INNOVATING SCIENCE: supporting tuberculosis detection programs worldwide

News

5 Sep 2014

In a recent article in the Oxford Journal of International Health KIT and partners radically challenge current thinking on scientific evidence making. A new and innovative way of measuring and evaluating tuberculosis detection programs offers policy makers and health care specialists a new form of evidence to what works and what does not in detecting tuberculosis. Fighting tuberculosis has become a worldwide challenge. The disease claims millions of victims and has a crippling effect on economies worldwide. Meanwhile the danger is growing: the bacteria increasingly becomes resistant towards regular medicine cocktails.

33% increase of patients

KIT and HLSP have been involved in the work of TB REACH from the early start. They were asked to monitor and evaluate the results of all projects funded by TB REACH, a fund that aims at increasing detection and treatment of tuberculosispatients. KIT and HLSP designed a method to draw & share lessons for future projects. TB REACH was launched in January 2010 and supports innovative approaches in populations that are poor and vulnerable and have limited access to care, like high risk populations such as children, migrants and prisoners. TB REACH has so far supported 143 projects in 46 countries through the first four rounds of funding. First results show a 33% average increase in located patients within one year after a project received financing by TB REACH.

Co-designing

Lucie Blok, senior advisor KIT Health: “being there from the start offers great advantages. Some grantees are very experienced working in the field, but not that skilled in effective evaluation design. We co-design evaluation and monitoring plans, which helps the local partners grow their own skills. You see how projects and ambitions grow to a higher level and bigger scale. And that is exactly the effect we are after: worldwide millions of infected people are missed and do not receive proper treatment. We need to share the interventions that work!”

Evidence 2.0

Scientific evidence tends to be delivered on hard terms. Only a randomized trial with a large number of patients, stripped of local context, may be considered “proof” that a method works or not. Blok: “standarised trials requireconsiderable investment of money and time and program conditions do not always allow these. We believe that information collected in the field has a value of its own and, when properly structured, can be valuable “evidence” for policy makers in health. Information from innovative projects in the field offers additional information: what worked well and why especially within the context. Like educating community health workers and offering them a motorbike so they collect samples of suspected patients and deliver them to a regional hospital, rather than asking anyone that coughs in a remote area in Ethiopia to travel 50 km to the nearest hospital to get tested. By documenting and evaluating what worked, when and why we believe we can have real impact in designing policy in public health that effectively stops the advance of infectious diseases worldwide. ”

More KIT & TB

KIT has a long track record in supporting disease control programmes and has developed specialised technical expertise in tuberculosis, leprosy and HIV/AIDS. KIT has supported Ministries of Health and others in formulation of global and national policies. KIT supported national programme staff in developing action plans for the practical implementation of such policies at national, district and community level through long term technical assistance, consultancy advisory visits, tailor-made courses, operational research and evaluation missions. KIT also develops innovative diagnostic testing methods for tuberculosis and supports laboratory management and policy makers designing effective laboratory systems to detect tuberculosis and other infectious diseases in f.e. Moldova, Georgia and Uzbekhistan.