Join us for a 60-minute Twitter chat to share your views about “Funding TB priorities through the Global Fund COVID-19 response mechanism in South Africa” using the hashtag #TBproof. All stakeholders including community health workers, healthcare professionals, patients, NGO’s, policymakers, payers, journalists, educators, nurses and researchers locally and globally are welcome. The public transcript will be recorded by Symplur.
QUESTIONS T1: If funding for TB is secured through the Global Fund COVID-19 response mechanism, what would you recommend as a top priority to be funded? Why do you think this would have the biggest impact to close gaps in the TB care cascade? T2: How can we raise awareness about the overlap between COVID-19 and TB and what should the key messages be? T3: How can communities advocate effectively for countries to release TB Recovery Plans to mitigate the impact of COVID-19 on TB? T4: How can we ensure that health workers test all people who present with a cough for both TB and COVID-19? T5: At community-level, who is responsible for providing home-based care and social support? Are they adequately trained in their role? CT: (Closing Thoughts): Is there anything you feel is important to add to this conversation?
Start your answers with T1, T2, T3, T4, T5 or CT for transcript purposes Answer only after the moderator prompts. Questions will be prompted every 8-10 minutes, but keep answers coming using the relevant T and number. Introduce yourself if you are joining. Use the #TBproof hashtag in all tweets so you are visible to others in the chat as well as on the Symplur transcript afterwards.
Funding TB priorities through the Global Fund COVID-19 response mechanism in South Africa
Many people are not aware that COVID-19 and TB both spread through the air, present with the same symptoms including cough and fever, and can be prevented by mask wearing and adequate ventilation as part of infection control measures.
Amidst the COVID-19 pandemic, there was a catastrophic 48% drop in the number of TB tests conducted in South Africa, meaning that people with TB were missed (NICD, 2020). The Department of Health updated screening guidelines to test a person with a cough of any duration for both TB and COVID-19. Yet, community health workers (CHWs) reported being concerned that people who presented with a cough and fever were being tested for COVID-19, but not also for TB at community-level.
TB Proof co-led community consultations during May – June 2021 for input on key TB priorities. Communities affected by TB reported that TB is not being prioritised on the national health agenda. Civil society calls for inclusion of TB priorities in Global Fund COVID-19 funding mechanisms to strengthen the national-level responses to both diseases through:
Community-based & community-led services e.g. integrated TB/ COVID-19 testing, screening and contact tracing.
TB/ COVID-19 stigma reduction campaigns on transmission, symptoms, infection control measures led by networks of community leaders.
Reaching key and vulnerable populations to provide rights-based, gender responsive, community led interventions that are culturally appropriate to address barriers to care informed by local needs assessments.
Advocacy and communication campaigns e.g. influence decision makers to address TB as part of COVID-19 agenda.
Community-led monitoring (CLM) and addressing human rights & gender related barriers e.g. Conduct rapid stigma assessments to understand the level and dimension of stigma.
Planning and programming e.g. release and implement the TB Recovery Plan.
Priority 1: Integrated community-based & community-led services, implemented through support groups, civil society and CHWs:
Integrated bi-directional COVID-19 and TB screening and testing.
This could be done through community outreach including x-rays and linking services as both diseases present with similar symptoms and spread through the air. Health workers should be made aware that TB testing guidelines have changed and that anyone with a cough should be screened for both TB and COVID-19. TB testing needs to be expanded to reach high risk groups and could be done at all levels of the health system, including pharmacies, by CHWs, in primary care clinics and hospitals.
Integrated contact tracing to follow up with TB treatment and TB Preventive Therapy (TPT), especially among priority groups including people living with HIV and children under 5 years.
TPT awareness raising led by CHWs and TB survivors using accessible information and decentralised points to collect TPT are needed. Support groups can help to facilitate contact tracing by counselling people diagnosed with TB to refer to their households.
Integrated home care for uninterrupted delivery of TB medication.
Tailored approaches for service delivery depending on the setting are needed. People need to be reached at work, community settings and at household-level to increase access to care.
Integrated social support to ensure that nutritional and psychological support is provided to people affected by TB and/ or COVID-19.
Income grants should be extended, with widespread availability of nutritional support for patients with TB, including food vouchers for local “spaza” shops. CHWs can be trained on counseling to offer psychosocial support to families and also need capacity building to use digital data management and tracking systems. Strong political commitment and practical implementation guidelines are needed to achieve integrated care for both TB and COVID-19. Community leaders need to advocate for South Africa to release and implement the national TB Recovery Plan and increased funding for TB programmes through COVID-19 responses.
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