REACH Trust has been implementing TB projects in the country to improve case detection and treatment initiation and completion. The Trust conducts community based projects as it appreciates the critical role community play as part of the solution.  The Trust’s projects’ results have shown that there is need to do more including working across all sectors to integrate TB in their activities and prevent it through poverty reduction and social protection to achieve universal coverage. Recently, the Trust conducted a cluster randomised trial to investigate the effectiveness of engaging unpaid informal providers (IPs) to promote access in rural Lilongwe. The intervention consisted of training IPs in TB and HIV disease recognition, sputum specimen collection, appropriate referrals, and raising awareness. The results showed that their engagement increased TB and HIV diagnosis uptake and also increased ART initiation. Despite phasing out of the project, these IPs continue carrying out the activities.

The 2015 World Stop TB Day (WSTBD) theme is “Reach, Treat, Cure Everyone” a continuation from the previous year’s “Reach the 3 million”. In reaching the 3 million cases that are either undiagnosed, untreated or are diagnosed but not registered for treatment community engagement could be critical, as demonstrated by REACH Trust.  The world commemorates WSTBD annually to provide an opportunity to create awareness among the general public as well as policy makers on the dangers of the disease and what they can collectively do to reduce its burden.

In Malawi, WSTBD commemoration took place at Chimkusa Community Ground in Mzimba. Pre-commemoration activities included TB screening among all prisoners at Mzimba Prison. This was a historic event in the history of Malawi and WSTBD commemoration. The Ministry of Health (MoH) spearheaded preparations in collaboration with its partners. Honourable Dr. Jean Kalilani Mrs, MP, and Minister of Health presided over the function. Policy makers, traditional leaders and the community graced it.

In her speech, she called for concerted efforts from policy makers, health providers and all Malawians to Reach who has tuberculosis and diagnose them, Treat everybody with very effective anti-TB drugs and Cure every one of them in order to accelerate progress towards zero TB deaths, zero TB infections and zero TB stigmatization. She emphasised that TB is curable and treatment is free in all health facilities in Malawi. She said preliminary information from a just completed TB prevalence survey, indicates that Malawi may still be missing half of the people with TB. In trying to reach missed populations at diagnosis, she said her ministry with support from partners, has introduced new diagnostic technologies Gene Xpert machines to get results quickly so that those with TB initiate treatment quickly. She further said that so far 45 health facilities and prisons countrywide are using these machines which produce TB results in 2 hours. She called upon the general public to play a role in referring potential TB patients to health facilities.

In response to the Minister’s speech, Mrs. Mtisunge Mphande, Health Communication Specialist for REACH Trust informed the Minister that the Trust is currently implementing another community based project called Triage II plus project to improve case detection of chronic airways disease (chronic obstructive pulmonary disease, asthma, bronchiectasis and emphysema) and TB among people with chronic cough at primary health care level in two districts in the country. The project seeks to determine the effect of two interventions: engaging IPs and adapting WHO’s Practical Approach to Lung Health (PAL) strategy, on the detection and management of chronic airways disease and TB in the intervention districts.

During the event, there were various activities for awareness-raising. The Honourable Minister of Health visited exhibition stands mounted by REACH Trust and TB Care II. The Trust showcased materials it produces for the community and its expertise in qualitative and quantitative research through copies of publications and reports. There were also traditional dances with TB messages in their songs, drama, and success stories from ex TB patients.

World Stop TB Day (WSTBD) is commemorated on 24th March every year, a day when a German scientist, Dr. Robert Koch discovered TB bacilli. Despite considerable progress made for more than 130 years, TB remains one of the world’s killer diseases. Over the last 12 months, World Health Organisation (WHO) estimated that TB was responsible for over half a million deaths in the African Region. Many of these people live in the world’s poorest, most vulnerable and hard-to-reach communities where they have no access to quality health care, but are served by less trained health care workers and health care delivery systems are weak.