Report on governance of the TB response in 22 countries

1 June 2021, Geneva, Switzerland - The Stop TB Partnership and the United States Agency for International Development (USAID) today launched a new report – the first of its kind – that assesses the governance of National Tuberculosis Programmes (NTPs) in 22 countries which together account for over 70% of the global TB burden. The report “Governance of TB Programmes: An assessment of practices in 22 countries” is envisioned to support and strengthen the performance of national-level action against tuberculosis (TB), a preventable and curable disease, which needlessly kills 4,000 people every day.
 
Good governance is a critical aspect of an effective NTP to ensure more effective and efficient implementation of NTPs, and appropriate legal and policy frameworks. It also allows for more transparency and inclusiveness. While recent years have seen investment in the technical capacity of NTPs and stakeholders, strengthened governance has not been sufficiently prioritized or measured.

The 2021 report will serve as a baseline against which future progress can be measured. It assesses the country programmes' performance in four thematic areas: transparency, inclusiveness, legal framework, and processes efficiency and effectiveness.
 
“This report analyses, in detail, areas of national TB responses that are often overlooked and not regularly discussed and strengthened. However, as much as these areas are neglected, it is essential that we assess, strengthen, and invest in legal frameworks, transparency, ensure availability of data and information, inclusiveness, and efficiencies of processes if we want to end this disease,” said Lucica Ditiu, Executive Director of the Stop TB Partnership. “Addressing the findings of this report and supporting the NTPs and their teams to attain the highest standards in their work will ensure that the TB response is mature and indeed adequate to end TB by 2030.”

“Governance structure and approaches are key to influencing the performance of the TB programmes. This report will, therefore, not only show us where we are in regards to the matter of governance of the NTPs but also enlighten us on areas where national TB programmes ought to improve,” said Lungu Saili Patrick, National TB Programme Manager, Zambia. “I am hopeful that TB programmes and partners will embrace the report and that we will use it positively to improve on the benchmarks that are highlighted.”
 
Anna Marie Celina G. Garfin, National TB Programme Manager from the Philippines stated that “this report is important for us to identify what the Philippines has done well, where there is room for improvement, and to share best practices across the board in our efforts to end TB.”
 
“Equity, inclusion, and participation are critical for good governance. Civil society and TB-affected communities must be at the center of the effort to end TB,” said Rhoda Lewa, a TB-affected community representative from Kenya.

The TB governance report is an important component of the USAID Global Accelerator to End TB, which is designed to increase public and private investments and build local commitment and capacity to achieve the targets and commitments agreed on at the 2018 United Nations High-Level Meeting on TB by the 2022 deadline.

The report is based on responses received from NTPs using a semi-structured questionnaire, as well as through desk review of available data and documents from already existing and credible sources.

Click to access the full report

A few excerpts of key findings based on the four thematic areas from the report:

• Transparency – Three (14%) countries achieved the benchmark for a working NTP website, owned by NTP, with latest relevant information. Only one (5%) country achieved the benchmark for availability of the latest case notification data, five (23%) for availability of the latest TB guidelines and none (0%) achieved the benchmark for availability of the current National Strategic Plan (NSP) with annual budget on the website. Eight (36%) countries achieved the benchmark for conducting joint external programme reviews and making reports available.
  
  
• Inclusiveness – While 14 (64%) countries achieved the benchmark for including TB civil society/TB survivors, and an equal number of countries achieved the benchmark for having a platform to collect feedback from the TB community and subnational entities, none (0%) achieved all indicators considered for benchmarking for inclusion of key populations (KPs) in their NSP and none achieved all indicators considered for benchmarking for gender inclusiveness in various NTP activities. Only one (5%) achieved the benchmark for having a mechanism and practice for the social contracting of NGOs and private sector using government funds.
  
  
• Legal Framework – 13 (59%) countries achieved the benchmark for mandatory TB notification and 11 (50%) for having medicines for drug-resistant TB in the national essential medicines list and available for free to the people who need it. However, the performance under other benchmarks of this theme was not good, with only three (14%) having achieved the benchmark for inclusion of human rights issues in TB training modules or guidance documents, two (9%) for featuring and measuring TB stigma in the NSP and one (5%) for availability of social protection schemes and social health insurance for all people with TB.
  
  
• Process efficiency and effectiveness – Four (18%) countries achieved the benchmark for the ability to rapidly adopt/adapt international guidelines as national policies and seven (32%) achieved the benchmark for approval efficiency, as assessed for the last training undertaken in the country. None (0%) of the countries achieved the other three benchmarks under this theme, such as those on NTP capacity to absorb funds from different sources, NTP manager empowerment, and NTP capacity (number of staff in relation to population/burden/provinces).

Source: Stop TB Partnership