The Reviewed and
Revised Compendium of Christian Projects
Addressing the Diseases
of Poverty: HIV/AIDS, Malaria, and TB
SANRU III Project (TB Component)
Project/ Program name: SANRU III Project (TB Component)
COUNTRY: Democratic Republic of Congo
Church or
denomination: Interchurch Medical Assistance, Inc. (I.M.A.) is a non-profit
association of twelve Protestant relief and development agencies that represent
a constituency of churches in America and throughout the world. The Eglise du Christ au Congo (ECC),
I.M.A.’s partner in the SANRU III project, comprises 61 Protestant church
communities of several denominations representing millions of parishioners in
the Democratic Republic of Congo.
Project summary:
Tuberculosis
interventions are featured among the several components of the 5-year SANRU III
project in the Democratic Republic of Congo (DRC). SANRU III was launched by I.M.A. in 2001 in partnership with the
Eglise du Christ au Congo (ECC) with funding from the United States Agency for
International Development (USAID).
I.M.A. and ECC are bringing assistance from several Congolese and
American organizations to bear on the health needs of DRC, in addition to the
assistance from USAID.
Background/
History: For almost forty years, I.M.A. has gathered and distributed
medicines and medical supplies for international health care programs that
serve people in need without regard to ethnicity, creed, color, gender,
national origin, religious or political affiliation. Other sectors of ministry
include international disease control programs and strengthening of health care
systems, working in collaboration with governmental, non-governmental and
corporate partners.
The Eglise du Christ au Congo, the SANRU
III implementing partner in D.R. Congo, unites the majority of Protestant
congregations there. In its health work, it works closely with other faith
networks (Catholic, Kimbanguist) and secular organizations as well as with
government health authorities. ECC was the implementing partner in the widely
acclaimed SANRU I & II rural health projects from 1981 to 1992, with
support from USAID. After USAID withdrew support to its programs in Zaire/Congo
due to civil unrest, ECC was able to continue its exemplary work in primary
health care with assistance from several donors in the 1990's.
Tuberculosis
(TB), like Trypanosomiasis, Onchocerciasis and other diseases that seemed to be
declining, has re-emerged as a major health problem in the DRC. Merely a decade
ago, the incidence of Tuberculosis was stable and other diseases such as
Sleeping Sickness were quiescent and thought to be eradicated. Today these are
all increasing in alarming numbers and are among the leading causes of
morbidity and mortality in the DRC. Without screening, prevention and early
diagnosis and treatment, these numbers and subsequent mortality rates will rise
dramatically.
The Ministry of
Health has been involved in developing and instituting a national Tuberculosis
program over the past 20 years. The most recent protocol instituted in 1996 is
based on the DOTS strategy (direct observed and short course treatment) in
accordance with international strategies and recommendations. However, as noted
in the USAID 2001 Action Plan, “only 45-50% of the country is currently
covered” and those are largely in urban or select areas. Cure rates (60%) fall
short of international set standards (85%).
Even though
recognized and approved protocols have been adopted, the implementation of
these screening, diagnostic and treatment activities is severely lacking. SANRU
III will support the use of such protocols and strategies in all adopted health
zones.
Goals: SANRU III supports the National Tuberculosis Program (NTP)
of the DRC. It recognizes the effectiveness of the DOTS strategy and the need
for uniform protocols in DRC. SANRU’s role will be the implementation of such
strategies in rural health zones. Project resources will be used to print and
disseminate internationally approved standards, provide training in screening
and diagnosis, and equip health centers and reference hospitals with necessary
screening and diagnostic material. Lastly, the medication and operational
support provided by SANRU III to these institutions will provide the means for
affordable and accessible treatment.
Objectives: The objective of
this component will be to increase the capacity of rural health zones to assure
the application of the National Program to Combat Tuberculosis (PNLT).
Who does the work? Key implementers of SANRU III TB
interventions include community health workers (relais communautaires), health
center personnel (nurses and nurse’s aides), and health zone staff (nurse
supervisors and doctors).
Main activities:
1)
Detect pulmonary TB,
i.e., that are 75% microscopic smear positive (TPM+)
2)
Treat 100% of recognized positive cases
3)
Cure at least 80% of recognized treated patients
4)
Train personnel to diagnose and treat tuberculosis
5)
Supply health centers with laboratory equipment
6)
Supply health centers with anti-tuberculosis medicine
7)
Provide technical assistance with Information, Education and
Communication (IEC) campaigns
8)
Supervise health centers
9)
Support activities of information collection system and evaluate
detection methods and treatment
The costs of
this program include printing and distribution of current national protocols
(NTP) and dissemination to over 1200 health clinics and hospitals; training of
key personnel in the diagnosis, screening and treatment of tuberculosis;
diagnostic and treatment related equipment; and subsidies for treatment and
follow-up of positive cases
In the
short-term, the project will promote the adoption of a uniform strategy in
adopted health zones for the diagnosis and management of TB. This will include
the training of key personnel and equipping of facilities. At the same time,
data may show an initial increase in the number if new TB cases in rural
settings due to enhanced diagnosis and reporting methods.
In the long-term,
through implementation of the DOTS strategy and providing affordable treatment,
90% coverage will be achieved within five years and a reversal of the rise of
TB in DRC.
Follow-up and
supervision as envisioned in SANRU III will help to measure the impact of such
assistance and reverse this explosive trend in the interior of the DRC.
Expected
outcomes: Indicators
for this component will include an increase in all of the following:
§
Increase the percentage of population in targeted areas treated
per year
§
Increase the percentage of health centers following the National
TB Program
§
Increase the number of cases detected
§
Increase the percentage of population covered by National TB
Program
§
Increase the number of trained nurses and doctors
§
Increase the number of laboratory equipment kits distributed
§
Decrease the number of days stock out for anti-tuberculosis
medicine
§
Decrease the number of new cases of tuberculosis / 100.000
inhabitants per year
§
Decrease the percentage of TPM+ / pulmonary tuberculosis
§
Increase the percentage of cured tuberculosis cases among treated
ones
Results: Implementation of this component is just
now beginning as part of year two (2002-2003) SANRU activities.
Lessons learned: N/A
Funding and
other resources: Support provided for this initiative by USAID is
approximately $1.3 million over 5 years.
We are seeking additional contributions
Further readings
or documents: Additional information on the SANRU program is available at
www.sanru.org. The ECC web site is
http://ecc.faithweb.com. The Stop TB
web site is http://www.stoptb.org.
Contact
information:
SANRU 3
75, Av. de la Justice/Kinshasa-Gombe
B.P. 4938 Kinshasa I
Fax: 002243-12-34482
Dr. Léon Ngoma Miezi Kintaudi, Director SANRU
Dr. Félix Minuku, Technical
Coordinator
Also:
Interchurch Medical Assistance (I.M.A.)
P.O. Box 429
New Windsor MD 21776
Telephone: 410-635-8720
Fax: 410-635-8726
E-mail: imainfo@interchurch.org
Web site: www.interchurch.org; www.sanru.org