Four Emerging Themes on Recommendations to Strengthen TB Prevention and Control Efforts
| Recommendation | Quote | Stakeholder Perspective |
|---|---|---|
| Ensuring leadership and governance for sustainable national health budgets | Investing in research: Research, guidance and funding are urgently required to identify, prioritise and deliver those interventions that could best alleviate the impact of COVID-19-related disruptions40 …building upstream operational research capacity has generated downstream dividends in strengthening health system resilience for tackling pandemics46 | Political leadership, public health leadership, research funding agencies, philanthropic trusts and foundations |
| Prioritizing community TB care: Decentralise TB treatment to community health workers and increase access to TB treatment for home-based TB care… support private hospitals, and academic or research centres, to provide TB testing and treatment32 | Political leadership, public health leadership, community leadership | |
| Renewing political will to support existing and emerging health priorities: …strong political will and support for research communities are essential, especially in low- and middle-income settings, to advocate for and allocate resources needed to investigate these coinciding pandemics37 | Political leadership, public health leadership, research funding agencies, philanthropic trusts and foundations | |
| Supporting social protection of all citizens: Provision should also be made for [TB]-specific social protection, which could take the form of cash transfers or food parcels for [TB]-affected households45 This [restoring routine TB services] has to be followed by a combination of measures: access to food through universal PDS, direct cash transfers and making gainful employment available34 | Political leadership, public health leadership, community leadership | |
| Promoting national leadership: …it is critically important that political leaders possess appropriate cognitive abilities, procedural hard stops, and advisory capacity to put into place effective solutions43 | Political leadership | |
| Building networks of community stakeholders | Promoting shared learning among community stakeholders: A positive aspect to these two pandemics colliding is that people—communities, public health professionals and policy makers—can learn from each other6 | Public health leadership, health care workers, community leadership, policy makers |
| Forming multi-sectoral community partnerships: Non-governmental organisations may partner with governments and national [TB] programmes to mitigate the effects of the COVID-19 pandemic on the provision of biomedical care for [TB]-affected households. This might include sharing diagnostic and laboratory capacity and strengthening caregiver and community health worker roles to support care delivery45 | Public health leadership, health care workers, community leadership, non-governmental organizations | |
| Establishing key connections with researchers: However, as is the case for the capacity of TB diagnostic services, careful planning and close collaboration between the TB, HIV, and COVID-19 research communities will be crucial not to overburden these infrastructures, especially in resource-poor settings37 | Community leadership, academic institutions | |
| Integrating efforts to build trust and reduce stigma in health system efforts: …it is therefore important to establish reliable health services and strategies that prioritise care for both TB and COVID-19 patients. This approach will assist in building trust in the health system and allow people to take meaningful measures to keep themselves and their families safe47 | Public health leadership, community leadership, patients | |
| Supporting high-quality health care workforce training and safe workplace environments | Reinforcing clinical training through short courses: Provide short-term training for students and health professionals and recruit additional staff to work on TB programs32 | Public health leadership, health care workers, academic institutions |
| Building research capacity: SORT IT teaches multiple and practical skills for activities such as generating and utilizing data, conducting operational research and using evidence to influence policy and/or practice46 Moreover, with a renewed global focus on active case-finding in TB programs, resources dedicated for COVID-19 community-based research, such as household contact tracing or seroprevalence surveys, could easily be linked to programs to test for TB as well, providing a gateway for training, capacity building, and future TB research37 | Public health leadership, health care workers | |
| Ensuring that health care workers are protected in the workplace environment: In both diseases, the frontline health care workers need to be well trained, equipped, protected, supported and enabled to care for their patients36 | Public health leadership, health care workers | |
| Highlighting health care workers' role in health education: Health education has the potential mitigating stigmatization. Thus, a unique health education platform that connects the two diseases is strongly needed.41 | Public health leadership, health care workers | |
| Using digital health interventions for TB care | Supporting person-centered care model for TB management: People-centred models of care, including hospitalization for those with severe diseases, community-based services, video-supported treatment or home-based care are among the interventions that can be expanded or adapted for COVID-1936 | Public health leadership, health care workers, information technology, patients |
| Advancing current technologies to support TB patients in long-term management: The creation of these systems [at-home management with toll-free helplines and WhatsApp support groups] provides a long-overdue opportunity to replace TB DOT with virtual supportive adherence counselling and clinical management, and could supplement the existing digital and mobile health technologies (mHealth solutions)39 | Public health leadership, health care workers, information technology, patients | |
| Applying novel technology for COVID-19 to enhance TB services: …many new initiatives that have already arisen from the COVID-19 pandemic, be it in modelling, artificial intelligence for clinical algorithms to predict disease severity, international clinical trial platforms, or drug and vaccine developments6 | Public health leadership, health care workers, biomedical scientists, patients | |
| Using innovative approaches to strengthen TB contact tracing and case notification: If TB was integrated into the geospatial mapping system set up to inform the COVID-19 tracing efforts and tracking in real time, this could strengthen the tracing of contacts, recording and notification processes of both the TB and RR-TB programmes39 | Public health leadership, health care workers, geospatial experts, patients | |
| Offering additional support for health care workers: COVID-19 is radically changing the way we manage TB in the immediate future and is forcing us to accelerate the adoption of digital innovations that simplify and facilitate the workload of healthcare workers20 | Public health leadership, health care workers, information technology |
Abbreviations: COVID-19, coronavirus disease; DOT, directly observed therapy; RR-TB, rifampicin-resistant TB.