Tuberculosis is one of the main causes of infection-related mortality in the world and is the primary cause of mortality in people living with HIV (PLHIV). According to the WHO, 10 million people contracted tuberculosis and 1.5 million died of it in 2018 including 251,000 HIV carriers. Children, as well as PLHIV, are particularly affected by the disease, with around 251,000 deaths in 2018 (including children with tuberculosis linked to HIV). In 2014, the WHO devised the End TB strategy whose objective is to achieve a reduction of 95% in mortality by 2035 and of 90% in the number of new cases compared to 2015. This strategy requires improved diagnosis of TB, improved treatment especially of multiresistant strains, the introduction of preventive strategies and continued collaboration between TB and HIV programmes. Solthis is involved with this strategy in Sierra Leone through the TB-speed project, whose objective is to improve tuberculosis testing and care for children
Solthis is currently involved in the TB-Speed project, which aims to improve screening for tuberculosis in children.
Our goal over the next few years will be to develop comprehensive approaches to tuberculosis control as part of the End TB strategy. Our efforts will be concentrated on 3 main areas:
screening for tuberculosis in children (TB-Speed project)
screening for tuberculosis among PLWHA, and better coordination between HIV and tuberculosis programs.
implementation of preventive tuberculosis treatment in populations most at risk.
“Managing Risk in Fragile States: Putting Health First!
Optimising the Efficiency of the Global Fund's Grants”
This evidence-based report is the result of a work over several months, including 4 missions (Guinea, Mali, Niger and Sierra Leone) and interviews with 140 stakeholders. Through this work, we identified bottlenecks in the implementation of the Global Fund's grants in the field, showing that the Global Fund's Risk Management Policy is not well-adapted to fragile states. The additional safeguard measures which have been put in place by the Secretariat after the investigations of the Office of the Inspector General were meant to mitigate the financial risks and to reassure donors. However, experiences in challenging operating environments clearly show that these measures are mainly focused on financial risks and have caused significant malfunctions that jeopardise both the impact and the sustainability of the programmes. In order to make progress and to cope with the challenges specific to fragile states, we think it is now time for the Board members and the donors of the Global Fund to opt for an ambitious and innovative policy, which would put financial risk at its proper place: behind risks to public health. The main recommendations we are addressing in the report aim to place the public health risk at the centre of the mechanism, by:
Improving the balance between the analysis and the management of the different risks.
Simplifying and clarifying the control procedures: limit the number of contractors and the levels of validation.
Defining indicators or objectives for terminating additional safeguard measures to encourage appropriation and capacity building.
Investigating the possibility of an increased presence of the Global Fund in the field, by missions of several weeks or several months.
Adapting the indicators and procedures of performance-based funding and accountability measures to fragile states.
The Scientific Days, organized by the ULSS and CMT, in partnership with Solthis and GIP Esther, took place on 2 and 3 October 2009 in Niamey in the presence of Professor Katlama (Solthis President), Prof. Brucker (Treasurer Solthis and CEO of Esther) but also of Dr Kassi (Ivory Coast) and Professor Toure (Senegal). More than 250 physicians, health professionals, representatives of the fight against HIV, tuberculosis in Niger attended these days. Many topics on Chess therapeutic Opportunistic Infections, PMTCT, Accidents of exposure to blood and the delegation of tasks were discussed.
HIV/AIDS care and follow-up on a national scale in low resource settings: experience of the Niger Initiative on Antiretroviral Access (INAARV), NigerAuthor(s) : M. Ide, Y. Madec, M. Boubacar, E. Adehossi, C. Dezé, GM. Lawal, O. Amadou, S. Diallo, C. Pizzocolo, IA. Touré, S. Mamadou, C. Katlama and the National Technical Committee Download the presentationPilot cell comprehensive care: a multidisciplinary service orientation and listening PHAs, NigerAuthor(s) : A. Alzouma, C. Dezé, B. Sabo, M. Bako, S. Maman, I. Mourtala, M. Goundara, F. Djermakoye, M. Ide, F. Aeberhard Download the presentationThe impact of prior recourse to traditional medicine on the out-of-pocket expenditure of HIV/AIDS patients in NigerAuthor(s): S. Walker, S. Tchiombiano, A. Maiga, R. Hassane, M. Idé, AH. Souna, V. Bignon, O. Weil, L. Pizarro Download the presentationIncidence and risk factor for tuberculosis (TB) in HIV patients on ART, Niger Author(s): A. Foucher, Y. Madec, S. Diallo, Z. Thiousso, I. Dillé, S. Gambo, HA. Souna, A. Oumarou, A. Manou, GM. Laoual, Al. Touré, C. Pizzocolo, L. Pizarro, A. Fontanet Download the presentationDecentralized access to triple therapy and viral load monitoring in West Africa (Mali)Author(s) : A. Akondé, Y. Madec, AB. Dicko, I. Haidarra, I. Katile, B. Diarra, M. Kye, A. Doumbia, C. Pizzocolo, C. Katlama and the Segou Medical Technical Committee Download the presentationA method of HAART decentralization in rural areas: Solthis' experience in Segou (Mali)Author(s) : P. Teisseire, A. Akondé, C. Pizzocolo, S. Calmettes, S. Dalglish, N. Bodo, L. Pizarro Download the presentationPrevention of mother-to-child transmission of HIV (PMTCT) in a rural setting : the experience of the Segou region in MaliAuthor(s) : CD. Traoré, A.akondé, T. Samake, T. Traoré, Y. Coulibaly, O. Coulibaly, A. Sidibé, D. Germanaud, Z. Traoré, A. Maiga, AG. Marcelin, C. Pizzocolo, C. Katlama and the Segou Medical Technical Committee Download the presentationAppraisal of treatment modification in HIV patient follow-up in the region of Segou (Mali)Author(s) : J. Landier, A. Akondé, C. Pizzocolo, I. Haidara, M. Drabo, L. Pizarro, A. Fontanet, C. Katlama, Y. Madec Download the presentationEtude virologique chez des sujets VIH-1 suivis à MadagascarAuthor(s) : F. Lamontagne, S. Andriantsimietry, ML. Chaix, JP. Viard, M. Randria, J. Nely, S. Randriamampionona, C. Aguilar, S. Royer, C. Pizzocolo, LR. Razanakolona, C. Rouzioux Download the presentation