First infectious cause of mortality among people living with HIV
Tuberculosis is one of the leading infectious causes of death in the world and is the leading cause of death among people living with HIV (PLHIV). According to the WHO, 9.9 million people were infected with TB and 1.5 million died from it in 2020, including 214,000 HIV-positive people. Children, along with PLHIV, are particularly affected by the disease, with an estimated 1.1 million cases worldwide in 2020.
In 2014, WHO developed the End TB strategy with the goal of achieving a 95% reduction of mortality and 90% reduction in new cases by 2035 compared to 2015. This strategy requires improving TB diagnosis, improving treatment especially of multidrug-resistant forms, implementing preventive strategies, and continuing collaboration of TB and HIV programs.
Our work: tackling the challenge of tuberculosis under-diagnosis
Solthis is participating in the End tuberculosis strategy in Sierra Leone through the TB-speed project, which aims to improve TB diagnosis among children under 5 years of age. In Sierra Leone, as in other countries particularly affected by tuberculosis, a majority of those affected by the disease are not diagnosed or declared and therefore do not receive appropriate treatment.
This lack of diagnosis is due to the absence of child-friendly tuberculosis diagnostic capacity in many primary health centers. Childhood TB services are concentrated in regional and national level health facilities, limiting access in remote areas. Solthis is currently participating in the TB-speed project to help test new and effective testing strategies in remote areas to address this need. Learn more about the TB-Speed project.
In addition, Solthis continues to develop comprehensive approaches to TB control to help achieve the goals of the End TB strategy. Its efforts are focused on the following main areas:
TB testing and management
TB testing in children (TB-speed project)
TB testing for PLWHA and better coordination between HIV and TB programs.
testing for tuberculosis in the general population, in rural areas
implementation of preventive treatment of tuberculosis in populations most at risk (PLWHA)
work on stigma issues (sharing status, peer involvement), which remains an obstacle to the fight against this pandemic
integration of psychosocial dimensions in patient care, and in particular the issues of therapeutic compliance, which guarantees effectiveness, and the prevention of the emergence of resistant strains.
“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
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