Multisectoral Accountability Framework For TB To Boost TB Case Finding in Zimbabwe

A Multisectoral accountability framework for TB (MAF-TB) has been launched in Zimbabwe with the aim to support effective accountability of government and all stakeholders to accelerate progress to end the tuberculosis pandemic.

By Michael Gwarisa

The MAF-TB process is being led by the Ministry of Health and Child Care through the National TB and Leprosy Control Program (NTLP) in collaboration with United States Agency for International Development (USAID), the Stop TB Partnership Zimbabwe, World Health Organization (WHO) Zimbabwe country office and Jointed Hands Welfare Organisation (JHWO). The program was developed following the UN High level meeting on TB that brought together world leaders who committed to accelerating efforts in ending TB and reaching all affected people with prevention, care and support.

Officiating at the launch, Ministry of Health and Child Care (MoHCC) Director Public Health, Dr Munyaradzi Dobbie said the MAF-TB would improve accountability and TB case finding outcomes ahead of the target to end TB deaths by year 2030.

There are still programmatic gaps in TB case finding including missed opportunities along the TB Screening, Diagnosis care cascade, sub-optimum treatment outcomes compounded by patients delays  in seeking care and lack of treatment adherence support even though 80 percent of TB patients experience catastrophic costs. To address the challenges effectively and efficiently, there is need for a multisectoral approach and active participation and involvement of all sectors that contribute to health,” said Dr Dobbie.

He added that ending TB remains a priority for the Ministry of Health and Child Care and in recent years, Zimbabwe invested in TB by adopting innovative tools and strategies in line with global best practices. The strategies have contributed to sustainable gains and key impact and outcome indicators on TB.

TB kills more than 1.5 million people each year and millions more with enormous effects on families and communities through catastrophic costs linked to TB care. Zimbabwe was recently removed from the 30 high burden countries for TB, HIV and Multi Drug Resistant TB.

“Consequently, Zimbabwe is among seven high TB burden countries that have achieved the 2020 milestones of 20 percent reduction in TB incidence compared to the 2015 baseline. Premised on this great achievement, Zimbabwe was removed from the top countries in Africa from the world top 30 list with triple burden of TB, HIV and Multi Drug Resistant TB (MDR-TB).”

The TB Pandemic in Zimbabwe is largely HIV driven with a core infection rate of 50 percent and an HIV prevalence rate of 12.9 percent. TB remains among the top 10 leading causes of death in the world and the same is true for Zimbabwe. The Global End TB strategy aims to reduce the TB death rate by 90 percent, incidence by 80 percent and remove catastrophic costs for TB patients by the year 2030.

World Health Organisation (WHO)Zimbabwe Technical Officer for TB and HIV, Dr Mkhokeli Ngwenya who was standing in for WHO country representative, Dr Alex Gasasira said, “We note that the MoHCC is giving the MAF-TB a very high level of commitment it deserves, especially during the time when there are several other priorities to be addressed. WHO is committed to support the MoHCC to assess the baseline status of the components of the MAF-TB; involve officials and stakeholders in adapting the framework; and monitor and review its use.

“Implementing the MAF-TB is a tremendous accomplishment requiring strong political commitment that the MoHCC is clearly demonstrating. We believe that this meeting is very critical, and the launch will facilitate the processes necessary for the country to develop its own MAF-TB. We are very grateful to all who are working so hard to enable Zimbabwe to adapt the MAF-TB facilitating its use.”

Meanwhile, Dr Fungai Kavenga, the acting Director, TB Unit in the Ministry of Health said 
while Zimbabwe has improved its capacity to screen and test for TB and the plan is to now 
identify and test all missing cases.

“In terms of  health Services infrastructure and TB Diagnostic Tools, the total number  of  Government health facilities in the country stand at 1650 and the total number of  Gene Xpert machines in the public sector is 155. The total number of Truenat  machines in  the public sector is 20 while total number of  digital X-ray machines in the  public sector is 36.

“In Zimbabwe, HIV prevalence is high at 12.9%. The TB epidemic is largely driven by HIV-with a co-infection rate of 50%.TB/HIV co-infection has declined from 70% in 2010 to 50% in 2021 TB/HIV burden is still high. There is need to sustain and strengthen TB/HIV interventions with a focus on screening all PLHIVs for TB and enrolling them on TPT,” said Dr Kavenga.

To achieve its aim, the MAF-TB will lead to the engagement of all sectors of the economy which influence health (Agriculture, Mining, Education, Justice, Housing, Defense, Social services, Manufacturing, Retail services, Finance, Media, Entertainment, Sports, Telecommunication, Public and Private services among others) and push for collaborative efforts in effectively addressing TB and other health issues. Furthermore, the MAF-TB will transform the national TB response so that it promotes and protects human rights and gender equality.






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