By Michael Gwarisa
In a bid to accelerate progress to end Tuberculosis (TB) by the year 2030, Zimbabwe has developed and endorsed its Multi-Sectorial Accountability Framework for Tuberculosis (MAF-TB) framework for TB baseline assessment findings.
Launched in January 2023 in Zimbabwe, the MAF-TB aims to support the effective accountability of government and all stakeholders in the country, to accelerate progress to end the tuberculosis epidemic; and to be aligned fully with the End TB Strategy and the 2030 Agenda for Sustainable Development.
Development of MAF-TB in Zimbabwe was done by the Ministry of Health and Child Care (MoHCC) through support from the Stop TB Partnership, the World Health Organization (WHO) Zimbabwe country office, the United States Agency for International Development (USAID), Stop TB Partnership Zimbabwe, and the Jointed Hands Welfare Organization (JHWO).
Speaking at the official validation meeting in Harare, the Director AIDS and TB Unit in the Ministry of Health and Child Care, Dr Own Mugurungi said the MAF-TB was a critical step in line with Zimbabwe’s commitments to combat TB.
TB remains a global health challenge affecting millions of lives each year. It is our duty as leaders to ensure that no one dies of TB and no one is left behind in our fight against TB. The MAF-TB represents a collaborative effort, a bridge connecting various sectors of the economy toward one goal of ending TB,” said Dr Mugurungi.
The MAF-TB brings together government departments, Parliament, healthcare professionals, policymakers, civil society organizations, the private sector, the media, traditional leaders, researchers, and affected communities among others to play their part in the TB response.
“TB is not just a medical challenge; it intersects with social, economic, and environmental factors. Thus, the multi-sectoral approach is crucial because by involving multiple sectors, we gain a holistic perspective and can address the root causes and difference determinants of the disease.
“It is also important to note that, TB control cannot rest solely on the shoulders of our ministry. Education, housing, nutrition, mining, employment and other sectors—all play a role. Our collective responsibility ensures a more effective TB response. When different sectors collaborate, innovation flourishes. We can leverage technology, data, and community engagement to accelerate progress towards the achievement of the Sustainable Development Goal of ending TB by 2030.”
Meanwhile, Zimbabwe has undertaken some critical steps in adopting the components of the Multi-Sectoral Accountability Framework for TB. These include launching of the Multi-Sectoral Accountability Framework for TB (MAF-TB) on the 17th of January 2023 as well as conducting a Baseline Assessment with the assistance of two consultants.
“As we are here today to validate the findings of the baseline assessment, we acknowledge that accountability is not a buzzword; it is our commitment to jointly play our role in accelerating progress to end TB and remain answerable for our actions to the communities we represent. Through this multi-sectoral approach, we will establish mechanisms to track progress, hold ourselves accountable, and transparently report to our fellow countrymen,” added Dr Mugurungi.
TB remains a major cause of ill-health and mortality globally and in many countries especially high burden TB countries. Before COVID-19, TB was the leading cause of death from a single I infectious agent and it was killing more people than HIV/AIDS.
WHO Zimbabwe National Professional Officer - Tuberculosis and Leprosy, Dr Mkhokeli Ngwenya said dealing with TB was not a health sector problem alone.
“When you want to deal with TB, you cannot deal with TB as the health sector alone because there are various issues and factors that lead to TB. Above all, the affected people, and the families suffer from a lot of stigma and discrimination and marginalisation as a result of all those issues. To fight TB, we need an approach which includes all sectors,” said Dr Ngwenya.
Zimbabwe is guided by the World Health Organisation END TB Strategy under the three pillars of the END TB strategy. These include integrated patient-centered TB Care and Prevention where there is an emphasis on early diagnosis of TB and treatment of all people with TB. It also speaks to access to recommend TB diagnostic tests offered to patients.
The TB Prevention element emphasises the need to offer TB preventive Therapy services to all those at high risk of TB infection. The second pillar speaks to policies and supportive systems where community engagement, stakeholder engagement and engagement of other sectors beyond the health sectors, political commitment and engagement of TB survivors, champions the media and every sector. The last pillar focuses on intensified research and innovation.
“Our vision is also to be a TB-free Zimbabwe by 2030 and we are guided by two strategic goals. The first one is to reduce the incidence of all forms of TB by 80 percent compared to the 2915 baseline. We also want to reduce the number of TB deaths by 80 percent compared to the 2015 baseline and i can confirm that as a country we are making progress towards achieving our goals,” said Dr Fungai Kavenga, the acting Deputy Director AIDS & TB Programs (TB Control) in the Ministry of Health and Child Care (MoHCC).
Zimbabwe also has eight strategic objectives around TB. Zimbabwe aims to increase the treatment coverage of drug-susceptible TB from 83% in 2018 to 90% by 2026, to increase the treatment success rate of patients with drug-susceptible TB from 83% in 2017 to 90% by 2026 and to achieve universal HIV testing and ART coverage for TB cases by 2021 and sustain coverage through to 2026.
Zimbabwe also ails to cumulatively detect 2,680 patients with RR/MDR TB between 2021 and 2026, to Increase the treatment success rate of patients with RR/MDR TB from 57% (2016) to 75% by 2026, to Decrease the proportion of households facing catastrophic costs due to TB from 80% in 2019 to 50% by 2026, to scale up leprosy prevention alongside integrated active case detection and strengthen Programme coordination and management and enhance accountability.
