The International Union Against Tuberculosis and Lung Disease

(The Union)

Promoting Lung Health Since 1920

I.D. Rusen MD, MScDirector, Department of Tuberculosis, The UnionDecember 4, 2009, Cancun

Outline• Union mission

• Pillars of work

• Tuberculosis burden

• FIDELIS

• Questions and answers

Union Background• World’s oldest humanitarian organization dealing with

health founded in Paris in 1920

• Mission: to bring innovation, expertise, solutions and support to address health challenges in low- and middle-income populations

• Headquarters in Paris with several regional and country offices including Mexico, New York, Delhi, Kinshasa and Kampala

Union Pillars

• Technical Assistance

• Research

• Training

Union Technical Departments• Tuberculosis

• Lung Health

• HIV

• Tobacco Control

Tuberculosis• 9.27 million cases globally in 2007

• 1.77 million deaths due to TB

• 511,000 cases MDR-TB

• 1.4 million HIV co-infected cases

• Poverty spiral – economically productive most affected

Special Tuberculosis Initiatives

• FIDELIS

• TREAT TB

FIDELIS• Fund for innovative DOTS expansion through local

initiatives to Stop TB

• CIDA multi-lateral grant managed by The Union

• Launched in April, 2003

• Aim to increase global case detection of new smear positive tuberculosis while maintaining high cure rates

FIDELIS (main principles)

• Small projects of one-year duration (USD 150K-250K)

• Local solutions to local problems

• Encourage innovative ideas within existing programs

• Focus on populations with limited access

• Systematic monitoring and evaluation

FIDELIS (activities)• 6 application rounds completed

• 53 phase I projects implemented/approved in 18 countries (166 proposals)

• 13 projects approved for phase II activities

• Final ‘best practice’ project completing activities

FIDELIS (phase I countries)• China (15)

• Pakistan (9)

• Kenya (5)

• Indonesia (4)

• Tanzania (4)

• Bangladesh, Nigeria, Uganda (2 each)

• Afghanistan, Ethiopia, Eritrea, Madagascar, Myanmar, Sierra Leone, Somalia, Sri Lanka, Sudan, Tajikistan (1 each)

FIDELIS (results)• 51 phase I projects completed one year of activities

• A total of 273,239 new smear positive cases were detected in these 51 projects

• Represented an additional 85,267 NSP cases over the previous year in project sites

FIDELIS (project highlights)

• In rural Bangladesh, project utilized community leaders to mobilize the community to seek care for symptoms

FIDELIS (project highlights)

• In Indonesia, project to engage private practitioners to strengthen tuberculosis control services

FIDELIS (project highlights)

• In Anhui, China, project mobilized primary school students to identify tuberculosis suspects in their families with follow up assured by village doctors

Future Directions• Need to address (emphasize again) basic approaches

to tuberculosis control

• Need to support research into new tools and approaches to diagnosis and care (TREAT TB)

• Need to strengthen systems – health systems, laboratory systems – that serve beyond tuberculosis

International Union Against Tuberculosis International Union Against Tuberculosis and Lung Disease (The Union)and Lung Disease (The Union)68 boulevard Saint-Michel68 boulevard Saint-MichelParis 75006 Paris 75006 FranceFranceTel (+33) 1 44 32 03 60 Tel (+33) 1 44 32 03 60 Fax : (+33) 1 43 29 90 87 Fax : (+33) 1 43 29 90 87 e-mail: e-mail: IRusen@theunion.org www.theunion.org