Public-private mix for TB care and control
Ways in which businesses can contribute responsibly to TB care and control
Outlined below are a few simple but cost effective ways, businesses can contribute to TB care and control efforts. Many of these are based on working examples on the ground. Some of these require little or no investment and may prove cost-effective for the company, community and the country as a whole.
Increase awareness among workers, families and community
From the beginning, the TB and HIV/AIDS epidemics have been accompanied by an epidemic of fear and ignorance, leading to stigma and discrimination. Only by creating positive awareness and understanding of TB and HIV in the population can stigma be reduced. People ought to know and believe that TB can be easily detected and is treatable and curable. The business sector can contribute significantly, in a variety of ways, to help spread this awareness within and beyond workplaces.
Identify TB cases among workers and support TB care at the workplace
Referral of TB symptomatics, intensified tuberculosis case-finding and treatment support are simple activities that workplaces could contribute to with very little investment. With appropriate training, medical, paramedical staff or even workers can identify the symptoms of TB and refer symptomatics either to the workplace health center, contracted medical institutions or to the public sector. These staff could also be engaged in supporting/supervising treatment.
Offer TB and HIV testing and counseling at the workplace
Even with advances in technology and extensive global and national efforts, only an estimated 1% of people living with HIV/AIDS are screened for TB. Further, various case studies show that workplaces can greatly help identify TB cases and significantly reduce the delays that exist between the onset of TB symptoms and diagnosis. Businesses could contribute to the early detection of TB and HIV cases by facilitating access to TB and HIV testing and counseling services for their employees, and/or dependents - on-site or in collaboration with public or private institutions.
Provide TB and HIV treatment and care at the workplace
Though there has been significant progress made in increasing treatment access in several regions of the world through global efforts. An estimated one-third of the 32 million people living with HIV worldwide are co-infected with TB, without proper treatment, a large proportion of these people die within months of contracting TB. Workplaces are important and valuable venues for facilitating access to TB and HIV treatment and care. Treatment default is one of the major causes of drug resistant TB. The reasons for default may be work-related, such as inconvenient time of treatment which clashes with work, distance to site of treatment, or fear of loss of wages or job. Workers who are able to easily access treatment tend not to default.
Include TB prevention, diagnosis and treatment in HIV workplace programs
Many companies, especially in high-HIV prevalent settings, have HIV workplace programs in place, however TB care and control are not adequately addressed or incorporated. There is an urgent need to include TB prevention, diagnosis and treatment in HIV workplace programs. Anecdotal evidence showed that, large multinational companies with strong HIV programs in place have no TB care and control services. HIV workplace programs could bring down the number of HIV related deaths and benefit by including collaborative TB/HIV activities into its HIV control efforts.
Implement comprehensive TB and HIV care programs for workers, families and communities
Health services including TB and HIV services, do not always reach all segments of populations because of inadequate health service infrastructure in some countries, insufficient decentralization, and needs that exceed locally available resources. Companies can take responsibility for providing a comprehensive package of TB and HIV/TB services not only to the workers and their families, but also to the communities in which workers live. Alternatively, companies may adopt underserved communities or villages in close consultation with national TB and HIV programmes.