A guide for affected community and civil society organizations, national TB programs and policy-makers in eastern Europe and central Asia
Ending tuberculosis (TB) by 2030 requires not only strong health systems but also investments in rights-based, people-centred care. In a significant stride towards this goal, the World Health Organization Regional Office for Europe (WHO/Europe) has unveiled a groundbreaking standardized package of community-based support services. The initiative aims to improve TB outcomes and contribute to the global mission of eradicating the disease.
Standardized package of community-based support
The package was developed by the project “Advancing people-centred quality tuberculosis care: TB-REP”, funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria. The project focuses on assisting countries in eastern Europe and central Asia in implementing a new care model to detect and treat drug-resistant TB at an early stage.
The package pays particular attention to key populations that often face increased vulnerability. It offers recommendations for a set of community-based services tailored to engage and reach these populations effectively, addressing their complex and comprehensive needs.
Emphasizing the engagement of affected communities and civil society actors in service delivery, the package provides practical tools for implementing standards for community-based, nonmedical services. These services aim to complement the efforts of health-care providers and shift the focus from medical settings to the specific requirements of individuals affected by TB within their communities.
National policy-makers, national programme managers and community representatives can use the guide to establish service delivery to affected communities and determine implementation costs effectively.
“Involving civil society organizations can make a difference when this involvement is supported by the evidence of effectiveness. Linking the work of civil society organizations to the standard TB indicators, carefully assessing the pilots and judiciously managing the costs can significantly advance the cause of fighting TB,” pointed out Dumitru Laticevschi, Regional Manager of the Global Fund’s Eastern Europe and Central Asia Team.
The launch of this package marks a paradigm shift in the approach to TB care. By incorporating community-based support services, the initiative recognizes the multifaceted nature of the disease and the challenges faced by individuals affected by TB, particularly members of key and vulnerable populations. The provision of support services not only ensures timely access to care but also addresses the stigma and discrimination associated with TB.
People-centred care with support from local communities
The services can be delivered by medical providers and by social workers; however, they are best delivered by the people who understand the particular circumstances of people affected by TB – members of the same community, people who have completed treatment or support groups. This approach aligns with the people-centred model of care that WHO/Europe encourages.
To fully harness the potential of community-based TB support services, it is crucial to establish clear organizational frameworks and regulations. The new package is a valuable resource that can help civil society organizations to plan, implement and evaluate these services effectively. Furthermore, it offers guidance to national TB programmes and governments for investing in and integrating community-based support services into essential TB care packages.
“There is a growing awareness that the problems with TB control at the country level can only be solved through joint efforts of the state, medical institutions, communities and each individual person,” emphasized Ainura Ibraimova, who works with the United States Agency for International Development’s Cure Tuberculosis Project in Kyrgyzstan. Ainura was also a member of the package’s review panel.
She added, “For the first time, this document provides a list of services that can be delegated to local communities and nongovernmental organizations, which fills in the gap for the development and implementation of comprehensive care for patients with TB in countries.”
One step closer to a TB-free world
The WHO European Region has made a significant progress in tackling TB infection. Nevertheless, the high-priority countries in the Region still bear a large share of the disease burden, especially of the drug-resistant form, and the Region falls short of achieving the targets of the End TB Strategy.
With the launch of the standardized package of community-based support services, WHO/Europe reinforces its commitment to eradicating TB. By prioritizing the holistic well-being of individuals affected by the disease and promoting inclusive care models, this initiative represents one more step towards a TB-free world.
Standardized package of community-based support services to improve tuberculosis outcomes. A guide for affected community and civil society organizations, national tuberculosis programmes and policy-makers in eastern Europe and central Asia (2023)