience, the Partnership has begun work on adding Kyiv to this initiative.
Non-governmental, national and local organizations, government bodies, international agencies and projects, associations of trade unions, private/business sectors, religious organizations, individuals who direct their activities to overcome the TB epidemic in Ukraine can join the Partnership. To do this, you have to contact the Partnership Secretariat at the following email address: StopTBUkraine@gmail.com
Author: Natalia Kravchuk 
Translator: Svetlana Fedoruk