AZ & The Red Cross

Our long-standing partnership with the British Red Cross is focused on helping to reduce the incidence of TB and improve the quality of life of people living with TB and TB/HIV co-infection in vulnerable communities in Central Asia and sub-Saharan Africa.  

A significant problem in the treatment of TB is not the availability of effective medicines, but the fact that treatment regimes are long and complicated. This means that many patients give up the treatment once the symptoms are no longer apparent, but before the infection is fully treated which may lead to relapse and makes drug resistance more likely.  Encouraging patients to finish their course of treatment is therefore critical.    

Another major challenge is that TB and HIV form a potentially lethal combination, each speeding the other’s progress, and TB is the biggest killer of people living with HIV.  

And, as well as the threat to health, both diseases also have a social stigma attached to them, which can create added difficulties for patients in their communities.

Our partnership with the British Red Cross Society is focused on helping the  International Red Cross and Red Crescent Societies to deliver community-based programmes which:

• Encourage people to seek early diagnosis
• Improve patient compliance
• Provide care in the home
• Promote TB and TB/HIV awareness/education
• Address the stigma associated with the diseases

IN CENTRAL ASIA

We first joined forces against TB in 2002.  Work initially targeted Kyrgyzstan and Turkmenistan, as countries with widespread poverty and seriously high levels of TB incidence but, since 2006, we have also been supporting the charity in a programme in Kazakhstan, aimed at mitigating the consequences of TB/HIV co-infection – a major threat to public health in the region.

In Kyrgyzstan and Turkmenistan, the programmes are managed by the local Red Crescent Societies and work is focused on improving patient compliance, raising awareness of TB and fighting the stigma associated with the disease.

Progress to date includes:

• Over 7,500 people successfully completing their TB treatment.
• TB treatment completion rates exceeding 90% among the most poor and vulnerable people in Kyrgyzstan and Turkmenistan
• A significant increase in community awareness following media campaigns and health education sessions in schools and public places that have reached over 1 million people.

In Kazakhstan, the local Red Crescent Society is working to establish effective, sustainable and replicable models of community based social support for people living with TB and HIV, and their families. The programme brings together people with a range of skills, such as social workers, psychologists and employment lawyers, who work with volunteers – many of them former patients, to offer a range of support to those on treatment and those who have recently completed treatment. Consultations are provided at Red Crescent centres and through home visits to encourage treatment compliance and to help patients deal with any social and emotional difficulties associated with the disease and its treatment.

With the support of the Ministry of Health, the National Aids Centre and local TB dispensaries, the Red Crescent has implemented a TB/HIV co-infection programme in three cities - Almaty, Karaganda and Temirtau.  Each year, approximately 150 people living with TB/HIV co-infection benefit from long-term comprehensive care. This approach has led to a marked improvement in the number of treatment interruptions from 49% in 2006 to 13% in 2007  

Overall, our long-term support in Central Asia has helped the Red Crescent to expand their coverage geographically and form strong relationships with the Ministry of Health and partner organisations. It is now playing a significant role in TB control and prevention, aligned to national TB programmes in Kyrgyzstan, Turkmenistan and Kazakhstan that are contributing to a stabilisation and reduction in TB incidence in these countries.

IN SUB SAHARAN AFRICA

To help the British Red Cross broaden its approach to the TB and TB/HIV co-infection challenge, we further expanded our partnership in 2006 and are supporting the charity in their work to help local communities combat the threat in hard-hit areas of South Africa and Lesotho.  Building on the experience in Central Asia, their goal is to contribute to the reduction in TB incidence and to improve the quality of life of people affected by TB and TB/HIV.

South Africa is one of the world’s high-burden TB countries with TB and TB/HIV incidence remaining at very high levels across the country. In response, activities related to TB/HIV and multi-drug resistant (MDR)-TB are being scaled up nationally but, whilst South Africa has a national policy of counselling and testing TB patients for HIV, there is no national surveillance system. In addition, according to the latest World Health Organisation (WHO) report, TB treatment success rates remain low.

With our support, the South African Red Cross Society (SARCS) is helping to deliver improved care and support to people living with TB or TB/HIV in 10 areas, including the provinces of KwaZulu Natal, Western Cape, Eastern Cape, Limpopo, Gauteng and Free State. Following a TB training programme for 500 Red Cross volunteers, over 1,800 people affected by TB or TB/HIV have now successfully completed their treatment, with low defaulter rates being achieved. This is being achieved mainly through daily one to one contact with patients by trained volunteers who, when required, also collect treatment from clinics and oversee the patient taking it. Volunteers also distribute TB prevention information through household visits and local community events. Between June and August 2008 alone, they made over 7,500 home visits to promote TB education – including awareness information tailored for orphans and vulnerable children.

Lesotho is another hard-hit country - one of fifteen with the highest estimated TB incidence rates per capita and corresponding incidence rates of HIV-positive TB cases, according to the latest WHO report. Our support has enabled the Lesotho Red Cross Society (LRCS) to deliver improved TB and TB/HIV care to people living in isolated and rural communities with little access to formal health facilities (the programme is targeting less numbers than South Africa because of its focus on remote, rural districts).  Following a training programme for 110 Red Cross volunteers,TB care and support has already been provided to over 320 patients in the districts of Kena, Mapholaneng and Sebapala and in the first six months of 2009, LRCS are aiming to reach over 1,000 people affected by TB. The LRCS also works in collaboration with the National STOP TB Campaign, as part of the Ministry of Health TB Control Programme, to provide disease education to people living with the disease and their immediate families.

During 2008, we again expanded the geographic coverage of our partnership with a new project in Liberia, where TB incidence rates have almost tripled since 1990 (from 113 to 310 per 100,000).  Treatment completion rates are estimated to be below 75%.   Project development began in April 2008 and field implementation began in December 2008.

ENCOURAGING COMMITMENT

The HIV/TB Global Leaders’ Forum convened at the United Nations in June 2008 was the first time that heads of government, public health and business leaders, heads of UN agencies and NGOs came together to seek a common way forward in the fight against HIV/TB.  Particular emphasis was put on the need for partnership and collaboration.  Speaking at the Forum, Mr Shimelis Adugna, African Vice President of the International Federation of Red Cross/Red Crescent, said: “I will give one example of a partnership arrangement today, hoping that it will be seen by governments and other stakeholders as a valuable way of proceeding.  Our community-based work in TB and HIV/TB co-infection needs the support of donors prepared to take a long-term perspective. In this context, we very much appreciate the value of the partnership between the British Red Cross and AstraZeneca, which has, since 2002, helped thousands of people living with TB to successfully complete their treatment and provided education to many more thousands of people living at risk.”

Our partnership with the British Red Cross was commended in 2007 by the Global Business Coalition on HIV/AIDS, tuberculosis and malaria (businessfightsaids.org) as one of the leading community-based programmes in the fight against TB.

The content of this page was externally assured by Bureau Veritas, February 2009.