GTZ-SPAA Private Sector Involvement in National TB Control

1. GTZ-SPAA • Private Sector Involvement in • National TB Control • Examples in Ghana, Malawi and Namibia • By • Dr Valentine Douala- Mouteng • Chief Executive Officer, PABC

2. INTRODUCTION • In 2008, 9.4 million newly infected with TB. Asia (55%) and Africa (30%). • The situation worsened due to the dual infection with HIV and TB and of multi and extremely-drug resistant tuberculosis (MDR-TB) and (XDR-TB). • The direct and indirect costs of tuberculosis and the social consequences are often catastrophic for the individual, the family and the wider community. • Tuberculosis affects the business of companies • Private sector have introduced TB workplace programmes . But are they geared to contribute towards eradication of the disease?

3. THE STUDY • Study performed by SPAA project and the PABC, to provide information about: • the transmissibility of TB and the implication for the workplace • Existing TB control activities at the workplace • The existence of legislation for infection control relevant for workplaces • METHODOLOGY • A review of literature and publications (not complete) • Interview with key informants: National Business Coalitions (NBCs) , National TB program, companies, ILO, GTZ representatives. • LIMITATIONS: only 3 countries; few informants,

4. Workplaces: environment with high level of disease transmission • Infectiousness starts before onset of symptoms (up to 3 months) • Treatment delay increases transmission to close contact in households and workplaces. • A long delay is common in African countries • Studies report high numbers of transmission in workplace settings (34% – 39% infection rates of contacts) • Poorly ventilated areas, share car rides to and from work and joint lunches identified as factors contributing to transmission . • PLWHA are very vulnerable to TB transmission

5. The economic impact of TB is huge • 75% of people infected are between 15 and 54 years of age. • Estimation: TB reduces workers’ productivity by as much as US$ 13 billion annually. • A large gold mining industry in S. A. estimated that each case of TB among its unskilled employees cost US$ 410 in lost shift • The disease causes severe losses through absenteeism, reduced productivity, need for replacement of lost workers. • On average, an employee with active TB will lose up to nine months of work. • With treatment infected employees take up work again after two to four weeks.

6. TB legislation In the workplace • Education programme • Screening, for TB and referral for diagnosis and treatment • Prevention of discrimination and stigmatization • measure such as improving the ventilation

8. National Business Coalitions involvement

9. National Business Coalitions involvement i

10. EXAMPLES OF GOOD PRACTICES

11. CONCLUSION/RECOMMANDATIONS • Increase awareness on the importance of combined TB and HIV control among national business coalitions, the private sector and public partners • Increase the support for NBCs to respond to the demand of the companies and the need to mobilize more companies to implement TB programmes as NBCs play a critical role. • Perform contact tracing systematically at company level • Expand collaboration between NBCs and the NTBP (including re- assessment of the policy) • Realise research on the financial impact of TB on companies in different economic sectors

12. THANK YOU FOR YOUR ATTENTION MERCI